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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by rjlockhart04-08 on June 11, 2012, at 1:45:25
I don't know how many times I've read but when we feel alive...its vary crude awnser but usally dopamine is envolved, when we have a successful way to make money...when we eat fav food and enjoy it, maybe some of us even enjoy wine and beer....its all directed toward the pleasure systems in our brain...if we had no dopamine release...we would not love the things that we do for pleasure. There's alot more indepth info on this...this is just a tiny view....but I've realized that I have lost my ability to expierience life and pleasure...nothing makes me feel like im alive unless I use methamphetamine, cocaine occastionally....but theirs got to be a reason why this happening...I can't just rely on substances to let me feel normal...there got to be some other way to fix this without medication. I know the first thought is ECT..wouldnt mind it, but its the last resort. Like i've thought about changing my belief and thought structures to diffrent aspects to see reality diffrent.
I'm awnsering my own post, but im asking who ever reads this...i feel trapped in this grey thinking of numb to get away from radiating pain of failure.
anyone?
Posted by Zyprexa on June 12, 2012, at 22:25:42
In reply to Boring reality...no dopamine release, posted by rjlockhart04-08 on June 11, 2012, at 1:45:25
You know that the coke and meth are what is depleating your dopamine? When you use the drugs you get an instant rush of dopamine. gradualy the dopamine receptors in your brain stop producing as much dopamine, the more you use drugs. So the only pleasure is when you use drugs. But eventualy it get worse the more drugs you use and it takes more and more. Eventualy your receptors stop working. The only way to stop the depleation of dopamine is to stop using drugs, and eventualy dopamine will get back to normal after a long time. I belive the same happens with drugs like adderal, etc.
Not trying to bring you down...
Posted by novelagent on June 13, 2012, at 16:36:40
In reply to Boring reality...no dopamine release, posted by rjlockhart04-08 on June 11, 2012, at 1:45:25
Ideally, a low dose each day of a psychostimulant like Vyvanse would be perfect for someone with anhedonia induced by a history of drug abuse-- it can't be snorted or injected, and it peaks out just after the therapeutic window of dosing.
Unfortunately, people who have abused drugs basically have the mindset of children who can't grow up, and want to live in neverland. If you try to help them with a low dose of a stimulant, they'll just take an excessive dose for as long as it lasts, and then live with the anhedonia once their supply runs out. Even though Vyvanse peaks at a certain dose, they'll just find out what dose that is, and try to always be at that dose.
You've demonstrated little maturity in your reflections on this board, so I can't feel terribly sympathetic for your cause. I'm not even convinced the Nuvigil isn't "working"-- assuming you're taking it regularly- in the sense it's treating your anhedonia.
It doesn't even sound like you care about treating your anedhonia-- as in, if someone came up with a cure for anhedonia tomorrow, and you took it, I don't think you'd really care. I think what you're really obsessing over is the absence of feeling euphoric, which is something else altogether.
I m not very sympathetic. For one, you're the reason why it's so difficult with some doctors I see, and why I get treated like a drug addict for taking a stimulant when I'm not an addict. Heck, I got psychosis in large part because I lost klonopin, and suffered without it out of fear if I reported it missing, I'd be deemed as having drug-seeking behavior and never again get my medicine. So I endured, and it lowered the threshold for psychosis.
All so you could get high now and then. So no, I will not sit with you during this pity party. People like you have ruined my life, and continue to ruin my life-- I still can't get at a reasonable dose of Vyvanse in part because drug addicts make doctors paranoid they'll be held accountable for prescribing even moderate, low doses.
In other words, save it and get a life, respectfully. You could have appreciated the power of these drugs, and respected them by not taking them recreationally. Now that they could treat your anhedonia, you can't have them, because you've proven you aren't willing to respect how powerful they are.
Do we really have to go over this tired pity-me session? Am I suppose to feel sorry you have yet to take responsibility for why you are like this? You're not saying, "man, anhedonia sucks, and it was pretty stupid of me to take those drugs that caused this." You're just saying "anedhonia sucks-- pity me." If you knew how responsible you are for this, you wouldn't be seeking pity.
So until you get the maturity to post something cliche like that, try avoiding this trope again. It's getting old.
We're here to support people, not pity them.
--
> I don't know how many times I've read but when we feel alive...its vary crude awnser but usally dopamine is envolved, when we have a successful way to make money...when we eat fav food and enjoy it, maybe some of us even enjoy wine and beer....its all directed toward the pleasure systems in our brain...if we had no dopamine release...we would not love the things that we do for pleasure. There's alot more indepth info on this...this is just a tiny view....but I've realized that I have lost my ability to expierience life and pleasure...nothing makes me feel like im alive unless I use methamphetamine, cocaine occastionally....but theirs got to be a reason why this happening...I can't just rely on substances to let me feel normal...there got to be some other way to fix this without medication. I know the first thought is ECT..wouldnt mind it, but its the last resort. Like i've thought about changing my belief and thought structures to diffrent aspects to see reality diffrent.
>
> I'm awnsering my own post, but im asking who ever reads this...i feel trapped in this grey thinking of numb to get away from radiating pain of failure.
> anyone?
>
Posted by novelagent on June 13, 2012, at 16:44:35
In reply to Re: Boring reality...no dopamine release » rjlockhart04-08, posted by Zyprexa on June 12, 2012, at 22:25:42
He's burnt out his receptors. He'll have to be on Nuvigil for the rest of his life. The anhedonia is permament. There's not any cases where anhedonia spontaneously goes away over time... people who abused stimulants but didn't quite burnt out their receptors, they're fine over time... but someone either is addicted or not, and the way they know they're addicted is if they sleep for a few days, like they're in a coma, almost, upon acutely withdrawing from their stimulant.
I got anhedonia from taking high doses of a stimulant, but that was from what I thought was a sleeping disorder, and my doc was stupid enough to let me have the high doses for so long. I'm not an addict, though, so I now take low doses of a stimulant for my ADD, and it happens to treat my anhedonia, and I'm fine. But if you go over his posts, you'll find a pattern of woe-is-me, I-don't-deserve-this. He's not at a stage in life where he'd be able to do the same thing, not that any doctor is stupid enough to trust an addict with a stimulant, anyhow.
> You know that the coke and meth are what is depleating your dopamine? When you use the drugs you get an instant rush of dopamine. gradualy the dopamine receptors in your brain stop producing as much dopamine, the more you use drugs. So the only pleasure is when you use drugs. But eventualy it get worse the more drugs you use and it takes more and more. Eventualy your receptors stop working. The only way to stop the depleation of dopamine is to stop using drugs, and eventualy dopamine will get back to normal after a long time. I belive the same happens with drugs like adderal, etc.
>
> Not trying to bring you down...
Posted by novelagent on June 14, 2012, at 0:10:34
In reply to Boring reality...no dopamine release, posted by rjlockhart04-08 on June 11, 2012, at 1:45:25
Posted by rjlockhart04-08 on June 15, 2012, at 0:59:40
In reply to Re: Boring reality...no dopamine release » rjlockhart04-08, posted by novelagent on June 13, 2012, at 16:36:40
and again.....I have to read people who have no understanding of my situation expect through their own no circumstacial judgement. Did I ask you to puty me...i don't think so, and defently didnt ask you post all this hatred over a subject taht I was just making a question about. I didnt make any "poor me, please forgive me, "lowlife b*llsh*t" So what else you have on your mind this time? I think it would do you really good to write a book about your opinions and publish it, you would make some money...instead posting stuff here to someething that had nothing to do with what I was implying about my posts....pity...if you really want to think about it...people here on babble do pity others....and they vary supportive at it too....the key term is : selectivity of persons. I usally get the most f*ck*ng end of all opinions, people will refuse and will not even akowedge...what the root problem is, and that's just who they are...alot of corrupt people in this world...
And if you think that I am main source of ruining you life...im happy to disappoint you vary much, i've gotta alot of things I'm ruined about but do I blame other people? its easy to read a book by its cover, and some people are going to stay ignorant because they choose to stay in the upmost high feeling of theirselves to even admit their wrong, best thing is just let them keep thinking this way....
so, now I have about 3 maybe 4 posters who have posted in similar manners of this when they won't understand at all the problem, and of course they won't listen either....i have 1000 reality insults to make of this but im just going to let this one slide.
whats your opinion of supportive? and how it realates to your posts reguarding me?
Posted by Zyprexa on June 15, 2012, at 3:52:17
In reply to Re: Boring reality...no dopamine release » rjlockhart04-08, posted by novelagent on June 13, 2012, at 16:36:40
I don't think its all RJ's falt. He was put on the stimulants at a young age and probably had no choise in the matter. They got him addicted to stims. And now that he's hooked they take it away from him and he can't function with out the stims/meth anymore. What is he to do? I'm sure there is no answer, except to take the meds to funtion now. If only they could ration the stims in a way that he could only get them one at a time.
Posted by bleauberry on June 15, 2012, at 8:02:20
In reply to Boring reality...no dopamine release, posted by rjlockhart04-08 on June 11, 2012, at 1:45:25
I don't know, in my own journeys I have discovered that norepinephrine is just as big a player in the pleasure department as dopamine is. I think they work in concert. If one is a bit off, the whole team suffers. It isn't just one or other. It isn't just dopamine.
Savella is the only thing I've ever tried that seemed to wake the pleasure department pretty good without numbing things down....anti-anhedonia even after ECT failure! That's pretty good for any med. Also sort of close in the same way was low dose nortriptyline with low dose zoloft. Low dose Parnate also. It's hard to pindown exactly what chemistries we are dealing with, because it could be ritalin or vicodan that livens up the pleasure department on one day but not another day.
Your combo of prozac and zyprexa is actually pretty potent at boosting brain firing of dopamine and norepinephrine. I think a problem may be though that a lot of it is being blunted by the high dose of prozac and being blunted by the blocking of dopamine receptors by high dose zyprexa. The other meds except nuvagil are probably making it worse too.
If you are satisfied for the time being with how your meds are working overall, except for the pleasure thing, then my guess is the straightest way to get the pleasure department going is with either a higher dose of nuvagil or ritalin.
> I don't know how many times I've read but when we feel alive...its vary crude awnser but usally dopamine is envolved, when we have a successful way to make money...when we eat fav food and enjoy it, maybe some of us even enjoy wine and beer....its all directed toward the pleasure systems in our brain...if we had no dopamine release...we would not love the things that we do for pleasure. There's alot more indepth info on this...this is just a tiny view....but I've realized that I have lost my ability to expierience life and pleasure...nothing makes me feel like im alive unless I use methamphetamine, cocaine occastionally....but theirs got to be a reason why this happening...I can't just rely on substances to let me feel normal...there got to be some other way to fix this without medication. I know the first thought is ECT..wouldnt mind it, but its the last resort. Like i've thought about changing my belief and thought structures to diffrent aspects to see reality diffrent.
>
> I'm awnsering my own post, but im asking who ever reads this...i feel trapped in this grey thinking of numb to get away from radiating pain of failure.
> anyone?
>
Posted by rjlockhart04-08 on June 15, 2012, at 14:08:26
In reply to Re: Boring reality...no dopamine release » Zyprexa, posted by novelagent on June 13, 2012, at 16:44:35
My dopamine receptors are not burned out, I think your thinking of the people that use meth everyday at high levels, and look like they have deteriated their whole entire system from methamphetamine use....now the only things I posted was using methamphetamine once and while...its not frequent, and I stated various times in the posts that if you have no more dopamine left in your mind, its like hitting the accelorator in car with no oil or gasoline. I could of never said this happened, and I would of been in a better postion to not be accused of having something that I don't have. If you really read my posts, most of the time you will come across that I am frustrated that my meds will not absorb in my system, and that's the main problem im not getting any effect from them, and please keep comment of my body is too worn down to even process them....no its a digestive issue im going to have to figure out with my doctor.
if you have negative comments about a situation that you could easily make to other here that post about expiermenting with benzos and various medications to relieve them from their depressed state, I encourage you do this...its really not that pleasant for someone to complain about the grass not growing because its out in the middle of the desert....
much regards to you novelagent....theirs a similar poster that posts to my posts and is nothing but negative and condenming...emanuel98 what ever the name is...these people complain about and condenm a problem that the only solution is too have them miserable the rest of their lives....i don't choose to do this...this is why I am open to the spirit world to get support because man does not understand what I am going through....and of course your going to probly say I burned out my dopamine receptors...no...im having bad depression because of things that where already present even before substance abuse....doing things backwards, not understanding completely what instructions where....i have always had difficulty over simple things sometimes and then that is what caused me to use substances such as methamphetamine to increase my preforance and the feeling of feeling powerful....im posting right now with no influence of any kinda of substnacve besides my medications which are not absorbing correctly...which is another problem that is preventing me from getting better....I admit...this is a pretty dark place im in...body has developed immunity or tolerance to all substances but in my body exept for ingresting methamphetamine under my tongue. Now I do know about the excuse that someone is in pain, and they make a big deal saying that using herion is their relief....its not a good anology...and it sounds much like an excuse to use, and get the feeling of pleasure rather than the pain relief. Their are people on this board that post about recreactional use and they can vary well post it and get positive and people thinking its ok...and have no problem with others not disagreeing with them.
I suggest you open my book, and stop critizing my cover until you have read every page of my situations, if you still want to condenm my grass not growing in the middle of the desert...ill feel alot better to not grow until I can find a better location to grw in...like the forests in washington...meaning Its where I am in life that In need to relocate to get better results. If you still want to insult new things, then I will know you never be satisfied with who I am.
rj
Posted by novelagent on June 15, 2012, at 16:42:09
In reply to Re: Boring reality...no dopamine release, posted by rjlockhart04-08 on June 15, 2012, at 0:59:40
Maybe I was overly judgmental, and if I was, I apologize.
But I noticed you weren't ending your concerns by asking, "so what's a good drug for anhedonia?" And in one post, you were asking for "medicinal use" of methamphetamine.
Well, if you must know, there is some debate going on, and many studies, of "replacement" or "substiution" therapy for methamphetamine and cocaine addicts. it involves offering methamphetamine or d-amphetamine to meth addicts, and cocaine to cocaine addicts, as these are both schedule class II substances that one can prescribe.
Unfortunately, doctors are expected to "prescribe in accordance with their peers," and while their peers are offering these studies, it's hardly a consensus, and it's easy to see how a DEA agent without a medical degree will be quick to testify in court this is an abberation from their peers. So doctors are unlikely to prescribe amphetamine for you, but I have yet to be convinced you would only take it as prescribed even if such a God send were offered.
All I know about you, and I don't know enough to pass judgment, I will admit, is that I mentioned aricept has been shown to help with anhedonia and cognitive impairment of patients with stimulant abuse-- and instead of being like, "so, how did you feel on the aricept? Were the side effects bad?" You basically lamented of your anhedonia without requesting how you might find relief from it. In an earlier post, it almost sound like you wanted to get talked out of taking meth. Maybe that was a misread.
Look, we all want you to feel better, but you have to understand, we're not here because our life is super awesome. All of our lives sucks, or we wouldn't be here. So we're here to ask for help with specific solutions, not to complain about how sucky life is for us. i have anhedonia when I'm off a stimulant, so we have a lot in common. That's why it's so disappointing when I revealed to you my personal experience with Aricept helping so much with that, and making my days so much brighter when I was on it.
Anyhow, most people who ask for advice don't genuinely want it. That's why it's so frustrating to give it and clearly see it's not being taken. You have to understand that that's frustrating, can't you? I do hope you do well, and find relief.
Posted by novelagent on June 15, 2012, at 16:47:55
In reply to Re: Boring reality...no dopamine release, posted by Zyprexa on June 15, 2012, at 3:52:17
You have a point.
RJ: Search on medline for "replacement therapy" or "substitution therapy" (with quotes) and "methamphetamine".
You'll find hundreds of studies of people with past methamphetamine abuse who received methamphetamine or d-amphetamine and did well. Print some of these out and bring them to your doctor, along with a print out of the patent for Vyvanse. The patent explains it plateaus shortly after the therapeutic margin of efficacy. So it's impossible to abuse, unless you define "abuse" as including taking the drug at therapeutic doses. It's also impossible to snort, or inject.
Your doctor will not read these, remind herself she's accepting your insurance, and that you didn't pay her $500 for the first appointment. But at least you'll be able to tell yourself you tried. =/
best of luck, novel
> I don't think its all RJ's falt. He was put on the stimulants at a young age and probably had no choise in the matter. They got him addicted to stims. And now that he's hooked they take it away from him and he can't function with out the stims/meth anymore. What is he to do? I'm sure there is no answer, except to take the meds to funtion now. If only they could ration the stims in a way that he could only get them one at a time.
Posted by novelagent on June 15, 2012, at 16:58:51
In reply to Re: Boring reality...no dopamine release, posted by rjlockhart04-08 on June 15, 2012, at 14:08:26
Have you had psychosis in the past? Because if you did, that would explain the anhedonia-- there's overlap, as anhedonia can be caused by amphetamine abuse or schizophrenia/schizophreniform.
In the case of schizophrenia, if you have anhedonia, the only thing that really works is amphetamine. But the way you write, it doesn't sound like substitution therapy will work-- I feel like you wouldn't take it with an orthodox discipline. Maybe I'm wrong? But the remark about thinking you take meth under your tongue doesn't help. If you take meth, and ingest it, it will be metabolized. Thinking it won't is the definition of psychosis.
It doesn't matter that you believe your drugs don't metabolize in your stomach. You need to take them as directed, and that includes taking the Nuvigil as prescribed, which I trust you're taking. In a study of meth addicts, compliance was a big issue for people taking Provigil for their meth addiction.
You're probably just not at the right dose of the Nuvigil, because at a moderate dose, you do feel wired... but because of insurance, it doesn't matter: you can't get that dose covered.
Anyway, i know you hate me and think I'm the devil, but Aricept could change your life. It will make your Provigil feel like amphetamine, because the way it potentiates that drug's effect. This is based on the way it potentiates amphetamine's effect, which also works on dopamine.
This is the end of the thread.
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