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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 22 to 46 of 50. Go back in thread:
Posted by pedr on September 15, 2019, at 13:53:54
In reply to Re: stimulants for treatment-resistant depression?, posted by Ruuudy on September 15, 2019, at 13:27:33
keep us posted on the Spravato.
I'm due to start in ~ 6 weeks. They're making me try it before I get VNS/DBS surgery done. It's highly unlikely to work because I've had Ketamine (for chronic pain) before and it made me feel belligerent, more depressed, hyper-irritable and just super miserable. Go figure.
You're right about the cost. Assuming my insurance coughs up, it's still $450 A TREATMENT out of my pocket and they require you try 8 treatments minimum (4 at the lower dose and 4 at the higher dose (or vice-versa)).
Posted by pedr on September 15, 2019, at 13:54:01
In reply to Re: stimulants for treatment-resistant depression?, posted by Ruuudy on September 15, 2019, at 13:27:33
keep us posted on the Spravato.
I'm due to start in ~ 6 weeks. They're making me try it before I get VNS/DBS surgery done. It's highly unlikely to work because I've had Ketamine (for chronic pain) before and it made me feel belligerent, more depressed, hyper-irritable and just super miserable. Go figure.
You're right about the cost. Assuming my insurance coughs up, it's still $450 A TREATMENT out of my pocket and they require you try 8 treatments minimum (4 at the lower dose and 4 at the higher dose (or vice-versa)).
Posted by bleauberry on October 18, 2019, at 16:38:38
In reply to stimulants for treatment-resistant depression?, posted by Roslynn on August 11, 2019, at 14:37:06
I am a huge fan of stimulants for treatment resistant depression, or any depression.
I believe they should be first line, not last line.
Ritalin is, by far, my favorite choice. It helps the most people with the most symptoms of any other med any doctor can prescribe.
Ritalin can work in hours to day, rather than weeks to months.
Modafinil is also a good choice, very often overlooked.
I tend to shy away from Adderall as it is just a prescription version of the street drug that usually doesn't end well in the long run.
Ritalin, Modafinil or any stimulant can work on their own. Sometimes they work better combined with a reuptake inhibitor like prozac, which is in my opinion still the best out there after all these years.
Posted by undopaminergic on December 9, 2019, at 13:10:41
In reply to stimulants for treatment-resistant depression?, posted by Roslynn on August 11, 2019, at 14:37:06
> Hi, anyone using a stimulant as a main component of their depression treatment and has it been successful?
>
> Is this more of an add-on/augmentation thing or can they be used as monotherapy for depression?
>I think they are rarely used as monotherapy. However I've done so, and it worked out well, even though there were things left to be desired. Sometimes, there were even after-effects for some time after cessation.
I love to stay up late...
-undopaminergic
Posted by greg rizzo on January 9, 2020, at 20:57:07
In reply to Re: stimulants for treatment-resistant depression? » Roslynn, posted by undopaminergic on December 9, 2019, at 13:10:41
Provigil, modafinil,nuvigil (extended release formula (all pretty much the same thing, were developed for narcolepsy (when people can't stay awake).
I have been using it for over a year and I cannot describe how truly amazing it is for depression. I am amazed more psych docs don't recommend it for other than narcolepsy,To save time just google it, but basically increases seratonin and dopamine. It works immediately, is entirely legal (usually need script but I have ways around that). Otherwise very expensive. Take early in am or you'll have trouble sleeping. I have told very few people about this drug--just joined psych-babble.
The source I use is a covert secret--"tell ya but then I'd have to kill ya." Kidding of
course!
On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
Posted by greg rizzo on January 9, 2020, at 21:30:19
In reply to Re: stimulants for treatment-resistant depression? » Roslynn, posted by undopaminergic on December 9, 2019, at 13:10:41
Provigil, modafinil,nuvigil (extended release formula (all pretty much the same thing, were developed for narcolepsy (when people can't stay awake).
I have been using it for over a year and I cannot describe how truly amazing it is for depression. I am amazed more psych docs don't recommend it for other than narcolepsy,To save time just google it, but basically increases seratonin and dopamine. It works immediately, is entirely legal (usually need script but I have ways around that). Otherwise very expensive. Take early in am or you'll have trouble sleeping. I have told very few people about this drug--just joined psych-babble.
The source I use is a covert secret--"tell ya but then I'd have to kill ya." Kidding of
course!
On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
Posted by greg rizzo on January 9, 2020, at 21:32:32
In reply to Re: stimulants for treatment-resistant depression? » Ruuudy, posted by pedr on September 15, 2019, at 13:54:01
Provigil, modafinil,nuvigil (extended release formula (all pretty much the same thing, were developed for narcolepsy (when people can't stay awake).
I have been using it for over a year and I cannot describe how truly amazing it is for depression. I am amazed more psych docs don't recommend it for other than narcolepsy,To save time just google it, but basically increases seratonin and dopamine. It works immediately, is entirely legal (usually need script but I have ways around that). Otherwise very expensive. Take early in am or you'll have trouble sleeping. I have told very few people about this drug--just joined psych-babble.
The source I use is a covert secret--"tell ya but then I'd have to kill ya." Kidding of
course!
On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
Posted by greg rizzo on January 9, 2020, at 21:38:01
In reply to Re: stimulants for treatment-resistant depression?, posted by bleauberry on October 18, 2019, at 16:38:38
Provigil, modafinil,nuvigil (extended release formula (all pretty much the same thing, were developed for narcolepsy (when people can't stay awake).
I have been using it for over a year and I cannot describe how truly amazing it is for depression. I am amazed more psych docs don't recommend it for other than narcolepsy,To save time just google it, but basically increases seratonin and dopamine. It works immediately, is entirely legal (usually need script but I have ways around that). Otherwise very expensive. Take early in am or you'll have trouble sleeping. I have told very few people about this drug--just joined psych-babble.
The source I use is a covert secret--"tell ya but then I'd have to kill ya." Kidding of
course!
On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
Posted by undopaminergic on January 10, 2020, at 3:40:37
In reply to SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION, posted by greg rizzo on January 9, 2020, at 21:38:01
Goddammitt, man, how many times have you posted this duplicate, and why? It is beginning to annoy the hell out of me.
> Provigil, modafinil,nuvigil (extended release formula (all pretty much the same thing, were developed for narcolepsy (when people can't stay awake).
[...]
> On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
>It is not really *that* good for most people.
-undopaminergic
Posted by greg rizzo on January 10, 2020, at 16:38:00
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » greg rizzo, posted by undopaminergic on January 10, 2020, at 3:40:37
i'M NEW HERE SO BITE ME MAN. YOU POST MORE REPETITIVE CRAP THAN ANYONE ELSE, USUALLY FROM THE NET, NOT PERSONAL OR ORIGINAL EXPERIENCE.
Posted by greg rizzo on January 10, 2020, at 17:33:13
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » greg rizzo, posted by undopaminergic on January 10, 2020, at 3:40:37
tO DOPAMANIC:
WROTE: On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
----------------------------------------------
YOU REPLIED:It is not really *that* good for most peopLE.MY QUESTION---HOW WOULD YOU KNOW? EVER TRIED IT?
DOUBT IT--JUST MORE INTERNET PLAGARISM.
Posted by greg rizzo on January 10, 2020, at 17:36:04
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » greg rizzo, posted by undopaminergic on January 10, 2020, at 3:40:37
undopamanic
I wrote On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
----------------------------------------------
>YOU REPLIED:It is not really *that* good for most peopLE.MY QUESTION---HOW WOULD YOU KNOW? EVER TRIED IT?
DOUBT IT--JUST MORE INTERNET PLAGARISM.
Posted by undopaminergic on January 11, 2020, at 3:24:05
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION, posted by greg rizzo on January 10, 2020, at 17:33:13
> tO DOPAMANIC:
> WROTE: On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
> ----------------------------------------------
> YOU REPLIED:It is not really *that* good for most peopLE.
>
> MY QUESTION---HOW WOULD YOU KNOW? EVER TRIED IT?Sure did. I had to take it in combination with methylphenidate, or I would get no effect at all.
What plagiarism?
And why are you writing in all caps?
-undopaminergic
Posted by undopaminergic on January 11, 2020, at 3:25:21
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION, posted by greg rizzo on January 10, 2020, at 16:38:00
> i'M NEW HERE SO BITE ME MAN. YOU POST MORE REPETITIVE CRAP THAN ANYONE ELSE, USUALLY FROM THE NET, NOT PERSONAL OR ORIGINAL EXPERIENCE.
>Did I ever post 5+ duplicates like you? No, I didn't.
-undopaminergic
Posted by undopaminergic on January 11, 2020, at 3:28:11
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION, posted by greg rizzo on January 10, 2020, at 17:36:04
> undopamanic
> I wrote On a scale of 1 to 10 for immediate relief of depression and more energy I give it a 10. It's that good.
> ----------------------------------------------
> >YOU REPLIED:It is not really *that* good for most peopLE.
>
> MY QUESTION---HOW WOULD YOU KNOW? EVER TRIED IT?
> DOUBT IT--JUST MORE INTERNET PLAGARISM.There you go with another duplicate. I already replied to it.
-undopaminergic
Posted by pedr on January 11, 2020, at 8:29:52
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » greg rizzo, posted by undopaminergic on January 10, 2020, at 3:40:37
> It is not really *that* good for most people.
>
> -undopaminergicFor me, I can get ~ 5 days of ~ 7 hours relief per day from my TRD if I take 400mg Provigil. Which is remarkable. Only Provigil and Adderall have that effect on me. But then it poops-out (or my brain down/up-regulates or whatever). I stopped it cold last time and went into a *severe* state of catatonia until I took another 200mg dose. Be wary, folks.
Pete
Posted by undopaminergic on January 11, 2020, at 10:34:37
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » undopaminergic, posted by pedr on January 11, 2020, at 8:29:52
>
> > It is not really *that* good for most people.
> >
> > -undopaminergic
>
> For me, I can get ~ 5 days of ~ 7 hours relief per day from my TRD if I take 400mg Provigil. Which is remarkable. Only Provigil and Adderall have that effect on me. But then it poops-out (or my brain down/up-regulates or whatever). I stopped it cold last time and went into a *severe* state of catatonia until I took another 200mg dose. Be wary, folks.
>
> PeteHave you tried taking memantine or acamprosate with the stimulants? Apparently this augmentation strategy works better with amphetamines than with reuptake inhibitors (eg. methylphenidate). I don't know about modafinil, which is a reuptake inhibitor, but has other effects as well.
-undopaminergic
Posted by pedr on January 11, 2020, at 14:38:23
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » pedr, posted by undopaminergic on January 11, 2020, at 10:34:37
> Have you tried taking memantine or acamprosate with the stimulants? Apparently this augmentation strategy works better with amphetamines than with reuptake inhibitors (eg. methylphenidate). I don't know about modafinil, which is a reuptake inhibitor, but has other effects as well.
>
> -undopaminergicooh, no, I haven't. I've not heard of those two. TBH every single non-psychotropic/non-prescribed substance that're supposed to be good for depression that I've tried have failed miserably. I've tried all the big/popular ones I know of.
That said, I have no other options and if they're inexpensive, I'll duly give them a whirl.
Many thanks,
Pete
Posted by Ruuudy on January 11, 2020, at 16:07:47
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » undopaminergic, posted by pedr on January 11, 2020, at 14:38:23
So as for modafinil,,,
Last year, I had brought up the thought of adding on modafinil as an adjunctive drug for my fluoxetine to my awesome psychiatrist. He thought it seemed to be a good idea, but explained to me of that rare side effect of a rash that can be very serious,,, so that kinda pushed me away from that idea.But now as I have been educating myself up on sleep disorders, I have read that modafinil is used to treat DSPD (Delayed Sleep-Wake Pattern Disorder), of which I have.
I read thru all the reviews on drugs.com and there were a great percentage that had very favorable responses to modafinil. Didn't read any issues with a rash. Makes me feel confident in trying it.
I have an appointment to discuss with doctor on Tuesday.I took fluoxetine for 29-1/2 years before switching over to Pristiq (desvenlafaxine), which is not "cutting the mustard". So I'm tapering off that and am considering Trintellix or Viibryd.
I'm also considering starting the Spravato treatments back up now that my Savings Card renewed at the beginning of the new year.I'm like the previous poster, Pete, in that I've tried every vitamin, mineral, and supplement under the sun, and I just never notice anything.
The only vitamin I 100% strongly believe in is Vitamin C, because I have SEEN that it works!
Years ago, as I was actively playing drums in my punk rock bands, I was a very hard-hitting drummer that would come home with a huge bruise from also hitting my leg. Megadose Vitamin C cleared that right up.The recent studies showing that there weren't many natural supplements that proved to be beneficial to mental health except for a few convinced me to add back in some quality fish oil - I actually got my psychiatrist to prescribed Vescepa (pure prescription EPA) that I take daily along with vitamin C and magnesium threonate, and when I can wake up in time to take it, dextroamphetamine.
I'm quite surprised there hasn't been more discussion of ketamine or esketamine (Spravato) on this message board!
I guess Dr. Bob is gonna have to start a "Psychedelics" board!
Posted by undopaminergic on January 12, 2020, at 3:26:27
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » undopaminergic, posted by pedr on January 11, 2020, at 14:38:23
>
> > Have you tried taking memantine or acamprosate with the stimulants? Apparently this augmentation strategy works better with amphetamines than with reuptake inhibitors (eg. methylphenidate). I don't know about modafinil, which is a reuptake inhibitor, but has other effects as well.
> >
> > -undopaminergic
>
> ooh, no, I haven't. I've not heard of those two. TBH every single non-psychotropic/non-prescribed substance that're supposed to be good for depression that I've tried have failed miserably. I've tried all the big/popular ones I know of.
>Me too. But huperzine A worked, and I seemed to notice something from L-theanine.
> That said, I have no other options and if they're inexpensive, I'll duly give them a whirl.
>Last time I checked, memantine was expensive, but you can get it a lot cheaper if you buy from a chemical supplier, which I did.
-undopaminergic
Posted by pedr on January 12, 2020, at 6:04:59
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » pedr, posted by undopaminergic on January 12, 2020, at 3:26:27
> Me too. But huperzine A worked, and I seemed to notice something from L-theanine.
Another I don't know!
> > That said, I have no other options and if they're inexpensive, I'll duly give them a whirl.
> >
>
> Last time I checked, memantine was expensive, but you can get it a lot cheaper if you buy from a chemical supplier, which I did.It's not on amazon.com and that's about the extent of places I know to get supplements...
Posted by undopaminergic on January 12, 2020, at 6:47:14
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » undopaminergic, posted by pedr on January 12, 2020, at 6:04:59
> > Me too. But huperzine A worked, and I seemed to notice something from L-theanine.
>
> Another I don't know!Well, huperzine A is an acetylcholinesterase inhibitor, and L-theanine is an amino acid found in green tea.
> It's not on amazon.com and that's about the extent of places I know to get supplements...
>Memantine (and acamprosate) are pharmaceutical drugs, not supplements. You better check online pharmacies instead.
-undopaminergic
Posted by pedr on January 12, 2020, at 8:36:13
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » pedr, posted by undopaminergic on January 12, 2020, at 6:47:14
> Memantine (and acamprosate) are pharmaceutical drugs, not supplements. You better check online pharmacies instead.
>
> -undopaminergicdo you mean illegal places? There's almost no chance I'll be prescribed them, with the giant regimen I'm already on.
Posted by undopaminergic on January 12, 2020, at 9:20:44
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » undopaminergic, posted by pedr on January 12, 2020, at 8:36:13
>
> > Memantine (and acamprosate) are pharmaceutical drugs, not supplements. You better check online pharmacies instead.
> >
> > -undopaminergic
>
> do you mean illegal places? There's almost no chance I'll be prescribed them, with the giant regimen I'm already on.
>I think online pharmacies are usually legal in the countries they are located in. Whether it is legal for you to order prescription drugs from them by mail is a different question, that will depend on where you live.
Tell your doctor that these medications may help combat amphetamine tolerance, and maybe he'll understand.
-undopaminergic
Posted by sigismund on January 12, 2020, at 14:41:46
In reply to Re: SOLVED-BEST LEGAL STIMULANT FOR DEPRESSION » undopaminergic, posted by pedr on January 12, 2020, at 8:36:13
Isn't acamprosate just slightly altered taurine?
I take it (to reduce the desire to drink) and it seems harmless.
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Dr. Bob is Robert Hsiung, MD,
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