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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 JohnL on November 10, 1999, at 5:13:02
Hi everyone. I understand stimulants are sometimes used in the elderly as antidepressents. And they are used as augmentations in conjunction with antidepressents.
My question is, which ones are best know for mood elevation? Is there one more than another with greater influence on overall mood brightening? I have no experience with these. What are the choices? What are the therapeutic characteristics of the different choices?
Posted by Noa on November 11, 1999, at 21:48:00
In reply to Stimulants for Depression?, posted by JohnL on November 10, 1999, at 5:13:02
I am making the switch from regular ritalin to Ritalin SR, which will hopefully take care of the rebound dips that I get several times a day. It means a slight increase, from 30 mgs/day to 40 mgs/day--20 at 6 am and 20 at around noon. I will keep you posted if I notice any differences. BTW, my doctor said if the SR doesn't do it, we could try Dexedrine or Adderall.
Posted by anita on November 12, 1999, at 0:56:15
In reply to Re: Stimulants for Depression--a tangent, posted by Noa on November 11, 1999, at 21:48:00
If they don't work out, try amisulpride. It's like ritalin but without the "downs" due to it's longish half-life.
anita
> I am making the switch from regular ritalin to Ritalin SR, which will hopefully take care of the rebound dips that I get several times a day. It means a slight increase, from 30 mgs/day to 40 mgs/day--20 at 6 am and 20 at around noon. I will keep you posted if I notice any differences. BTW, my doctor said if the SR doesn't do it, we could try Dexedrine or Adderall.
Posted by Zannah on November 12, 1999, at 8:39:10
In reply to Re: Stimulants for Depression--a tangent, posted by anita on November 12, 1999, at 0:56:15
> If they don't work out, try amisulpride. It's like ritalin but without the "downs" due to it's longish half-life.
>
> anita
>
>
> > I am making the switch from regular ritalin to Ritalin SR, which will hopefully take care of the rebound dips that I get several times a day. It means a slight increase, from 30 mgs/day to 40 mgs/day--20 at 6 am and 20 at around noon. I will keep you posted if I notice any differences. BTW, my doctor said if the SR doesn't do it, we could try Dexedrine or Adderall.Anyone ever use the appetite suppressant Phentermine (the 'phen' half of the now defunct fen-phen combo) as an antidepressant? I used it for a while (got it from a diet clinic) and it made me far more functional than any of the AD's I have tried since I lost the weight. I was not consciously utilizing it in a psychologically therapeutic way. But, when I no longer had it, the fact that I have had depression or some sort of mood disorder for years, quickly became glaringly evident. I have tried TCA's, prozac, celexa, all for many weeks, even months at a time-no help. I have been using Wellbutrin for the past 5 months, simply because it enables me to at least get out of bed most days. I had one terrific week on it, since then, it's efficacy has been minimal. My doc tried to take me from 150SR 2x's a day to 450mgs. a day a while back, but I couldn't handle the muscle tension. I do have a 3 week sample pack of Effexor in the med cabinet. My g.p. gave it to me & wanted me to stop the WB and start the Eff. But, I didn't. I have read that some of you posters have intermingled the 2 drugs. Don't know where I go from here. GADS, try a new AD during the holidays? Shiver.
Posted by CarolAnn on November 12, 1999, at 16:28:19
In reply to Re: Stimulants for Depression--a tangent, posted by Zannah on November 12, 1999, at 8:39:10
First to Zannah--I have been on 150mgs Wellbutrin twice a day for 6 wks. Only result has been 15 pounds extra(due to sweets cravings). My Pdoc was amazed at such an atypical response. 3 days ago, he added 75mgs Serzone(increase to 150mgs in a week). Too soon for anything but unpleasant side effects, but will keep you posted--you're right about new AD during the holidays-Aarrgh!.....Now for a question to anyone regarding stimulants....
I was on 20 mgs Ritalin 3 times a day, and was stupid enough to just take more on the rebounds, after a while, I was taking 40 to 60mgs at a time as I developed a tolerance(Please don't scold, I know how bad I was and finally went off altogether). I just could not control my need for the feeling of energy and well-being that such large doses gave. Okay, here's the question:Any recommendations for a specific stimulant that would not be so compelling(yeah, I know-addicting)? I really do need something to pick me up without encouraging disabuse.
Ciao! CarolAnn
Posted by Craig on November 12, 1999, at 17:44:33
In reply to Re: Stimulants for Depression--Advice?Anyone?., posted by CarolAnn on November 12, 1999, at 16:28:19
> First to Zannah--I have been on 150mgs Wellbutrin twice a day for 6 wks. Only result has been 15 pounds extra(due to sweets cravings). My Pdoc was amazed at such an atypical response. 3 days ago, he added 75mgs Serzone(increase to 150mgs in a week). Too soon for anything but unpleasant side effects, but will keep you posted--you're right about new AD during the holidays-Aarrgh!.....
Carol Ann (sorry for the cheesey Polterguist quip) :
There's not enough stimulant effect from the Wellbutrin? Maybe a higher dose, and maybe you can get that lift from something other than a stimulant (another AD such as an SSRI or Reboxetine?) SSRI really energized me for a while.
Here's a question for you...You're adding Serzone to Wellbutrin -- why? to control the cravings or reduce tension?
I'm about to do the opposite (add Wellbutrin to my Serzone for a little zip) and would like to know how they go together.
Posted by CarolAnn(Sorry! hit submit accidently) on November 13, 1999, at 9:04:36
In reply to CarolAnn -- Don't go into the light!, posted by Craig on November 12, 1999, at 17:44:33
Poltergiest is one of my favorite scare movies(horror without gore!)
Yes, it's weird that Wellbutrin has now stimulant effect for me, also very atypical to gain weight on it.
The serzone is for two main reasons- to increase sex drive(from none to some) and to stop food cravings.
My theory(and my Pdoc agrees) is that when I went off Prozac(at start of Wellbutrin) my serotonin level went down causing me to crave simple carbohydrates which are known to increase serotonin levels. Since Serzone does affect serotonin, cravings should stop once it kicks in.
As for having no sex drive(another very odd Wellburin response),studies on Serzone have found that it increases sex drive in most people.
Anyway, I haven't been on the stuff for even a week yet, but will keep you posted on effectiveness. Good luck to you! CarolAnn
Posted by Paul on December 14, 1999, at 0:15:24
In reply to Re: Stimulants for Depression--Advice?Anyone?., posted by CarolAnn on November 12, 1999, at 16:28:19
> First to Zannah--I have been on 150mgs Wellbutrin twice a day for 6 wks. Only result has been 15 pounds extra(due to sweets cravings). My Pdoc was amazed at such an atypical response. 3 days ago, he added 75mgs Serzone(increase to 150mgs in a week). Too soon for anything but unpleasant side effects, but will keep you posted--you're right about new AD during the holidays-Aarrgh!.....Now for a question to anyone regarding stimulants....
> I was on 20 mgs Ritalin 3 times a day, and was stupid enough to just take more on the rebounds, after a while, I was taking 40 to 60mgs at a time as I developed a tolerance(Please don't scold, I know how bad I was and finally went off altogether). I just could not control my need for the feeling of energy and well-being that such large doses gave. Okay, here's the question:
>
> Any recommendations for a specific stimulant that would not be so compelling(yeah, I know-addicting)? I really do need something to pick me up without encouraging disabuse.
> Ciao! CarolAnn
My experience with stimulants is that they brighten my mood by about the same fixed amount irrespective of how if feel. If I'm feeling only moderately depressed, stimulants will improve my mood to the point that I feel O.K. If, however, I'm really depressed, a stimulant will brighten my mood, but not by enough to feel O.K.I would talk to my doctor about trying the narcolepsy drug modafinil(a/k/a provigil). It's not addictive, it doesn't seem to cause a tolerance, and it's Schedule 4. It's also rather expensive, so hopefully your doctor can be a little creative about getting this paid by your insurance company.
Bonne chance,
Paul
Posted by Scott L. Schofield on December 23, 1999, at 19:33:57
In reply to Re: Stimulants for Depression--Advice?Anyone?., posted by CarolAnn on November 12, 1999, at 16:28:19
> Any recommendations for a specific stimulant that would not be so compelling(yeah, I know-addicting)? I really do need something to pick me up without encouraging disabuse.I have seen doctors who have used pemoline with success on some of their patients. I've tried to rattle my brain so as to remember the trade-name of this dopaminergic drug, but not enough of my neurons seem to be firing at the moment. Pemoline acts to promote the passive release of dopamine without inhibiting its reuptake. It can be used in combination with MAOIs. I believe Parnate was the one that was more often augmented with it. Pemoline has also been used for AD/HD, although I don't know to what extent it is currently used for this indication.
You may also consider using one of the direct-acting dopamine agonists such as bromocryptine or pergolide.
How does caffeine affect you? Just curious.
Good luck finding your ever-ready energizer.
- Scott
Posted by Noa on December 23, 1999, at 21:07:07
In reply to Re: Stimulants for Depression--Advice?Anyone?., posted by Scott L. Schofield on December 23, 1999, at 19:33:57
Cylert?
Posted by CarolAnn on December 24, 1999, at 11:41:28
In reply to Re: Stimulants for Depression--Advice?Anyone?., posted by Scott L. Schofield on December 23, 1999, at 19:33:57
Thanx for the info, Scott.
As for the effect of caffiene, I don't get much from it at all. I do *have* to have my morning coffee, but other then that it really doesn't act as a strong stimulant for me. In fact, a couple times I have taken up to 400mgs(you know, those caffiene pills), and actually got back into bed and taken a nap!CarolAnn
Posted by Scott L. Schofield on December 25, 1999, at 11:40:01
In reply to Re: Stimulants for Depression--Advice?Anyone?., posted by Noa on December 23, 1999, at 21:07:07
> Cylert?
Yeah. That's it.
I spent the better part of the day
trying to remember it. Now I can go
to sleep.Thanks.
- Scott
This is the end of the thread.
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