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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 eldon on August 14, 2000, at 13:29:22
WHICH SEEMS TO BE MORE EFFECTIVE AGAINST SOCIAL PHOBIA,
ADRAFINIL OR PAXIL? AND WHICH IS CHEAPER?
THANX,
ELDON
Posted by JohnL on August 16, 2000, at 5:02:57
In reply to ADRAFINIL VS. PAXIL!, posted by eldon on August 14, 2000, at 13:29:22
> WHICH SEEMS TO BE MORE EFFECTIVE AGAINST SOCIAL PHOBIA,
> ADRAFINIL OR PAXIL? AND WHICH IS CHEAPER?
> THANX,
> ELDONEither one could be more effective, varying dramatically from one person to the next. It all depends on the person's unique chemistry, personality, circumstances, etc.
I found both to be good for social phobia. Paxil was good, but also created a kind of cocoon-like feeling where nothing really mattered. One becomes socially comfortable because one is basically numb. Adrafinil is good too, but makes me feel active instead of cocoon-like. I'm not socially comfortable because I feel safe/protected (Paxil), but rather because I feel confident and energetic (Adrafinil).
Adrafinil is by far the cheaper of the two.
But of course, only Paxil is FDA approved and could be monitored by one's doctor. By taking Adrafinil, one is pretty much taking on the role of self-doctor and patient simultaneously. It works for me. Works for others. But it's not for everyone. Caution is always advised when taking a medication your doctor isn't familiar with. Having said all the disclaimer stuff, I personally like Adrafinil the best. :-)
John
Posted by Billb on August 16, 2000, at 20:39:28
In reply to Re: ADRAFINIL VS. PAXIL!, posted by JohnL on August 16, 2000, at 5:02:57
JohnL, any thoughts on my 8/11 post, or have my lack of emanners offended you in some way. If so, I apologize.
Posted by JohnL on August 17, 2000, at 5:40:00
In reply to Re: JohnL, posted by Billb on August 16, 2000, at 20:39:28
> JohnL, any thoughts on my 8/11 post, or have my lack of emanners offended you in some way. If so, I apologize.
Bill,
I saw an 8/10 post, but not 8/11. I'm not sure what you are referring to.I was surprised to see you've already had some experience with Adrafinil. Here's an idea. I mention it only because it has worked so well with me. And since you are already initiated into the overseas mailorder arena. Try a little Amisulpride in combination with Adrafinil. 300mg Adrafinil + 25mg or 50mg Amisulpride is just great. Talk about being socially comfortable. Active. Interested. Motivated. Involved. Non-depression. Non-anxious. Adrafinil by itself for me was OK. Amisulpride by itself too. But when they are combined the end result is dramatically more impressive than either alone. As I said, Paxil made me feel comfortable, yet cocoon-like. Adrafinil+Amisulpride=ALIVE and WELL. For me anyway.
John
Posted by michael on August 17, 2000, at 19:06:41
In reply to Re: Billb, posted by JohnL on August 17, 2000, at 5:40:00
JohnL. -
Just wondering if you've experimented w/sulpiride at all? I'm trying it w/adrafinil at the moment. Gonna try adrafinil w/amisulpride next.
Also, (question open to anyone) any thoughts on adding bromocriptine to a regimen containing sulpiride or amisulpride? Wondering if there'd be a risk of too much dopamine agonism? (i.e.: risk of psychotic psymptoms?) Low doses of each med, whichever combination...
And one last question - just wondering how dr. jensen's suggestions/ideas compare to what you wound up going with...? (I'm guessing that he doesn't usually deal w/non-fda approved meds?) Thanks for your time. michael
> > JohnL, any thoughts on my 8/11 post, or have my lack of emanners offended you in some way. If so, I apologize.
>
> Bill,
> I saw an 8/10 post, but not 8/11. I'm not sure what you are referring to.
>
> I was surprised to see you've already had some experience with Adrafinil. Here's an idea. I mention it only because it has worked so well with me. And since you are already initiated into the overseas mailorder arena. Try a little Amisulpride in combination with Adrafinil. 300mg Adrafinil + 25mg or 50mg Amisulpride is just great. Talk about being socially comfortable. Active. Interested. Motivated. Involved. Non-depression. Non-anxious. Adrafinil by itself for me was OK. Amisulpride by itself too. But when they are combined the end result is dramatically more impressive than either alone. As I said, Paxil made me feel comfortable, yet cocoon-like. Adrafinil+Amisulpride=ALIVE and WELL. For me anyway.
> John
Posted by JohnB on August 17, 2000, at 22:58:16
In reply to Re: Billb, posted by JohnL on August 17, 2000, at 5:40:00
Thanks for all the info you've posted lately. One question: Your post of 8/7 said you had dropped the Amisulpride because of impotence problems. Does that still hold? Do you think that adrafinil can cause loss of sex drive? I've been taking 300mg and don't seem to have any interest.
Posted by JohnL on August 18, 2000, at 5:39:41
In reply to adrafinil sulpiride / amisulpride » JohnL, posted by michael on August 17, 2000, at 19:06:41
Michael,
I am not familiar with Sulpiride. I have heard from others that it is similar to Amisulpride, but that it is distinctly different as well. They are different enough that one may work when the other doesn't.
I don't know about adding Bromocriptine either. I don't understand agonism/antagonism theories well enough to make sense of it. For example, on one hand Amisulpride is a dopamine antagonist. On the other hand, Bromo is a dopamine agonist. Would they cancel each other out? Would they instead act synergistically somehow? I don't know. I have some Bromocriptine but have never tried it. I think self-experimentation would be the only way to answer your questions. Very good questions at that.
Dr Jensen does not deal with non-FDA meds as far as I know. I pretty much took his methods and ran with it. Since it was so hard to find a local doctor that would go along with the novel-seeming approach (but it isn't really, just seems that way), I did it myself with meds I could get a hold of myself. If that were to fail, then I would have gone back to the doc's office and more conventional ways.
I modified Jensen's methods a little bit too. While he seeks 5-day responses, I lengethened it to 2 weeks. Sort of a compromise between different strategies. I agree the correct med for a person's chemistry will act fast, but to me 2 weeks seemed more of a fair trial than 5 days. And if at the end of 2 weeks things were looking pretty good, then the trial could be extended. If however at the end of 2 weeks things were unchanged or worse, forget it. Move on. Whatever that med was, it wasn't in the right ballpark. Sure a med like that could work in 6 to 8 weeks, but only through a trickle down chain reaction process. I didn't want that. I wanted to target whatever the underlying problem was directly, and leave other stuff in my brain unchanged.
The one area of Jensen's methods that is tricky is the clue gathering process. For example, I responded badly to Reboxetine. Also Moclobemide. And any kind of herb that enhances NE. This seemed like a pretty strong clue that my chemistry was not NE related. But then I ended up responding real well to Adrafinil. It works on NE, though in a different way. It doesn't increase NE like the others did, but rather makes existing NE work better. But still, the clues could be misread. Maybe my body just didn't like the Reboxetine or Moclobemide molecules, and it had nothing to with NE at all. This is surely an area where Dr Jensen's expertise would shine far bove my own understanding. He understands all these meds right down to the molecules and the intricate finnicky traits and everything. What was confusing to me would make perfect sense to him. He's a real expert, no doubt about it.
As it stands right now, my own results are in agreement with his views. The meds I take are probably targeting the problem directly, because: only miniscule doses are needed, side effects are very minimal, response was rather quick (days or weeks, not months), and response has been robust and complete. It was all just like he said. I tried in vain to find fault in his teachings. I failed. Glad I did. On the other hand, generally accepted principles of current day psychiatry are chock full of flaws. General teachings of psychiatry are good, but no doubt leave a lot to be desired. Otherwise this board wouldn't exist. :-)
To anyone having difficulty with their depression and meds, I still strongly urge reading his book. Read it again. And again. Just read several pages for a few days, over and over. Move on, do the same with more pages. Get the whole framework solidly implanted. At that point everything starts to make a lot more sense. Regardless of whether one uses conventional psychiatry or Jensen's approach, everything makes better sense. His teachings really aren't in opposition to conventional psychiatry, but are rather complimentary. They take conventional psychiatry one step further, and offer explanations and remedies for the various disappointments of conventional psychiatry. His teachings fill in the gaps. And I'm glad for that. It's those gaps that give us all so much trouble.
John
Posted by JohnL on August 18, 2000, at 6:02:37
In reply to Re: JohnL, posted by JohnB on August 17, 2000, at 22:58:16
John,
Yes, I did become impotent on Amisulpride. Doses were 50mg, then 100mg, and then back to 50mg. Darn frustrating. So I quit. And then I got real depressed. Couldn't endure it. I had no choice but to start Amisulpride again. I craved feeling good. I figured I would take drug holidays for love-making. But then I thought, what about 25mg instead of 50? So far so good. I have the same good response as 50mg, maybe even better, but no sign of impotence. In my experience, dosing Amisulpride is tricky. 25mg has turned out to be the best. Good response, no side effects.
Adrafinil also caused me some loss of desire in love-making. I didn't expect that. Completely by accident I discovered that one dose of SAM-e (200mg) has eliminated that side effect. Very cool. I like happy accidents. :-) Because of all these intricate finnicky things, my cocktail has ended up being something I never would have imagined. But it works. Everything seems to be working in synergy. The sum is more than the components combined, if that makes any sense. And doses are so small I marvel at how well this thing works.
300mg Adrafinil (at breakfast)
25mg Amisulpride (at breakfast)
200mg SAM-e (mid-morning, with water, empty stomach)
7.5mg Remeron (evening)My only side effect is that usual hour-long hangover first thing in the morning, typical of Remeron. Other than that, real good response, no side effects, and a healthy love life. Each ingredient serves a purpose, and each ingredient seems to enhance the good of each other ingredient. The sum is more than all combined.
John
Posted by michael on August 18, 2000, at 17:18:38
In reply to Re: adrafinil,sulpiride/amisulpride,update Jensen, posted by JohnL on August 18, 2000, at 5:39:41
John -
Thanks for the reply. FWIW, I think (if I've understood correctly, and recall correctly) that amisulpride is a dopamine agonist at low doses (25mg, 50mg, maybe up to 100mg?), and an antagonist (ie: antipsychotic characteristics) at higher doses.
The lower doses are used to treat the negative symptoms of psychosis, which sound (at least to me) to be very similar to the anhedonic/dysthymic symptoms... The positive symptoms of psychosis are treated with much higher doses - don't recall the numbers off the top of my head (possibly something like 800mg - 1,200mg? - or that may be the doses of sulpride used to treat positive symptoms....).
I think. Anyway...
I believe sulpiride behaves the same way (except that it's a dopamine agonist up to 200mg/day - I think). Maybe Andrew or Scott or Cam, etc. can confirm/deny or shed further light...?
Also, I'm already a convert re: dr. jensen's methods. Still looking for the right combo for me, but if a med makes me worse, I move on, rather than try to endure until my body can tolerate it... just seems to make sense. Hope I and others have as much success as you have. (9 out of 10, wow, good deal! congratulations.) >Michael,
>
> I am not familiar with Sulpiride. I have heard from others that it is similar to Amisulpride, but that it is distinctly different as well. They are different enough that one may work when the other doesn't.
>
> I don't know about adding Bromocriptine either. I don't understand agonism/antagonism theories well enough to make sense of it. For example, on one hand Amisulpride is a dopamine antagonist. On the other hand, Bromo is a dopamine agonist. Would they cancel each other out? Would they instead act synergistically somehow? I don't know. I have some Bromocriptine but have never tried it. I think self-experimentation would be the only way to answer your questions. Very good questions at that.
>
Posted by AndrewB on August 18, 2000, at 18:30:50
In reply to Re: adrafinil,sulpiride/amisulpride,update Jensen » JohnL, posted by michael on August 18, 2000, at 17:18:38
Michael,
Amisulpride, up to 200mgs. is a presynaptic D2/D3 receptor antogonist. At higher doses, a postsynaptic receptor antogonist.
Sulpiride has a similar low dose/high dose D2/D3 receptor antagonism dichotomy.
Bromocriptine is (if I remember right) a D2 receptor agonist.
I read of a report where a women was taking sulpiride but had side effects due to raised prolactin levels (i.e. missed menses). Upon adding bromocriptine, the side effects disappeared while response to sulpiride was maintained.
I asked my psych. about the combo. of bromocriptine and amisulpride. He did not express a problem with it.
I have taken the D2/D3 agonist Mirapex (pramipexole) concurrently with amisulpride. The Mirapex did not diminish the effect of the amisulpride or cause any side effects.
JohnL, note that the adding of bromocriptine to amisulpride/adrafinil combo may well remove the sexual side effects you experience with this combo. Bromo. lowers the prolactin levels that amisulpride can raise. Raised prolactin levels can cause sexual dysfunction. Also note a posting above that where bromo. counteracted sexual dysfunction from adrafinil.
Also JohnL, I recently trialed Provigil and Adrafinil. Extreme headaches with both. Couldn’t stop the headaches with common headache meds or a beta blocker. Remember Scott saying he had heard that adrafinil was not (at least directly) (alpha 1) noradrenergic in action. I’m wondering if adrafinil’s action is, in the main, glutaminergic. Remember that provigil is a metabolite of adrafinil, so one would presume they have overlapping modes of action.
Best wishes,
AndrewB
Posted by JohnB on August 19, 2000, at 21:09:12
In reply to Re: JohnB , posted by JohnL on August 18, 2000, at 6:02:37
> My only side effect is that usual hour-long hangover first thing in the morning, typical of Remeron. Other than that, real good response, no side effects, and a healthy love life. Each ingredient serves a purpose, and each ingredient seems to enhance the good of each other ingredient. The sum is more than all combined.
> JohnJohn, I am currently trying Klonopin in place of Remeron. Seems to work just as well plus no hangover. -JB
Posted by michael on August 20, 2000, at 20:27:17
In reply to Re: JohnL -Remeron , posted by JohnB on August 19, 2000, at 21:09:12
JohnB.-
Just wondering - the klonopin - taking it at night for sleep? Mind if I ask what dose? Thanks for any info. michael
>
> > My only side effect is that usual hour-long hangover first thing in the morning, typical of Remeron. Other than that, real good response, no side effects, and a healthy love life. Each ingredient serves a purpose, and each ingredient seems to enhance the good of each other ingredient. The sum is more than all combined.
> > John
>
> John, I am currently trying Klonopin in place of Remeron. Seems to work just as well plus no hangover. -JB
This is the end of the thread.
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