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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by anita on September 18, 2000, at 1:55:45
Hi,
Has anyone been helped with depression, apathy, or fatigue by taking amantadine, alone or in combination with an antidepressant?
I ask because amantadine is the only dopamine agonist (that I haven't tried yet) that I can afford right now.
thanks,
anita
Posted by JohnL on September 18, 2000, at 4:35:27
In reply to Amantadine work for anybody?, posted by anita on September 18, 2000, at 1:55:45
> Hi,
>
> Has anyone been helped with depression, apathy, or fatigue by taking amantadine, alone or in combination with an antidepressant?
>
> I ask because amantadine is the only dopamine agonist (that I haven't tried yet) that I can afford right now.
>
> thanks,
> anitaAnita,
I can't recall anyone trying Amantadine. It is however discussed favorably in Dr Bobs Tips and in other literature. Sometimes depression is virus-related, and Amantadine might be worth a try because it could work from a couple different angles.If you are focusing on dopamine, Provigil might be another consideration. But unfortunately it doesn't fit your description of being affordable. It is pretty pricey. I mention it because even though they aren't sure how it works, they are in agreement on a couple things. First, it is a stimulant and can work on the symptoms of apathy and fatigue you described. Second, of all the unknown mechanisms, the one mechanism that IS known is that it has dopamine reuptake inhibition. Unlike other dopamine reuptake inhibitors like Wellbutrin or Effexor for example, Provigil works only on inhibiting the reuptake of dopamine, not NE or serotonin.
But if you can get your doctor to go along with Amantadine, that would be cool. It might work. I think you are at least on the right track. Because in my own personal experience, if apathy, anhedonia, and fatique are primary symptoms, then the dopamine circuitry(#1) and the NE circuitry(#2) are probably involved to a much greater degree than the serotonin circuitry. How exactly we manipulate the dopamine circuitry makes all the difference in the world. Increasing dopamine release, i.e. stimulants or Amisulpride, is one way. Dopamine reuptake inhibition is another way. One way might work while another doesn't. But no matter, if you're focusing on dopamine, Amantadine would be intersting. I've read about a few cases where patients were prescribed Amantadine for other nonpsychiatric reasons, only to be pleasantly surprised to see that their longstanding depression disappeared.
John
Posted by Darby on September 21, 2000, at 22:19:09
In reply to Re: Amantadine work for anybody?, posted by JohnL on September 18, 2000, at 4:35:27
I must disagree with the description of modafinil (Provigil) as a dopamine reuptake inhibitor. The only information I'm aware of that it has any dopaminergic action at all relates to very limited secondary actions on dopamine in the nucleus accumbens of the brain. Modafinil seems to be primarily a noradrenergic-acting compound with some GABA reducing actions. Its dopaminergic actions seem to be very limited.
Thanks,
Darby
Posted by JohnL on September 22, 2000, at 4:02:36
In reply to Provigil NOT Dopamine Re-Upt Inhibitor, posted by Darby on September 21, 2000, at 22:19:09
> I must disagree with the description of modafinil (Provigil) as a dopamine reuptake inhibitor. The only information I'm aware of that it has any dopaminergic action at all relates to very limited secondary actions on dopamine in the nucleus accumbens of the brain. Modafinil seems to be primarily a noradrenergic-acting compound with some GABA reducing actions. Its dopaminergic actions seem to be very limited.
>
> Thanks,
>
> DarbyDarby,
I was just basing information on the year 2000 Physician's Desk Reference Book, since it's the most commonly used source of information for doctors and psychiatrists with the latest scientific evidence. To date Provigil has shown no binding affinity to any of the common receptor sites, including NE, serotonin, GABA, histimine, and others. But it does bind to the dopamine receptor causing an increase of extracellular dopamine levels. Strangely, though it shows no direct NE alpha agonism, its effects can be reversed by alpha1 antagonists. It's rather wordy and lengthy, so I've just summed it up. But that's what it says. Whatever unknown mechanisms Provigil exhibits, one of them that is known is dopamine reuptake, but no increase in dopamine output. I'm sure there must be other mechanisms at play, but at this time they are not clinically known. Whatever noradrenergic or GABA effects Provigil might have, according to the PDR they are either nonexistant or clinically irrevelevant. Maybe you have some information that is more updated and more formal than the PDR book?What always amazes me is how they invent these medications and yet they don't know what they do. How can they do that? Weird.
John
Posted by Seamus2 on September 22, 2000, at 9:58:20
In reply to Re: Provigil Dop Re-Upt Inhibitor, PDR Book., posted by JohnL on September 22, 2000, at 4:02:36
> > What always amazes me is how they invent these medications and yet they don't know what they do. How can they do that? Weird.
> JohnHow can egg yolks and butter turn into such a heavenly sauce? How can it do THAT!?! Weird.
< g >
Seamus
Posted by Sassy on September 25, 2000, at 15:46:23
In reply to Amantadine work for anybody?, posted by anita on September 18, 2000, at 1:55:45
Hi Anita,
Saw my pdoc the same day I read your post. Had
to get off serzone, and asked about it. I was taking 50 mg serzone and 10 to 20 mg adderall(twice daily) sometimes with topomax. The serzone was wiping me out, so I substituted it for
left over prozac. Therefore, I was taking the prozac and adderall.I cannot take any ADs that slow me down.
I inquired about the amantadine, and my doc stated
it may be a good med to try. He indicated he
sometimes prescribes it to children with ADD.I've also read it was used in trials for hepatitis c and some other type of virus.
Since I have epstein barr, what the heck, if it
kills the virus and helps with the depression, great!It is day 4 and I have dropped the adderall and
take the prozac and amantadine.My experience so far is that I feel a little anxious. I drink coffee and have been under the
gun to pass an exam. My focus has not been
disrupted, nor do I have any sleepiness.
The bottle says it may impair the ability to drive and don't drink. With these comments, I
was prepared to be a little tired.I will give this time for the anxiety to go away.
Otherwise, I will go back to the adderrall.
Nothing except effexor has ever made that "cloud"
go away. I can't take effexor.No one medicine works totally with the depression,
taking away the cloud, focus and energy.Let me know your results.
Good Luck,
Sassy> Hi,
>
> Has anyone been helped with depression, apathy, or fatigue by taking amantadine, alone or in combination with an antidepressant?
>
> I ask because amantadine is the only dopamine agonist (that I haven't tried yet) that I can afford right now.
>
> thanks,
> anita
Posted by Anna P. on September 26, 2000, at 12:18:35
In reply to Re: Amantadine work for anybody?, posted by Sassy on September 25, 2000, at 15:46:23
> Hi Anita,
>
> Saw my pdoc the same day I read your post. Had
> to get off serzone, and asked about it. I was taking 50 mg serzone and 10 to 20 mg adderall(twice daily) sometimes with topomax. The serzone was wiping me out, so I substituted it for
> left over prozac. Therefore, I was taking the prozac and adderall.
>
> I cannot take any ADs that slow me down.
>
> I inquired about the amantadine, and my doc stated
> it may be a good med to try. He indicated he
> sometimes prescribes it to children with ADD.
>
> I've also read it was used in trials for hepatitis c and some other type of virus.
> Since I have epstein barr, what the heck, if it
> kills the virus and helps with the depression, great!
>
> Hi Sassy,What kind of test did you do for the Epstain Barr virus? I'm curious as one doc inthe past has suggested for me to do a test for this. Thanks,
Anna P.
Posted by Sassy on September 26, 2000, at 17:54:06
In reply to Re: Sassy Epstain Barr virus, posted by Anna P. on September 26, 2000, at 12:18:35
> > Hi Anita,
> >
> > Saw my pdoc the same day I read your post. Had
> > to get off serzone, and asked about it. I was taking 50 mg serzone and 10 to 20 mg adderall(twice daily) sometimes with topomax. The serzone was wiping me out, so I substituted it for
> > left over prozac. Therefore, I was taking the prozac and adderall.
> >
> > I cannot take any ADs that slow me down.
> >
> > I inquired about the amantadine, and my doc stated
> > it may be a good med to try. He indicated he
> > sometimes prescribes it to children with ADD.
> >
> > I've also read it was used in trials for hepatitis c and some other type of virus.
> > Since I have epstein barr, what the heck, if it
> > kills the virus and helps with the depression, great!
> >
Hi Anna,As I recall one test specifically was for epstein barr.
Everyone has a certain level of this in them, however, through a blood test, they can measure by a count of what is considered normal. I made
a copy of that report and if I can find it, I can be more specific. He also had some type of blood test that gives an indication of the condition of
your liver and if it is inflamed. He also had to do a test for hepatitis because he stated they will give out similiar results in other blood test, but I was cleared of the hepatitis.I was diagnosed in '97 and I am way better, but I
have my bad days.Hi Sassy,
>
> What kind of test did you do for the Epstain Barr virus? I'm curious as one doc inthe past has suggested for me to do a test for this. Thanks,
>
> Anna P.
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