![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 44. Go back in thread:
Posted by manowar on February 15, 2002, at 17:53:18
In reply to Questions about depression, posted by household06 on February 14, 2002, at 13:44:26
Hello,
I know how you feel. Hang in there, and learn as much as you can about this disorder.
I think many on this BB are the type of depressives that DON'T do well on serotonergic type meds. I certainly don't.Unfortunately, typical pstims like Dexedrine can help depression for a little while, but the effect soon wears off, and we're back to square one again. That's why no pdocs that I know of in this area of the country prescribe typical pstims like Dexedrine for people with depression.
The good news is that if an antidepressant is not working, some pdocs will augment an antidepressant with a pstim and sometimes the combo works wonders. I personally don't know of any doctors around here that will do that, but it seems to be commonplace in other areas around the country and world.
Try the non-serotonergic, non-tricyclic drugs like Wellbutrin. Wellbutrin has a very benign side effect profile and is very stimulating for most people. Another avenue to take is to try Modafinil (Provigil). Provigil is a drug indicated to treat people for Narcolepsy, but many people, including myself, experience a huge increase in energy and vigilance. It also has a powerful anti-depressant effect. It’s very expensive, but for me it works wonders with a side effect profile of zero. It is considered a pstim, but fortunately it’s not a controlled drug like other pstims.
Keep the faith, and get better soon,Tim
> I have been diagnosed with depression, and have tried so many AD's that I am getting frustrated. I have been on celexa, trazodone, effexor, celexa & trazodone, and now all three. They seem to work for a little while, but then I am back at square one. I have heard good things about dexadrine, as far as helping with the energy level during the day. I would like to hear from anyone that has been prescribed dexadrine to help with depression. Also, what dosage, and any adverse reactions.
Posted by Elizabeth on February 16, 2002, at 11:50:47
In reply to Re: Questions about depression, posted by manowar on February 15, 2002, at 17:53:18
> Unfortunately, typical pstims like Dexedrine can help depression for a little while, but the effect soon wears off, and we're back to square one again. That's why no pdocs that I know of in this area of the country prescribe typical pstims like Dexedrine for people with depression.
That's the reputation of stimulants. I don't know if it's really true. It certainly isn't true for everyone; amphetamine was a standard treatment for depression before MAOIs and TCAs were discovered. A relative of mine who died a couple years ago took it for years with no tolerance developing. I think it's more likely that the doctors in your area who never prescribe Dexedrine for depression are simply very conservative, because stimulants can be very effective for some depressed people who need catecholaminergic drugs rather than serotonergic ones.
> The good news is that if an antidepressant is not working, some pdocs will augment an antidepressant with a pstim and sometimes the combo works wonders.
If tolerance really were an inevitable consequence of taking stimulants for depression, people would become tolerant regardless of whether they were also taking an antidepressant or not. Also, I think that in most cases, if an antidepressant really isn't working, switching to something else is a better idea than augmenting. My guess is that people who have sudden miraculous responses when a stimulant is added to an ineffective antidepressant are responding to the stimulant and that discontinuing the antidepressant would probably make little or no difference (except for causing fewer side effects and saving the patient some money).
> Try the non-serotonergic, non-tricyclic drugs like Wellbutrin. Wellbutrin has a very benign side effect profile and is very stimulating for most people.
I haven't been too impressed by what I've heard about Wellbutrin. It seems to work well for some people, but most people who take it are using it for augmentation or to counteract SSRI (or, occasionally, MAOI) side effects. If someone needs a catecholaminergic drug rather than a serotonergic one, I would expect a stimulant (Dexedrine, Adderall, Ritalin/Concerta, Cylert, Provigil) to be more effective than Wellbutrin.
> Another avenue to take is to try Modafinil (Provigil).
This seems like a better idea than Wellbutrin. I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine.
> It is considered a pstim, but fortunately it’s not a controlled drug like other pstims.
It is a controlled substance, but like Cylert, it's only C-IV.
-elizabeth
Posted by IsoM on February 16, 2002, at 19:53:29
In reply to Re: Questions about depression, posted by Elizabeth on February 16, 2002, at 11:50:47
> > "...I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine."
Elizabeth, most people with narcolepsy don't experience cataplexy that often or as severe as it's sometimes dramatisised. Most of us just experience muscle weakness & trouble standing (tend to collapse unless sitting, then we keel over in the laughter or tears). Most of us find the most troubling aspect of narcolepsy is fighting the constant all-day sleepiness. That's why modafinil & adrafinil is so good. We can finally be productive without spending enormous effort at trying to stay awake & alert.
The review I read of adrafinil done by CNS Reviews by a team at Toronto, said that even after 3 years or more of use, tolerance to adrafinil wasn't seen.
http://www.nevapress.com/cnsdr/full/5/3/193.pdfI do know I could build tolerance to Dexedrine fairly quick when used continuously. I would give myself frequent drug holidays as what would once keep me alert soon lost its effect & would instead need an increase - something I wouldn't do, hence the drug holidays.
Posted by Ritch on February 16, 2002, at 21:35:59
In reply to Dexedrine/Provigil Tolerance? » Elizabeth, posted by IsoM on February 16, 2002, at 19:53:29
> > > "...I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine."
>
> Elizabeth, most people with narcolepsy don't experience cataplexy that often or as severe as it's sometimes dramatisised. Most of us just experience muscle weakness & trouble standing (tend to collapse unless sitting, then we keel over in the laughter or tears). Most of us find the most troubling aspect of narcolepsy is fighting the constant all-day sleepiness. That's why modafinil & adrafinil is so good. We can finally be productive without spending enormous effort at trying to stay awake & alert.
>
> The review I read of adrafinil done by CNS Reviews by a team at Toronto, said that even after 3 years or more of use, tolerance to adrafinil wasn't seen.
> http://www.nevapress.com/cnsdr/full/5/3/193.pdf
>
> I do know I could build tolerance to Dexedrine fairly quick when used continuously. I would give myself frequent drug holidays as what would once keep me alert soon lost its effect & would instead need an increase - something I wouldn't do, hence the drug holidays.
Hi IsoM,When I increase dosages of SSri's I get the most hypomanic, but the weird thing is...I tend to have spells of laughter. Sometimes the laughter spells involve loss of consciousness (a few seconds). For example, if someone tells me a really good joke and I respond with some laughter I will see *spots* in my eyes and I will sometimes fall to the floor. Does this not sound like the *cataplexy* involved with narcolepsy??
Mitch
Posted by IsoM on February 16, 2002, at 22:17:30
In reply to Re: Dexedrine/Provigil Tolerance? » IsoM, posted by Ritch on February 16, 2002, at 21:35:59
> > "...I tend to have spells of laughter. Sometimes the laughter spells involve loss of consciousness (a few seconds). For example, if someone tells me a really good joke and I respond with some laughter I will see *spots* in my eyes and I will sometimes fall to the floor. Does this not sound like the *cataplexy* involved with narcolepsy??"
Not really. I'm definitely no expert on narcolepsy but if symptoms are characteristc, I'd think it's a good chance that whoever had them would also have narcolepsy. But this doesn't sound like it. It's not so much as falling unconscious as sudden, unexpected emotion (a shock, crying, laughter can trigger the cataplexy part causing muscle weakness ranging from just wobbly muscles to complete loss of control (fall down, lose consciousness)
There's generally a tetrad of symptoms with narcolepsy. Here's a site on it, one of the best, I think:
http://www.sleepdisorderchannel.net/narcolepsy/Even if it doesn't sound like cataplexy to me (like I said - I'm no expert), check out to see if anything else related to your sleep sounds like it. If it does, you might want to check it out with a doctor who really recognises narcolepsy. Too many still think you have to fall over into an immediate sleep to qualify. Otherwise, I'm sorry to tell you but I'm baffled - haven't heard anything like this of yours.
Posted by manowar on February 19, 2002, at 15:57:04
In reply to Re: Questions about depression, posted by Elizabeth on February 16, 2002, at 11:50:47
Hello Elizabeth,
You make some very good points as usual. I've got a few questions for you:
> This seems like a better idea than Wellbutrin. I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine.
What is cataplexy?
What does IMO mean?>
> > It is considered a pstim, but fortunately it’s not a controlled drug like other pstims.
>
> It is a controlled substance, but like Cylert, it's only C-IV.What's the difference between a regular drug and C-IV drug?
Thanks,
Tim
Posted by fachad on February 19, 2002, at 20:45:12
In reply to Re: Questions about depression, posted by Elizabeth on February 16, 2002, at 11:50:47
Elizabeth wrote:
"My guess is that people who have sudden miraculous responses when a stimulant is added to an ineffective antidepressant are responding to the stimulant and that discontinuing the antidepressant would probably make little or no difference (except for causing fewer side effects and saving the patient some money)."
That's exactly how it worked for me - after a long trail of ineffective ADs, my pdoc added Ritalin. Later, I discontinued all ADs and just took Ritalin, and it's remained effective against my depression at the same dose for years.
I did switch to Concerta, so you can forget about that "saving some money" part.
> > Unfortunately, typical pstims like Dexedrine can help depression for a little while, but the effect soon wears off, and we're back to square one again. That's why no pdocs that I know of in this area of the country prescribe typical pstims like Dexedrine for people with depression.
>
> That's the reputation of stimulants. I don't know if it's really true. It certainly isn't true for everyone; amphetamine was a standard treatment for depression before MAOIs and TCAs were discovered. A relative of mine who died a couple years ago took it for years with no tolerance developing. I think it's more likely that the doctors in your area who never prescribe Dexedrine for depression are simply very conservative, because stimulants can be very effective for some depressed people who need catecholaminergic drugs rather than serotonergic ones.
>
> > The good news is that if an antidepressant is not working, some pdocs will augment an antidepressant with a pstim and sometimes the combo works wonders.
>
> If tolerance really were an inevitable consequence of taking stimulants for depression, people would become tolerant regardless of whether they were also taking an antidepressant or not. Also, I think that in most cases, if an antidepressant really isn't working, switching to something else is a better idea than augmenting. My guess is that people who have sudden miraculous responses when a stimulant is added to an ineffective antidepressant are responding to the stimulant and that discontinuing the antidepressant would probably make little or no difference (except for causing fewer side effects and saving the patient some money).
>
> > Try the non-serotonergic, non-tricyclic drugs like Wellbutrin. Wellbutrin has a very benign side effect profile and is very stimulating for most people.
>
> I haven't been too impressed by what I've heard about Wellbutrin. It seems to work well for some people, but most people who take it are using it for augmentation or to counteract SSRI (or, occasionally, MAOI) side effects. If someone needs a catecholaminergic drug rather than a serotonergic one, I would expect a stimulant (Dexedrine, Adderall, Ritalin/Concerta, Cylert, Provigil) to be more effective than Wellbutrin.
>
> > Another avenue to take is to try Modafinil (Provigil).
>
> This seems like a better idea than Wellbutrin. I've heard many positive stories about modafinil. The main complaint people seem to have is that it costs too much. It really isn't a great antinarcoleptic since it doesn't treat cataplexy; it's better for depression and ADD, IMO. The risk of tolerance to modafinil is probably not that different from the risk of tolerance to Dexedrine.
>
> > It is considered a pstim, but fortunately it’s not a controlled drug like other pstims.
>
> It is a controlled substance, but like Cylert, it's only C-IV.
>
> -elizabeth
Posted by Zo on February 20, 2002, at 0:48:04
In reply to Dexedrine/Provigil Tolerance? » Elizabeth, posted by IsoM on February 16, 2002, at 19:53:29
Sorry, you could build up a tolerance for Dex, or you have?
I've not heard of same, not in weeny Rx amounts. I can only stand 15mg on special days. . . And I am going to be on Dex rest of this life.
Best,
Zo
Posted by IsoM on February 20, 2002, at 2:22:33
In reply to Re: Dexedrine Tolerance?, posted by Zo on February 20, 2002, at 0:48:04
Not sure if your question is meant for me, but I can (& have) developed a certain tolerance for Dexedrine before. I no longer take it but use adrafinil instead which is supposed to have a record of no tolerance build-up.
Posted by Geezer on February 20, 2002, at 10:12:05
In reply to Re: Dexedrine Tolerance?, posted by Zo on February 20, 2002, at 0:48:04
Can anyone tell me why one person would develope tolerance to Dex. while someone else would not? I can completely agree with Elizabeth's post - when a stim. is added to an ineffective AD, probably the effect felt is from the stim. and has nothing to do with the AD. Every time I used Dex. I experienced EUPHORIA (at any dose), Tolerance developed quickly and abuse went like a rocket.
I have tried 2 doses of Provigil 100mg. (now, after the fact, I understand this drug requires some time to work). Provigil felt like the bumbed-out rebound depression I used to get when the Dex. wore off.
I am not looking for a way to take pstims again - God knows I have paid the price for that. I would like to understand WHY a drug that could mean death for one can be helpful to another. I guess that is the purpose of this board.
All comments welcome......Thank you
Geezer
Posted by fachad on February 21, 2002, at 8:21:28
In reply to Re: Dexedrine Tolerance?, posted by Geezer on February 20, 2002, at 10:12:05
Geezer,
As I posted in response to Elizabeth, I responded to a pstim (Ritalin) and was able to drop the AD (Serzone) without any loss of response.
In answer to your question about how some develop tolerance and some do not, I think it can be predicted by how a person perceives the initial drug effects.
If the initial "zap" that you experience from a pstim is experienced as euphoric, and you develop a liking for that feeling of euphoria, you will have to constantly increase the dose to get that same level of euphoria.
On the other hand, in my case, the initial "zap" was moderately disphoric - I felt edgy and uncomfortable - BUT my depression lifted.
I actually looked forward to developing "tolerance" to the zap so I could just enjoy not being depressed without being edgy.
After about a month of daily Ritalin, the "unsettled" feeling went away and it has worked for my depression for 7 years.
I think a valid analogy would be if someone really got off on the sedation an OTC antihistamine like Benadryl vs. someone whose allergies are relived by Benadryl.
The first person would find the drowsiness to wear off after a few days of constant use, and would have to increase the dose to get the same effect.
But the other person would find his allergies relived at the same dose for years, because histamine is still blocked, even though the subjective drowsiness is no longer perceived.
Just a guess, but it makes sense to me.
> Can anyone tell me why one person would develope tolerance to Dex. while someone else would not? I can completely agree with Elizabeth's post - when a stim. is added to an ineffective AD, probably the effect felt is from the stim. and has nothing to do with the AD. Every time I used Dex. I experienced EUPHORIA (at any dose), Tolerance developed quickly and abuse went like a rocket.
>
> I have tried 2 doses of Provigil 100mg. (now, after the fact, I understand this drug requires some time to work). Provigil felt like the bumbed-out rebound depression I used to get when the Dex. wore off.
>
> I am not looking for a way to take pstims again - God knows I have paid the price for that. I would like to understand WHY a drug that could mean death for one can be helpful to another. I guess that is the purpose of this board.
>
> All comments welcome......Thank you
>
> Geezer
Posted by Geezer on February 21, 2002, at 11:08:54
In reply to Re: Dexedrine Tolerance? A Theory » Geezer, posted by fachad on February 21, 2002, at 8:21:28
fachad,
Thank you so very much for your response RE: pstims. You have answered a question that goes far beyond casual interest in terms of importance.
The key factor you mentioned - "zap" = EURPHORIA, I believe and agree, is the predictor to good therapeutic treatment OR tolerance, abuse and serious consequences. My last experience with Dex. was 1985 (had abuse going back to 1962-intermittent). I started with 15mg. in AM, 4 months later I had increased the dose to 150mg. per day (honest). This episode required my full attention all day every day. I had 5 different docs writing scripts-had them filled at 5 different drug stores.
What ended the run? A pharmacist recognized my abuse and confronted me. He made it clear - detox. or else!
Here is what I have learned:
1) One size does not fit all. Pstims can be a blessing for some folks with depression and add but a potential death sentence for others with unstable mood disorders (I have Bipolar II-DXed in 2001).
2) The "zap theory". Any thing that makes you feel like Super Man with the first dose is no good for you.
3) Self medication based on my own subjective and flawed knowledge of psyc. meds. may result in a poor outcome.
4) A CORRECT DX is essential for treatment (never trust a pdoc that won't share the DX with you).
5) Modern day Mood Specialists (Psychopharmacologists) and contemporary psyc. drugs offer me a much better chance at survival (IMHO and yes I do men survival) than I had 30 years ago.Thanks fachad.....I take your post as much more than "just a guess". Important stuff to a "Geezer" looking for answers.
Posted by IsoM on February 21, 2002, at 13:01:23
In reply to Re: Dexedrine Tolerance? A Theory » Geezer, posted by fachad on February 21, 2002, at 8:21:28
I think it sounds like a pretty good guess but...
I can develop a tolerance to Dexedrine & I do experience that inital euphoria. But my 26 yr old son can also develop a tolerance to it & feels no euphoria on it at all. I was surprised he didn't - I assumed everyone would & questioned him about it. It only serves to keep him awake & focused. No euphoria whatsoever.
Posted by IsoM on February 21, 2002, at 13:06:20
In reply to Re: Dexedrine Tolerance? A Theory, posted by Geezer on February 21, 2002, at 11:08:54
Geezer, please read my response to fachad about tolerance. I hope you guys don't mind me throwing this monkey wrench in the works but when I'm trying to understand or develop my own theory, I want to hear ALL possible reasons & views so as to eliminate what may not be correct.
My own 'quest', so to speak, is to better understand the pharmokinetics (sp?) of adrafinil/modafinil & the reasons for such different reactions in different individuals. There's so little real, solid medical info or studies on them.
Posted by christophrejmc on February 21, 2002, at 14:34:48
In reply to Re: Dexedrine Tolerance? A Theory » fachad, posted by IsoM on February 21, 2002, at 13:01:23
> But my 26 yr old son can also develop a tolerance to it & feels no euphoria on it at all. I was surprised he didn't - I assumed everyone would & questioned him about it. It only serves to keep him awake & focused. No euphoria whatsoever.
I don't experience euphoria from stimulants (Ritalin, Dexedrine, Adderall), but I do develop tolerance to the stimulating properties (I can take a moderate dose and I'll still fall asleep). It still helps with ADD, just not fatigue. I had the same problem with Provigil -- it still helps with motivation, but not with fatigue (I would probably continue to use it if it didn't aggravate my back pain). Can you describe the euphoria you experience? (I overdosed on Dexedrine as a teen, but it only made me hallucinate.)
-chris
Posted by Zo on February 21, 2002, at 15:03:33
In reply to Re: Dexedrine Tolerance?, posted by Geezer on February 20, 2002, at 10:12:05
I think I would disagree with Elizabeth on the grounds that most ADs are incomplete, and I, for one, can't live without supplemented dopamine--and am (damn) highly allergic to Wellbutrin.
In my view, augmenting is rounding out the package, in one aspect or another--or it is the mysterious "booster" effect one drug can have for another, or synergistic.
I don't like the word stimulant, because it suggests a certain affect. For me and others with ADD and like conditions, Dex and similar meds are "organizing." While some theorize that they do indeed stimulate the left brain executive function to keep up with rock and roll right brain, that, in the end, has a "normalizing" effect.
In my experience, the fact that Dex and Adderall can leave one jazzed, depending on dose, is thorougly beside the point of their real purpose, and those effects should be dealt with on that basis, not as a contraindication.
Zo
Posted by Zo on February 21, 2002, at 15:05:48
In reply to Re: Dexedrine Tolerance? A Theory, posted by Geezer on February 21, 2002, at 11:08:54
I don't know what this proves. . but I had undiagnosed Bipolar II for several years while on Dexedrine, and it certainly did not aggravate it. If anything, it was stabilitizing because organizing.
Zo
Posted by Zo on February 21, 2002, at 15:12:18
In reply to Re: Dexedrine Tolerance? A Theory » IsoM, posted by christophrejmc on February 21, 2002, at 14:34:48
Another complicating factor: Some--a very few--people are put to sleep by Dex and similar meds. My pdoc has one patient who takes hers before bed. This doesn't mean it's not doing it's job! It means she's lucky, she doesn't need a sleeping pill! Maybe Dex won't "cure" your fatigue, but perhaps it will help with ADD/focus. . .etc. One must be careful not to throw the baby out with the bathwater. . and not to dismiss a whole class of meds. Nor to expect any one med to Solve All. Whatever med makes you alert--that's the one that makes you alert! I use well-timed Dex, organic coffee and green tea! To each her own!
And hey, you gotta get excellent sleep!
Zo
Posted by Geezer on February 21, 2002, at 15:23:50
In reply to Re: Dexedrine Tolerance? A Theory » Geezer, posted by IsoM on February 21, 2002, at 13:06:20
> Geezer, please read my response to fachad about tolerance. I hope you guys don't mind me throwing this monkey wrench in the works but when I'm trying to understand or develop my own theory, I want to hear ALL possible reasons & views so as to eliminate what may not be correct.
>
> My own 'quest', so to speak, is to better understand the pharmokinetics (sp?) of adrafinil/modafinil & the reasons for such different reactions in different individuals. There's so little real, solid medical info or studies on them.Hi IsoM
Good to hear from you. No monkey wrench at all!! I did as you suggested and went back and read your post to fachad. Also read my response to fachad - I should have said in #2...anything that makes ME feel like....is no good for ME. I know you are not challanging and like you I try so hard to find REAL answers. I don't think I can provide a better answer than you have in your post. Very possible the answers we are looking for in these meds. are not there (at least not yet). That's why I find comments like "everyone is different" very annoying - maybe the better thing to say is "I don't know" (and the truth be known neither does anyone else). I do believe a correct dx is important, I have experienced some of the drugs that diden't work (some that did more harm than good). I read a comment on another site the other day "defining the etiology of a mood disorder is like nailing jello to a tree". Hate to consider the possibility of psych drugs in the same vain - so I just choose not to.
Very best
Geezer
Posted by BLPBart on February 21, 2002, at 15:39:31
In reply to Re: Addiction to Dexedrine, posted by Scott L. Schofield on January 16, 2000, at 20:51:17
I am currently on dex and wellbutrin. I started on prozac which made me nearly catatonic. My pdoc added wellbutrin which helped some with energy but eventually I had to quit the prozac entirely. It has been a couple of months now without the prozac and the wellbutrin seems to be working fine on the depression. Interestingly, in doing my reading on this forum, I came across some information concerning ADD and found out that I have it. My doc added the dexedrine two weeks ago. He's starting me out on a very low dose (10 mg/day for the first week and then add 10 mg/day for the next week and so on). I'm only on my second week and so I'm only on 20 mg/day and so far I don't think I've reached a high enough dose yet. Interestingly, since wb is fairly stimulating on its own, it helped a little with the disorganization problems even before I started the dex. I'm hoping that next week at 30 mg/day will be the right dosage for me.
Posted by BLPBart on February 21, 2002, at 15:55:20
In reply to Re: Dexedrine Tolerance?, posted by Geezer on February 20, 2002, at 10:12:05
My dr gave me an interesting analogy about how different people respond to pstims. This was actually in regard to ADD people vs. "normal" people. He said that normal (i.e. non-ADDers) will respond initially to a low dose of pstims with a little more energy and focus than they normally would. As you increase the dosage, their reaction continues to increase along with it until you get to a point where the person is agitated and can't take any more. In other words the response is linear. He said that if you give pstims to a person with ADD that at a dose below what is therapeutic for them they don't feel anything. As you raise the dosage to a therapeutic level then the reaction is like a light switch being turned on. There's not a gradual response but a sudden one when the right dosage is reached. In my case my pdoc started me on 10 mg/day of dexedrine spansules and has me increasing by 10 mg/day each week. I'm only on 20 now and can't even tell that I'm taking anything.
Posted by christophrejmc on February 21, 2002, at 18:38:19
In reply to Re: Dexedrine Tolerance? A Theory » christophrejmc, posted by Zo on February 21, 2002, at 15:12:18
Well, it's not just fatigue... I take several "mini-naps" throughout the day -- I have an uncontrolable urge to sleep, and so I nod off for about 5-15 minutes, often leaning against a wall (no matter how much I sleep at night). Stimulants don't make me drowsy, they simply don't help keep me awake after a few days. I don't expect anything to cure all my symptoms (I have taken stimulants off and on for many years), but I'd like to find one that at least helped with this particular one.
-chris
Posted by Frankie on February 22, 2002, at 1:21:15
In reply to Re: amphetamine for depression, posted by BLPBart on February 15, 2002, at 9:28:23
Hello guys,
I would first off, not recommend taking a stimulant with an MAO-I. Most drug books warn against this. I have heard the good about particularly Nardil and Parnate. I used St. John's Wort for years, which has some MAO-I action, and it worked really well, for a cheap over the counter herbal remedy. So, I am sure both of these medications are very effective. I would watch the blood pressure though with the combination. Amphetamines will be wonderful for depression, but only if you have the lethargic type. If you are unmotivated, unwanting to get out of bed, always tired, etc... Ritalin, Dex., Adderal, will all be great additions. But, if you are the anxious depressive type, like I am, I would not advise the stimulant. The MAO-I will be great for this, but the stimulant will increase any type of anxiety disorder. I tried a small dose of Ritalin recently, and my head felt like it was going to explode. My mind was out of control! But, Ritalin is pretty harsh. Dex. is much milder. I believe that the key is elevating all the neurotransmitters somewhat with resistant depression. If it is more lethargic, shoot for a Wellbutrin, or Adderal, in combination with a low dose of an SSRI. If it is anxiety based, an MAO-I, or SSRI in combination with a small dose of a benzodiazepine. That is the combo I find most effective. The MAO-I's are the most versatile, from what I have read. I have yet to try one though. I don't want to have to watch everything I eat for fear of a fatal reaction.
Frankie.
Posted by Zo on February 22, 2002, at 2:05:28
In reply to Re: Dexedrine Tolerance? A Theory » Zo, posted by christophrejmc on February 21, 2002, at 18:38:19
Haven't followed yr. posts--just got back--but that sure sounds like no REM sleep, which I've had, and I sympathize. . .Have you looked at the sleep angle? Apnea? Narcolepsy? Sleep study?
Zo
Posted by IsoM on February 22, 2002, at 2:51:41
In reply to Re: Dexedrine Tolerance? A Theory » IsoM, posted by christophrejmc on February 21, 2002, at 14:34:48
Poor Chris, it's sure no fun being sleepy all the time. I was always battling a strong desire to crawl back to bed & sleep. Of course, when I'm working there's no bed nearby so I spent my working time (even when actively working) yawning & wiping tears from my eyes from yawning so much. Like you, I could still sleep on Dexedrine - not always but if I was sleepy enough, I could sleep right throught the dose. It never prevented me from falling asleep but it did keep me more alert & if I was busy, I wouldn't want to fall asleep then.
Adrafinil sure keeps me going now. Today, I worked about the place, lots of up & down the stairs active work. I had music going & regularly stopped to dance with certain songs. Went off to work this afternoon/evening shift & was VERY busy (I think I can outwalk anyone at work). I'm getting tired now but it's 12:40 AM - I should be now! My energy has never been a problem, but I didn't have this much stamina before. It's a great feeling.
Blithering on again... back to the question you asked. The euphoria I felt on Dexedrine wasn't a mania at all but a good, pleased elated feeling, sort of benevolent to everyone. Stupid or thoughtless people didn't get on my nerves & I felt very cheerful. Just much more magnanimous in general. Maybe my definition of euphoria isn't everyone's.
I agree with Zo. Have you looked into the possiblity you might have narcolepsy? It ranges in a spectrum from very severe to mildly.
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