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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by blackrain on December 29, 2002, at 9:41:36
Hi,
my question is simply: what are best and faster AD (of every kinda) for enhance mood?
I've my mood under my shoes!
This is all!
Thanx to everybody for your help
BRain
Posted by linkadge on December 29, 2002, at 15:11:30
In reply to What are best ADS for fast enhance of MOOD?, posted by blackrain on December 29, 2002, at 9:41:36
This may be atypical but I
felt very high after a single dose
of celexa, this effect wore off the
second day and I felt low again (although
much less anxious) slowly over the next
few weeks my mood rose to a normal level.Linkadge
Posted by BrittPark on December 29, 2002, at 20:46:42
In reply to Re: What are best ADS for fast enhance of MOOD?, posted by linkadge on December 29, 2002, at 15:11:30
When I first started taking imipramine 20 years ago, I felt much less anxious almost immediately and my mood was enough better within a few days to actually read a book. Before the medication I was in the throws of a severe depression, agoraphobia, and panic attacks and could do very little other than lie on the living room couch watching television re-runs and feeling hopeless.
As usual there are some disclaimers, I may well have been experiencing an active placebo effect since initiating TCA therapy is very noticable in terms of sedation. This is just my experience.
There is some evidence, however, that xanax (not an antidepresant by chemistry) can act as an antidepressant for people with mild depression. If it does act as an antidepressant it does so very quickly, sometimes with the first dose.
There is also some evidence that Pindolol in combination with an AD works more rapidly than the AD alone.
Just my 2 bits,
Britt
Posted by fachad on December 30, 2002, at 12:49:07
In reply to What are best ADS for fast enhance of MOOD?, posted by blackrain on December 29, 2002, at 9:41:36
In theory, all ADs work pretty slow, taking 4 to 8 weeks for *full* effect.
Each time a new drug comes out, the manufacturer claims it provides more rapid relief, but the studies are shakey.
Rapid efficacy has been claimed for Effexor and Remeron.
Personally, I find that some of the more potent sedative TCAs like doxepin and trimipramine make me feel better almoast immediately - within an hour of taking the first pill I feel a bright warm fuzzyness.
These drugs are not supposed to do that - they are not controlled substances and are not supposed to "feel good", but for me they do. Remeron is also this way for me.
YMMV
Posted by judy1 on December 30, 2002, at 21:29:07
In reply to What are best ADS for fast enhance of MOOD?, posted by blackrain on December 29, 2002, at 9:41:36
well let's see- I landed up in the hospital with a manic episode on prozac, but that's probably not what you're looking for. I have to agree with Fachad that remeron works well and quickly, you might want to try that. best of luck- judy
Posted by viridis on December 31, 2002, at 0:46:20
In reply to Re: What are best ADS for fast enhance of MOOD? » blackrain, posted by judy1 on December 30, 2002, at 21:29:07
I think that almost all ADs require an "adjustment" period of several weeks, although a few people seem to respond more quickly. My psychiatrist told me that for severely depressed patients, it's sometimes necessary to use a fast-acting stimulant such as Ritalin or an amphetamine to help "snap them out of it" while introducing an AD.
I should add that he also said this must be done with extreme caution and close monitoring -- he's very careful with stimulants, but will use them when he deems it necessary.
For me, benzos have the quickest AD effect, because my depression seems to be caused almost exclusively by anxiety.
Posted by viridis on December 31, 2002, at 1:15:30
In reply to Re: What are best ADS for fast enhance of MOOD?, posted by viridis on December 31, 2002, at 0:46:20
I should mention that I also have ADD, and derive antidepressant effects fom Adderall (an amphetamine mix) as well. But I still regard Klonopin as my primary antidepressant, with Adderall an excellent enhancer.
BTW, I can't tolerate SSRIs or Wellbutrin at all, although these drugs are great for some people.
Posted by JohnL on December 31, 2002, at 7:11:50
In reply to What are best ADS for fast enhance of MOOD?, posted by blackrain on December 29, 2002, at 9:41:36
Hi,
My opinions here for the best ADs for fast enhancement of mood are totally unscientific. They are based on observations over the years.
I think the AD that works the fastest is the one that combats the person's brain chemistry problem the most directly. Is the person's depression related to the serotonin system? Or is it norepinephrine? Dopamine? Are levels too low? Too high? Receptor binding problems? Malformed or damaged receptors? Electrical instability? We don't know any of these things until we try various medications. Trial and error is the only way to gather clues as to what the underlying brain problem is.
With me, for example, none of the SSRIs did much. After a couple years, it became apparent to me that my symptoms were not directly related to the serotonin system. My problems were elsewhere.
But the TCA Desipramine worked wonders for me in ONE DAY and continued afterward. That was a pretty strong clue that my problems were in the norepinephrine or dopamine circuitry, not serotonin. The side effects were too harsh for me though.
The European antipsychotic/antidepressant Amisulpride begins working for me at day 2, and I reach a level of at least total recovery or even better in one week, every time. It has a side effect of impotence for me that prevents me from taking it regularly.
So the best ADs for fast enhancement of mood, for me, are Amisulpride or Desipramine. But for someone else who has a different brain chemistry problem, these drugs might do nothing for them. It all depends on what the person's unique brain chemistry problem really is and how well a particular drug targets that problem directly (versus indirectly through cascade chain reactions, which takes time if it ever works at all).
As a blanket approach for the general population, the combination of Prozac plus Zyprexa, initiated at the same time, shows anecdotal evidence of being effective for many people within one week. My GP tells me he is having a great deal of success with Zyprexa combined with any of the SSRIs.
If someone is in real bad shape and needs to be lifted up immediately, Ritalin or Adderall can do that for many people, while they wait for their AD to take over (if it's going to).
Many opinions on this topic, I'm sure. I just feel that the fastest AD is the one that targets the real problem in the most direct manner. It will be different for every person, since we all have unique genes, chemistry, personality and circumstances.
JohnL
Posted by Dave1 on December 31, 2002, at 23:53:11
In reply to Re: What are best ADS for fast enhance of MOOD? » blackrain, posted by fachad on December 30, 2002, at 12:49:07
How about SSRI + Pindolol. The research supports this.
Dave
Posted by cybercafe on January 1, 2003, at 3:43:41
In reply to Re: What are best ADS for fast enhance of MOOD?, posted by Dave1 on December 31, 2002, at 23:53:11
> How about SSRI + Pindolol. The research supports this.
>does that include effexor?
i wonder how effexor differs (low dose) than other SSRIs..... enough to warrant its popularity, that is
Posted by JohnL on January 1, 2003, at 4:12:22
In reply to Re: What are best ADS for fast enhance of MOOD?, posted by Dave1 on December 31, 2002, at 23:53:11
Forget Pindolol.
Does scientific evidence support Pindolol? Some of it no, more of it yes.
But the real proof is right here at Psychobabble. If you search the archives going back as far as you want, you will find ZERO people who have tried it and found longlasting results. Every now and then we here of someone who gets an initial bump from it, but that's about it.I tried it myself a few years ago and got a lot of exhaustion and fuzzy headedness from it. It had no psychiatric benefits for me at all. And like I said, compared to other alternatives, you would have to search far and wide to find real people doing well with Pindolol.
JohnL
Posted by blackrain on January 1, 2003, at 7:54:46
In reply to Re: What are best ADS for fast enhance of MOOD?, posted by cybercafe on January 1, 2003, at 3:43:41
What do you mean about low dosage of effexor (75mg XR)?
Why it is different than other SSRIs?
You think it acts differently from celexa, paxil, proxac....etc.
Please let me know something more!
Thanx
BRain> does that include effexor?
>
> i wonder how effexor differs (low dose) than other SSRIs..... enough to warrant its popularity, that is
>
>
Posted by neo on January 1, 2003, at 8:44:47
In reply to Re: What are best ADS for fast enhance of MOOD?, posted by JohnL on December 31, 2002, at 7:11:50
Hi,
John I'm completely agree with you!
My exp is esemplar:
I was 15 d on rebox: first 2 d i felt better and actived, after i began to do awful thoughts about useless of life, suicide, remained all day in bed watching ceilig and thinking how ignoble man i am.
I went off and after 2 d felt better again, no more wanna kill myself,....
But i know that someone (...few) got better on rebox and felt more active and mood elevated.
In this way i am totally agree with you: probably i do not need to enhance norepinephrine ulike other people.
Every one is different and speak about what was useful for me or for you is, at the end, probably useless.
Happy new year to you all!!!!!
Bye
Neo
Posted by cybercafe on January 1, 2003, at 15:18:34
In reply to Re: What do you mean about EFFEXOR L.Dose? » cybercafe, posted by blackrain on January 1, 2003, at 7:54:46
> What do you mean about low dosage of effexor (75mg XR)?
> Why it is different than other SSRIs?
> You think it acts differently from celexa, paxil, proxac....etc.
> Please let me know something more!
> Thanx
> BRainat higher dosages (above 225 mg?) it begins to work on norepenephrine as well...
it also seems to have dopamine antagonism at lower dosages, but behaves as an agonist at higher dosages
not too sure about the dopamine thing, though
Posted by Caleb462 on January 2, 2003, at 13:52:54
In reply to Re: What do you mean about EFFEXOR L.Dose?, posted by cybercafe on January 1, 2003, at 15:18:34
> > What do you mean about low dosage of effexor (75mg XR)?
> > Why it is different than other SSRIs?
> > You think it acts differently from celexa, paxil, proxac....etc.
> > Please let me know something more!
> > Thanx
> > BRain
>
> at higher dosages (above 225 mg?) it begins to work on norepenephrine as well...
> it also seems to have dopamine antagonism at lower dosages, but behaves as an agonist at higher dosages
> not too sure about the dopamine thing, though
150 mg is the dose where norepinephrine begins to play a signifigant role, though there is some mild norepinephrine activity at the low doses as well. This could explain the subtle differences between low dose Effexor, and say, Celexa.It goes SOMETHING like this:
Low doses (37.5 mg to 75 mg): Serotonin Reuptake Inhibitor
Medium doses (150 mg and above): Serotonin Reuptake Inhibitor/Norepinephrine Reuptake Inhibitor
Large doses (Not sure the figures, but my assumption is in the 300-500 mg range): Serotonin Reuptake Inhibitor/Norepinephrine Reuptake Inhibitor/Dopamine Reuptake Inhibitor
This is the end of the thread.
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