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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 loolot on September 1, 2003, at 22:23:44
Hi. I have been on Wellbutrin for 4 yrs as a depression treatment. I have done well on the medication but it has started to wear off, which has lead me down the treacherous road of trying new medicines to supplement the wellbutrin. I am now detoxing from effexor (150) and , after trying many seratonin-activating meds I have decided that they are not for me.
I have realised, as I am sure many have, that the meds which work for me are the dop/norep combinations. I have terrible asthma and the only thing which cures it is taking one of these meds with norepinephrine. My asthma continues to get worse as the wellbutrin wears off. The effexor totally helped the asthma, but the side effects (weight gain, sleepiness, and sexual dysfunction) were not worth it.
My doctor has prescribed provigal as an adjunct, and on my first day I have not seen any improvement, but of course I will stay on it for longer to make sure...
The next move is to try a low dosage of ritalin as an adjunct to the wellbutrin.
My questions are:
1 Are there any new meds which work on these vectors which I can try as an adjuct to, or a substitute for the wellbutrin
2 Is there any way to get the wellbutrin to work again? (I am on 450/day)
3 Is all of the dopamine dosing going to fry my brain, and will these meds simply continue to wear off bc I am becoming addicted to the pleasure center thing?
I am not really an addictive type, but I thought this could happen bc I respond so favorably to the dopamine.
Thanks in advance
I am now scattered, cant work, etc, and I would
Posted by loolot on September 1, 2003, at 22:47:11
It didnt look like that when I typed it, I swear!
Anyway, alls I want to do is find a new medication which works on dopamine and norepinephrine combination to supplement my ailing wellbutrin
Posted by loolot on September 1, 2003, at 22:51:36
In reply to dopamine/norepiephrine combo meds, posted by loolot on September 1, 2003, at 22:23:44
> Hi. I have been on Wellbutrin for 4 yrs as a depression treatment. I have done well on the medication but it has started to wear off, which has lead me down the treacherous road of trying new medicines to supplement the wellbutrin. I am now detoxing from effexor (150) and , after trying many seratonin-activating meds I have decided that they are not for me.
> I have realised, as I am sure many have, that the meds which work for me are the dop/norep combinations. I have terrible asthma and the only thing which cures it is taking one of these meds with norepinephrine. My asthma continues to get worse as the wellbutrin wears off. The effexor totally helped the asthma, but the side effects (weight gain, sleepiness, and sexual dysfunction) were not worth it.
> My doctor has prescribed provigal as an adjunct, and on my first day I have not seen any improvement, but of course I will stay on it for longer to make sure...
> The next move is to try a low dosage of ritalin as an adjunct to the wellbutrin.
> My questions are:
> 1 Are there any new meds which work on these vectors which I can try as an adjuct to, or a substitute for the wellbutrin
> 2 Is there any way to get the wellbutrin to work again? (I am on 450/day)
> 3 Is all of the dopamine dosing going to fry my brain, and will these meds simply continue to wear off bc I am becoming addicted to the pleasure center thing?
> I am not really an addictive type, but I thought this could happen bc I respond so favorably to the dopamine.
> Thanks in advance
>
> BTW I am now scattered, cant work, etc, and I would like a med to help with these symptoms as well>>I am attempting to repost this bc my last attempt came out looking like some kind of demonic text
Posted by Ame Sans Vie on September 1, 2003, at 23:40:23
In reply to Why did my post come out all messed up and typo'd?, posted by loolot on September 1, 2003, at 22:47:11
Hmm... for both norepinephrine and dopamine, Meridia or Sanorex could be possibilities. I know they're for weight loss, but they have strong NE/DA reuptake inhibition properties (and Meridia has a bit of a 5HT reuptake inhibition effect as well). Apart from that, I'd say your best options are stimulants -- Ritalin, Metadate, Concerta, Adderall, Dexedrine, DextroStat, or Desoxyn in particular.
Another option would be to combine a dopamine-agonist (e.g. Mirapex, Requip, Symmetrel) with a NE reuptake inhibitor (Strattera or Reboxetine).
Posted by loolot on September 2, 2003, at 2:46:28
In reply to Re: Why did my post come out all messed up and typo'd? » loolot, posted by Ame Sans Vie on September 1, 2003, at 23:40:23
Thanks so much for your reply.
I have thought of supplementing the wellbutrin with ritalin, I think my doctor didnt prescibe it initially because it is such a pain to prescribe due to the 'controlled substance' label.
Is ritalin very addictive, though? I worry that I am getting more and more addicted to the dopamine and norepinephrine (I have those nasty involuntary tics now).
Is this stuff dangerous for longterm use? Will I keep needing higher amounts over time?
Posted by Ame Sans Vie on September 2, 2003, at 12:04:44
In reply to ritalin, etc, posted by loolot on September 2, 2003, at 2:46:28
> Is ritalin very addictive, though? I worry that I am getting more and more addicted to the dopamine and norepinephrine (I have those nasty involuntary tics now).
One can develop a dependency to Ritalin or any of the amphetamines after a few weeks of continual use. But if you genuinely need them and plan on continuing to take them, dependency shouldn't be an issue. "Addiction" is a term loosely thrown around to refer to dependency *or* addiction, which are two very different things. Dependency simply means that your body and/or mind relies on the drug to function properly (e.g. a diabetic on insulin; a cancer patient on fentanyl; a mentally ill person on stimulants). Addiction, on the other hand, is more accurately described as a combination of dependency and abuse. The addict compulsively seeks out higher and higher doses of the drug just to stave off withdrawal symptoms and/or get high, regardless of any negative consequences (e.g. a heroin junkie, an alcoholic). So, in a nutshell -- yes, you will become dependent on a stimulant after several weeks of regular use, but it is not difficult to slowly taper off the drug should you ever decide you don't need it any more. Stimulants are only addicting if you abuse them.
However, you mentioned involuntary tics? From what? Wellbutrin? Stimulants will make those tics worse... perhaps you should consider another medication if the Wellbutrin is causing the tics. A combination of Strattera or Edronax and a dopamine agonist may work very well for you, but of course I'm just shooting in the dark here. :-) For what it's worth though, I've found dopamine agonists to be absolutely wonderful at increasing drive, motivation, libido, confidence, and decreasing depression. Mirapex and Requip are (arguably) the best for this purpose, as they have a higher affinity for the D3 receptor than other DA agonists currently marketed -- the D3 receptor is postulated to be responsible for the decrease in depression, confidence boost, and increased motivation especially. Both Mirapex and Requip also target D2 and D4 receptors (to a lesser degree), and I believe that it's the D2 receptor that is implicated in increased/decreased libido.
> Is this stuff dangerous for longterm use? Will I keep needing higher amounts over time?
Stimulants, especially the amphetamines, are very safe provided that one doesn't abuse them. Their safety record can be demonstrated by the fact that they were among the earliest antidepressants (along with opium and its derivatives), and have been used for many years quite safely. In fact, there were some drugs that used to be manufactured, and marketed for depression, that contained a combination of an amphetamine and a barbiturate. Dexamyl (dextroamphetamine + amobarbital) was one; Desbutal (dextromethamphetamine + pentobarbital) was another. Ritalin (methylphenidate, not an amphetamine) may be slightly more dangerous due its very strong peripheral effects (i.e. effects on heart rate, blood pressure, etc.). This can lead to cardiovascular problems if taken long-term, so I would stick with the amphetamines personally.
As for whether you'll develop tolerance to them, it has been my experience that you will not. I've taken amphetamines off and on for years, never developing any kind of tolerance. Yes, the initial "high" that you get from them will disappear, but in all likelihood, their DA/NE release and reuptake inhibition effects will remain and continue to be helpful. Though this is totally subjective, it may help if I tell you that I found Ritalin to be absolutely awful -- like drinking wayyyy too much coffee. Adderall (dextroamphetamine + levoamphetamine + racemic amphetamine) was all right, but it had some of those same peripheral effects Ritalin did, albeit at a lesser degree. Dexedrine (dextroamphetamine) and Desoxyn (methamphetamine) have both been great for me. No peripheral effects that I can detect, and I'm the type of person who can drink half a cup of weak coffee and be absolutely wired, lol. I've settled on Dexedrine as it seems to be a bit more helpful with my symptoms of ADD than Desoxyn, though Desoxyn seemed more energizing.
Posted by Dr. Bob on September 2, 2003, at 23:24:55
In reply to Why did my post come out all messed up and typo'd?, posted by loolot on September 1, 2003, at 22:47:11
> It didnt look like that when I typed it, I swear!
It looks like the "language" indicator got set to Spanish somehow?
Bob
Posted by loolot on September 3, 2003, at 2:01:11
In reply to Re: Why did my post come out all messed up and typo'd? » loolot, posted by Ame Sans Vie on September 1, 2003, at 23:40:23
Posted by Kacy on September 3, 2003, at 17:48:56
In reply to Thanks (nm) » Ame Sans Vie, posted by loolot on September 3, 2003, at 2:01:11
I'm looking for the ne/da combination too, so I appreciate your posts and Ame's answers.
But mostly, thanks for the nice laugh I got after I picked my way through your first post and then read your others. I had assumed you were new to English.
Posted by btnd on September 3, 2003, at 18:54:37
In reply to Re: ritalin, etc » loolot, posted by Ame Sans Vie on September 2, 2003, at 12:04:44
> > Is ritalin very addictive, though? I worry that I am getting more and more addicted to the dopamine and norepinephrine (I have those nasty involuntary tics now).
>
> One can develop a dependency to Ritalin or any of the amphetamines after a few weeks of continual use. But if you genuinely need them and plan on continuing to take them, dependency shouldn't be an issue. "Addiction" is a term loosely thrown around to refer to dependency *or* addiction, which are two very different things. Dependency simply means that your body and/or mind relies on the drug to function properly (e.g. a diabetic on insulin; a cancer patient on fentanyl; a mentally ill person on stimulants).
[...]> As for whether you'll develop tolerance to them, it has been my experience that you will not. I've taken amphetamines off and on for years,never developing any kind of tolerance. Yes, the initial "high" that you get from them will disappear, but in all likelihood, their DA/NE release and reuptake inhibition effects will remain and continue to be helpful.
>Though this is totally subjective, it may help if I tell you that I found Ritalin to be absolutely awful -- like drinking wayyyy too much coffee.
I haven't tried Ritalin, but coffee is awful for me at any dosage - makes my anxiety sky-rocket, more concentration/attention problems and definitely very bad experiences (I have almost all ADD symptoms and amphetamines, on the other hand, help tremendously - especially Dexedrine).BTW, AmeSansVie - great info on stimulants. I've been researching the tolerance/sensitivity issue of amphetamines for few days now and definitely partial NDMA antagonists (glutamate antagonists)help with it. I'll post more in a couple days.
Posted by btnd on September 3, 2003, at 19:32:59
In reply to Re: Great info on stimulants » Ame Sans Vie, posted by btnd on September 3, 2003, at 18:54:37
I'm also reading up on the subject of amphetamines and health issues. There are dozens of abstracts on amphetamines & methamphetamines effect on hepatatoxicity, problems with heart, hyperthermia, increase in free radicals, increase in TNF-alpha. But the doses mostly used are way too high (for example 4-8 mg/kg) when compared to psycho-therapeutic doses of Adderall/Dexedrine (up to 0.5 mg/kg). It'd be great if someone knows the abstracts & websites on side-effects (at what level the side-effects manifest?) of amphetamines when using 0.5 mg/kg (or no more than 1 mg/kg).
Posted by loolot on September 4, 2003, at 14:50:03
In reply to Re: Thanks loolot, posted by Kacy on September 3, 2003, at 17:48:56
> I'm looking for the ne/da combination too, so I appreciate your posts and Ame's answers.
>
> But mostly, thanks for the nice laugh I got after I picked my way through your first post and then read your others. I had assumed you were new to English.I liked it too! Not too useful here but made for some good avant garde prose!
I am starting to write to the drug complanies to urge them to research and develop a new AD which works on dp/ne. Maybe all of us can start a writing campaign...
This is the end of the thread.
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