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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 43. This is the beginning of the thread.
Posted by qbsbrown on January 16, 2006, at 22:47:22
I believe that this is where my problems lies.
So this would be which ones cymbalta, effexor, prozac?????I just moved to china, and can not find any cymbalta.
I have symptoms of depression, ocd, bpII, panic, GAD.Thanks guys.
PS- im affraid of prozac w/ sexual SE, i never have from effexor.
Posted by davpet on January 16, 2006, at 23:50:40
In reply to Which ADs increase DOPAMINE the most?, posted by qbsbrown on January 16, 2006, at 22:47:22
Concerta (slow-release Ritalin) although not technically an AD is a dopamine re-uptake inhibitor.
Amineptine was an AD that was a dopamine re-uptake inhibitor , but it was removed from the market due to abuse potential . Its repalcement tianeptine (a serotonin re-uptake accelerator) was thought to have a similar effect without the abuse potential of amineptine.
Posted by yxibow on January 17, 2006, at 2:14:21
In reply to Re: Which ADs increase DOPAMINE the most?, posted by davpet on January 16, 2006, at 23:50:40
As for the SSRIs, Zoloft increases Dopamine slightly I believe. Not necessarily clinically significant although there have been a few cases of TD with it.
Posted by Tom Twilight on January 17, 2006, at 4:21:13
In reply to Re: Which ADs increase DOPAMINE the most?, posted by davpet on January 16, 2006, at 23:50:40
ADs that increase dopamine
(I'm listing ADs here, not stimulants)1. Parnate-Don't forget this one, the most doperminagic MAOI, other than Deprenyl.
2. Wellbutrin-Increases Dopamine, I think!
3. Deprenyl/Sellegiline-MAO-B inhibitor
4. The wonderful Amneptine as Davepet mentioned, it all but impossible to get hold of though!
Thats all I can think of of the top of my head right now
I don't mean to cause offence, to Dave but I don't think Tianeptine should be compared to Amneptine
Although there structurally similar Tianeptine has quite different effects.
Posted by blueberry on January 17, 2006, at 5:08:47
In reply to Which ADs increase DOPAMINE the most?, posted by qbsbrown on January 16, 2006, at 22:47:22
Prozac, zoloft, cymbalta, wellbutrin, and effexor do increase dopamine levels. In my own personal trials, I felt the most dopamine effect from prozac. But with any of them, the effects on other neurotransmitters might over ride the effects on dopamine. And with any of them, increased anxiety is a common early side effect that may or may not go away.
Zyprexa increases dopamine. The effect is more pronounced when combined with prozac. This would be a popular common prescription for your symptom cluster.
Stimulants and deprenyl could work, but the issue of anxiety could be a problem.
Herbs would include St Johns Wort, Pycnogenol, or Rhodiola Rosea. Of them all, I liked SJW a lot. It did cause early restlessness similar to anxiety, which after a couple weeks turned into a nice warm comfortable yet motivating anti-anxiety effect.
In my own personal trials, trying to predict which med or herb would work based on its mechanism proved fruitless. The only real way to find out is to try and see. Of everything mentioned here, I personally would go for SJW first and give it 30 days. If improvement, stay with it. If no improvement, move on. On paper anyway, it has qualities to it that seem to fit all of your symptoms, and it's cheap with fewer side effects than the meds.
Posted by blueberry on January 17, 2006, at 5:25:12
In reply to Which ADs increase DOPAMINE the most?, posted by qbsbrown on January 16, 2006, at 22:47:22
Forgot to mention Amisulpride or Sulpiride. Not sure if they are available in your country. They are antipsychotics but also antidepressants. All they do is increase dopamine with no effects on anything else. I've tried amisulpride before, and it was a real good antidepressant and anti-anxiety med, though there were some early anxiety side effects. But I stopped because the sexual side effects were intense...increased hormone prolactin levels.
Posted by SLS on January 17, 2006, at 11:24:19
In reply to Which ADs increase DOPAMINE the most?, posted by qbsbrown on January 16, 2006, at 22:47:22
To anyone:
What leads you to believe that Parnate is more dopaminergic than Nardil?
How easy is it to dispell the notion that it is actually Nardil that ultimately produces the greatest increase in the activity of those dopaminergic pathways involved in depression?
Just asking.
- Scott
Posted by linkadge on January 17, 2006, at 12:59:41
In reply to Re: Which ADs increase DOPAMINE the most?, posted by SLS on January 17, 2006, at 11:24:19
Thats a good question, and I don't know the answer. Two hypothesis would be the following:
1. Nardil has an effect on gaba metabolism. Gaba
asserts an inhibitory controll over
dopaminergic synapses.2. Parnate is structurally related to
amphetamine, (although it is debated as
to whether parnate posesses any stimulant-like
effect on dopamine release). There are case
reports of Parnate abuse, whereas I don't know
of any for Nardil.Linkadge
Posted by Tom Twilight on January 17, 2006, at 16:43:44
In reply to Re: Which ADs increase DOPAMINE the most?, posted by linkadge on January 17, 2006, at 12:59:41
I'm not absolutely sure why I think Parnate is more dopermanagic than Nardil.
I've tried neither Nardil nor Parnate, so I guess its lots of different pieces of information that led to associate Parnate with Dopamine.
I think Linkadge makes some good points, Parnate has somewhat Amphetamine like structure, and tends to be more stimulating than Nardil (although Parnate isn't always stimulating)
There also this piece of information:
http://www.biopsychiatry.com/tranylmoc.htm
Posted by qbsbrown on January 17, 2006, at 17:11:47
In reply to Which ADs increase DOPAMINE the most?, posted by Tom Twilight on January 17, 2006, at 16:43:44
So my question is, if i were to go w/ an AD, one that works with dopamine (even slightly), and has least sexual side-effects, which would it be? Top 3 please?
I have lexapro and paxil, but think both diminish dopamine, right? Same w/ my klonopin that im weaning off of.
Posted by qbsbrown on January 17, 2006, at 17:27:42
In reply to Re: Which ADs increase DOPAMINE the most?, posted by blueberry on January 17, 2006, at 5:08:47
If anxiety issues are at my core, wouldn't Wellbutriin be a bad idea?
or could it have an opposite (ritalyn) effect?Regards,
Brian
Posted by luca1975 on January 17, 2006, at 17:36:41
In reply to Re: Which ADs increase DOPAMINE the most?, posted by qbsbrown on January 17, 2006, at 17:27:42
The idea that wellbutrin increases anxiety has been exagerated. It causes mild increases in anxiety the first few days, afterwards I found it had a slight calming effect.
Posted by yxibow on January 17, 2006, at 19:11:55
In reply to Re: Which ADs increase DOPAMINE the most?, posted by luca1975 on January 17, 2006, at 17:36:41
> The idea that wellbutrin increases anxiety has been exagerated. It causes mild increases in anxiety the first few days, afterwards I found it had a slight calming effect.
In some, just as Adderall, Concerta, Strattera, Effexor, and other stimulants, are akin to fighting fire with fire and diminish certain anxiety disorders and depressive conditions.
However I've always had both anxiety and depression... although Wellbutrin was great for my libido, it was atrocious for my OCD. I had repetitive thoughts at night and couldn't sleep. Had to augment with Klonopin. At some point it was a zero sum gain.
It is related to the illegal drug Khat (cathinone) and is derived from diethylpropion (Tenuate), an amphetamine like weight loss drug from the 70s? which is not used much any more (strangely it is still listed at Walgreens.) So this explains why it will increase anxiety in some who are already predisposed in that direction.
Posted by Phillipa on January 17, 2006, at 19:16:17
In reply to Re: Which ADs increase DOPAMINE -- Wellbutrin » luca1975, posted by yxibow on January 17, 2006, at 19:11:55
Wellbutrin signigicantly incresed anxiety for me. Fondly, Phillipa
Posted by willyee on January 17, 2006, at 19:49:57
In reply to Re: Which ADs increase DOPAMINE the most?, posted by luca1975 on January 17, 2006, at 17:36:41
Dont think its exgareated.......from reading it seems certain people simply respond to wellburtin postivly.......and for a good number it cause severe anxiety.......who which again shows us were so off with our LOW SEROTIONION excuse my depression......who knows what is really going on,possable the cause of depression varies chemicaly in form from individual to invidual.
Posted by blueberry on January 17, 2006, at 21:32:01
In reply to Re: Which ADs increase DOPAMINE the most?, posted by qbsbrown on January 17, 2006, at 17:11:47
St Johns Wort. I mean, since you asked for the top three, that would be my first choice. But, understand everyone will have a different opinion.
I'm thinking dopamine...st johns wort is strong on that. It affects serotonin, norepinephrine, dopamine, gaba, and glutamate all with about equal affinity. Very balanced. Of the 30 or so meds I've been on over the years, nothing ever came close to being as good as SJW for me.
I'm thinking side effects, especially sexual...st johns wort usually does not have sexual side effects and often increases sex drive due to lowering of prolactin levels. Other side effects such as possible tiredness, restlessness, insomnia, or gastrointestinal discomfort are usually mild and go away within two weeks, and are nothing compared to medications.
Sure I could come up with some med choices too. But why? SJW has everything you are looking for, it is cheap, far easier on side effects, and it has the same likelihood of working as any of the meds.
Posted by shasling on January 17, 2006, at 23:16:54
In reply to Re: Which ADs increase DOPAMINE -- Wellbutrin, posted by Phillipa on January 17, 2006, at 19:16:17
> Wellbutrin signigicantly incresed anxiety for me. Fondly, Phillipa
Made me want to kill people. Other posts as well of people who developed rage in response to it. Wellbutrin.Might want to read up on Pergilode. Purely a dopamine agonist, and I recently read a study that said it tends to work very well at improving dopamine-dependent responses when taken with "another AD". If taken alone, not much response, but with an AD it does. I thought that curious... Seems worth looking into.
Posted by yxibow on January 18, 2006, at 0:24:31
In reply to Re: Which ADs increase DOPAMINE -- Wellbutrin, posted by shasling on January 17, 2006, at 23:16:54
Do remember that Pergolide is an ergot derived anti-Parkinsonism that targets D1 and D2 and anyone who may have the signs of psychosis probably should be precautious of it as it is one the two most common (3:1) side effects. The other is dyskinesia.
Posted by redscarlet on January 18, 2006, at 8:12:15
In reply to Re: Which ADs increase DOPAMINE -- Wellbutrin, posted by shasling on January 17, 2006, at 23:16:54
I too developed rage in response to Wellbutrin (not like me).
It took a long time for me to find out what was causing it but I will not take that stuff again.
Posted by shasling on January 18, 2006, at 11:39:35
In reply to Re: Which ADs increase DOPAMINE -- Wellbutrin » shasling, posted by yxibow on January 18, 2006, at 0:24:31
> Do remember that Pergolide is an ergot derived anti-Parkinsonism that targets D1 and D2 and anyone who may have the signs of psychosis probably should be precautious of it as it is one the two most common (3:1) side effects. The other is dyskinesia.
True, as with any efforts to affect a blanket increase in dopamine...
In fact, even if one has no existing signs of psychosis, tampering with dopamine can precipitate them.
Posted by idolamine on January 18, 2006, at 16:03:59
In reply to Which ADs increase DOPAMINE the most?, posted by qbsbrown on January 16, 2006, at 22:47:22
I read that wellbutrin preferentially blocks the reuptake or norepi, and not dopamine very much. Amineptine would do this. idolamine.
Posted by jerrympls on January 18, 2006, at 19:16:38
In reply to Re: Which ADs increase DOPAMINE the most?, posted by blueberry on January 17, 2006, at 5:08:47
The big problem is trying to get a doctor to prescribe something that increases release and/or synthesis of dopamine. Many docs won't do anything with a med if it's off-lable - which is sad because there are so many meds out there that, when used off-lable, could help those with hard to treat depression.
jerry
pharmacy student
Posted by cache-monkey on January 18, 2006, at 19:50:41
In reply to Re: Which ADs increase DOPAMINE the most?, posted by idolamine on January 18, 2006, at 16:03:59
Based on my experience and from what I've read here Wellbutrin can raise anxiety in a large class of people. Particularly those with a pre-existing anxiety condition. My experience parallels yxibow's: I had a huge increase in anxiety, leading to obsessive thinking way beyond my norm. Twas great for the libido and sexual function, though...
I think this has to do with the fact that when you take into account the total effect of Wellbutrin and its metabolizes, the impact is much stronger on NE reuptake than DA.
I would think that low-dose selegiline, with or without precursors, would be more preferential towards DA. At least that's my hope!
Good luck,
cache-monkey
Posted by djmmm on January 18, 2006, at 21:53:50
In reply to Re: Which ADs increase DOPAMINE the most?, posted by jerrympls on January 18, 2006, at 19:16:38
tianeptine (Stablon) can be legally purchased from many "smart-drug" and "antiaging" websites... Im not going to list the specific sites here...but Google will help.
Posted by shasling on January 18, 2006, at 23:21:33
In reply to Re: Which ADs increase DOPAMINE the most?, posted by djmmm on January 18, 2006, at 21:53:50
> tianeptine (Stablon) can be legally purchased from many "smart-drug" and "antiaging" websites... Im not going to list the specific sites here...but Google will help.
Is Stablon good? Have you taken it?Thanks
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