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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by garylee on May 17, 2008, at 8:36:15
Hi to whoever's reading this post.
I have always responded well to Dopaminergics. Pramipexole 'almost' gave me full remission, or very, very close anyway. I tried Piribedil and Ropinerole with less effect than Pramipxole, so went back to Pramipexole. Unfortunatley it didn't work half as good at the first time, very saddening indeed...
I have since been looking for more Dopaminergics to try, especially one's that antagonise the D1 receptor. At present the only one on the market that even goes close to D1 is Pergolide. I was wondering if anyone had had any experience on this med? Bipolar's (type II/NOS) reply preferably but all comments welcome! :O)
Thanks
Gary
Posted by SLS on May 17, 2008, at 9:21:09
In reply to Pergolide for Bipolar. @ SLS, your comments pls?, posted by garylee on May 17, 2008, at 8:36:15
Hi Gary.
You could try Dostinex (cabergoline) or Trivestal (piribedil) as DA agonists.
How did Wellbutrin treat you? What about Emsam?
I am dubious that DA agonists will work for severe depression. My impression is that they don't work for very long before you get diminishing returns. I have seen this with pergolide. You could try Abilify in combination with Wellbutrin and Lamictal. It is a partial DA agonist. You might want to consider going with Nardil or Parnate. These MAOIs do a better job overall than Emsam.
- Scott
****************************************************> Hi to whoever's reading this post.
>
> I have always responded well to Dopaminergics. Pramipexole 'almost' gave me full remission, or very, very close anyway. I tried Piribedil and Ropinerole with less effect than Pramipxole, so went back to Pramipexole. Unfortunatley it didn't work half as good at the first time, very saddening indeed...
>
> I have since been looking for more Dopaminergics to try, especially one's that antagonise the D1 receptor. At present the only one on the market that even goes close to D1 is Pergolide. I was wondering if anyone had had any experience on this med? Bipolar's (type II/NOS) reply preferably but all comments welcome! :O)
>
> Thanks
>
> Gary
Posted by Racer on May 17, 2008, at 10:15:11
In reply to Pergolide for Bipolar. @ SLS, your comments pls?, posted by garylee on May 17, 2008, at 8:36:15
Pergolide is used to treat Cushing's in horses, and one symptom it seems to improve is depression. Of course, we don't know their subjective experience, but the pergolide does help them...
It's an interesting question. How would you rate your depression? Do you suffer severe, moderate, mild, variable depression? That might also make a difference.
Also, I don't tend to find it all that helpful to say, "oh, I need to boost this neurotransmitter or that." I find it a lot more helpful to say, "The medications which have helped me most have shared these characteristics as far as mechanism goes..." The neurochemistry of our brains is far more complex than anyone yet understands. I have no doubts that the ratios are more important than actual amounts of the three catecholamines we discuss most here.
It's worth considering those unexpected choices -- such as pergolide. I think, though, that it might be more helpful to consider them due to their effects in the body and even their side effects -- rather than concentrating on mechanism of action to any great degree.
Good luck.
Posted by llurpsienoodle on May 17, 2008, at 12:19:40
In reply to Re: Pergolide for Bipolar. @ SLS, your comments pl, posted by SLS on May 17, 2008, at 9:21:09
> Hi Gary.
Hi Scott
>
> You could try Dostinex (cabergoline) or Trivestal (piribedil) as DA agonists.
>
> How did Wellbutrin treat you? What about Emsam?
>
> I am dubious that DA agonists will work for severe depression. My impression is that they don't work for very long before you get diminishing returns. I have seen this with pergolide. You could try Abilify in combination with Wellbutrin and Lamictal. It is a partial DA agonist.*that is my combo right now, and some zoloft 100mg, which probably pooped out and is doing nothing, but why mess with a good thing?*
You might want to consider going with Nardil or Parnate. These MAOIs do a better job overall than Emsam.
>
>
> - Scott
>
>
> ****************************************************
>
>
>
>
>
> > Hi to whoever's reading this post.
> >
> > I have always responded well to Dopaminergics. Pramipexole 'almost' gave me full remission, or very, very close anyway. I tried Piribedil and Ropinerole with less effect than Pramipxole, so went back to Pramipexole. Unfortunatley it didn't work half as good at the first time, very saddening indeed...
> >
> > I have since been looking for more Dopaminergics to try, especially one's that antagonise the D1 receptor. At present the only one on the market that even goes close to D1 is Pergolide. I was wondering if anyone had had any experience on this med? Bipolar's (type II/NOS) reply preferably but all comments welcome! :O)
> >
> > Thanks
> >
> > Gary
>
>Good luck Gary-- I have bipolar II (NOS) and I have been kinda shaky lately. Hyperhappy one day and in the dumps the next. rapid cycling ugh.
-Ll
Posted by garylee on May 17, 2008, at 12:48:42
In reply to Re: Pergolide for Bipolar. @ SLS, your comments pl, posted by SLS on May 17, 2008, at 9:21:09
> Hi Gary.
>
> You could try Dostinex (cabergoline) or Trivestal (piribedil) as DA agonists.
>
> How did Wellbutrin treat you? What about Emsam?
>
> I am dubious that DA agonists will work for severe depression. My impression is that they don't work for very long before you get diminishing returns. I have seen this with pergolide. You could try Abilify in combination with Wellbutrin and Lamictal. It is a partial DA agonist. You might want to consider going with Nardil or Parnate. These MAOIs do a better job overall than Emsam.
>
>
> - ScottHi Scott
As I mentioned in my post, Trivestal didn't work as well as the Mirapex, I got some benefit but not half as much as Mirapex.
I have never tried Dostinex, maybe I will do some research on Google and see.
As for Wellbutrin, no help at all, as with all other antidepressants I have tried.
I got the idea to try a direct DA from my years of dabbling with Cocaine. The drug never got me 'high' as it did with my friends, I just felt 'normal' (though this is when I was also taking my Lamictal and Sulpiride, I may have been taking Donipazil at the time too?), so I researched DA's and found lots of lit on Pramipexole. Tried it and within about 4-5 days I was almost a normal person. Regulated sleep (though still taking Seoquel and Clonazepam), up early, getting down the gym and eating better (I have a slight eating disorder). Most things I could wish for. I just regret coming off it now as it didn't work as well second time around.
I take Lamictal already (I have just gone up to 400mg two days ago and feel much better) and had a good response to Abilify, but the consipation and akathisia was too much to handle.
The search goes on...
Gary
Posted by SLS on May 17, 2008, at 13:22:50
In reply to Re: Pergolide for Bipolar. @ SLS, your comments pl, posted by garylee on May 17, 2008, at 12:48:42
> The search goes on...
Nice positive and constructive attitude.
Keep on searching in the manner you demostrated with the DA agonists, and I believe you will find an answer.
- Scott
Posted by undopaminergic on May 21, 2008, at 7:11:06
In reply to Re: Pergolide for Bipolar. @ SLS, your comments pl, posted by SLS on May 17, 2008, at 9:21:09
I recommend against the ergoline-based dopamine agonists. There's a serious chance that they will mess up your cardiac valves if used in the long term, and another risk is fibrosis.
MAOIs, stimulants, memantine, amisuplpride/sulpiride, or a combination of them is preferable.
> Hi Gary.
>
> You could try Dostinex (cabergoline) or Trivestal (piribedil) as DA agonists.
>
> How did Wellbutrin treat you? What about Emsam?
>
> I am dubious that DA agonists will work for severe depression. My impression is that they don't work for very long before you get diminishing returns. I have seen this with pergolide. You could try Abilify in combination with Wellbutrin and Lamictal. It is a partial DA agonist. You might want to consider going with Nardil or Parnate. These MAOIs do a better job overall than Emsam.
>
>
> - Scott
>
>
> ****************************************************
>
>
>
>
>
> > Hi to whoever's reading this post.
> >
> > I have always responded well to Dopaminergics. Pramipexole 'almost' gave me full remission, or very, very close anyway. I tried Piribedil and Ropinerole with less effect than Pramipxole, so went back to Pramipexole. Unfortunatley it didn't work half as good at the first time, very saddening indeed...
> >
> > I have since been looking for more Dopaminergics to try, especially one's that antagonise the D1 receptor. At present the only one on the market that even goes close to D1 is Pergolide. I was wondering if anyone had had any experience on this med? Bipolar's (type II/NOS) reply preferably but all comments welcome! :O)
> >
> > Thanks
> >
> > Gary
>
>
Posted by SLS on May 21, 2008, at 8:01:06
In reply to Re: Pergolide for Bipolar. @ SLS, your comments pl, posted by garylee on May 17, 2008, at 12:48:42
Undopaminergic is exactly right.
Pergolide and cabergoline are both agonists of the 5-HT 2B receptor. This is probably the mechanism by which cardiac valvulopathy develops. From what I've seen, cabergoline is thought to be more apt to produce this side effect than is pergolide. I'm not sure this is true, though. As Undopaminergic said, you should stay away from both of these drugs.
Mirapex and Requip seem to be safe with regard to valvulopathy.
- Scott
Posted by shasling on May 21, 2008, at 17:32:33
In reply to Pergolide for Bipolar. @ SLS, your comments pls?, posted by garylee on May 17, 2008, at 8:36:15
> Hi to whoever's reading this post.
>
> I have always responded well to Dopaminergics. Pramipexole 'almost' gave me full remission, or very, very close anyway. I tried Piribedil and Ropinerole with less effect than Pramipxole, so went back to Pramipexole. Unfortunatley it didn't work half as good at the first time, very saddening indeed...
>
> I have since been looking for more Dopaminergics to try, especially one's that antagonise the D1 receptor. At present the only one on the market that even goes close to D1 is Pergolide. I was wondering if anyone had had any experience on this med? Bipolar's (type II/NOS) reply preferably but all comments welcome! :O)
>
> Thanks
>
> GaryUGH! Pergolide felt to me like the dirtiest, most aggravating med ever. I am a dopamine agonist believer; I am now on parlodel and abilify and they do pretty well. I had an awful reaction to pergolide though...
Posted by SLS on May 21, 2008, at 17:34:47
In reply to Re: Pergolide for Bipolar. @ SLS, your comments pls?, posted by shasling on May 21, 2008, at 17:32:33
> UGH! Pergolide felt to me like the dirtiest, most aggravating med ever. I am a dopamine agonist believer; I am now on parlodel and abilify and they do pretty well. I had an awful reaction to pergolide though...
What other DA agonists have you tried?
- Scott
This is the end of the thread.
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