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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by uncouth on October 19, 2008, at 9:33:04
Hi, last question for me today. I'm on 40 Parnate plus 5mg Abilify and have felt better and more motivated than I have in a long time. However, I'm still feeling some residual anhedonia, and some restless legs at night, which along with the general feeling of insomnia that comes from parnate, has made sleep very difficult.
I've tried mirapex at night in the past for restless legs, and it has helped, at a relatively small dose. It also tends to make me sleepy when I've tried it during the day, so I figured it might be a worthy thing to try at night at a low dose (say 0.25- 0.50).
MY QUESTION: I'm hitting the dopamine receptors pretty hard with three things (possibly four, if I add a low dose of selegiline, see my other post). Doesn't seem to be a danger of combining parnate with abilify, but what about adding mirapex to the mix. At a low dose, will it counteract or magnify the effects of abilify on D2/D3 neurons?
I know it's all very complex, and different dosages hit presynaptic vs. postsynaptic receptors, but I'd hate to be causing dopamine chaos with an abilify plus mirapex combo.
Anyone have any experience with this?
Posted by linkadge on October 19, 2008, at 11:20:17
In reply to Mirapex plus abilify plus Parnate, posted by uncouth on October 19, 2008, at 9:33:04
The mirapex/abilify combination would be strange in one sense. Abilitfy act predominatly as a d3 antagonist, wheras mirapex is predominantly a d3 agonist.
Linkadge
Posted by uncouth on October 19, 2008, at 12:21:51
In reply to Re: Mirapex plus abilify plus Parnate, posted by linkadge on October 19, 2008, at 11:20:17
I thought abilify was a d2 stabilizer, with not as much activity on D3 receptors. In any event, thanks for the comment. I guess it's all experimentation at this point, but i'd rather not experiment with something that will simply cancel each other out, or be dangerous.
Posted by azalea on October 19, 2008, at 12:24:55
In reply to Mirapex plus abilify plus Parnate, posted by uncouth on October 19, 2008, at 9:33:04
Not heard of this combo before. It sounds like uncharted territory to me. Abilify is D2 receptor partial agonist, while effects on D3 are unclear according to Stahl's Essential Psychopharmacology. Combining this with Mirapex, a D3 agonist, has not been studied to my knowledge.
> Hi, last question for me today. I'm on 40 Parnate plus 5mg Abilify and have felt better and more motivated than I have in a long time. However, I'm still feeling some residual anhedonia, and some restless legs at night, which along with the general feeling of insomnia that comes from parnate, has made sleep very difficult.
>
> I've tried mirapex at night in the past for restless legs, and it has helped, at a relatively small dose. It also tends to make me sleepy when I've tried it during the day, so I figured it might be a worthy thing to try at night at a low dose (say 0.25- 0.50).
>
> MY QUESTION: I'm hitting the dopamine receptors pretty hard with three things (possibly four, if I add a low dose of selegiline, see my other post). Doesn't seem to be a danger of combining parnate with abilify, but what about adding mirapex to the mix. At a low dose, will it counteract or magnify the effects of abilify on D2/D3 neurons?
>
> I know it's all very complex, and different dosages hit presynaptic vs. postsynaptic receptors, but I'd hate to be causing dopamine chaos with an abilify plus mirapex combo.
>
> Anyone have any experience with this?
>
Posted by linkadge on October 19, 2008, at 15:08:07
In reply to Re: Mirapex plus abilify plus Parnate, posted by uncouth on October 19, 2008, at 12:21:51
I don't know what dopamine stabilizer is supposed to mean. I thought that was mainly a marketing thing, you know, this is not a 'neuroleptic'
According to the PDSP website, abilify has strongest yet similar affinity for d2 and d3 (~ ki 0.5-5) with less activity at d1, 5-ht1a, 5-ht2 receptors.
I don't know if its dangerous though.
Linkadge
Posted by linkadge on October 19, 2008, at 15:09:22
In reply to Re: Mirapex plus abilify plus Parnate » uncouth, posted by azalea on October 19, 2008, at 12:24:55
I meant, I don't think that the combination is dangerous.
Linkadge
Posted by bleauberry on October 19, 2008, at 19:21:04
In reply to Mirapex plus abilify plus Parnate, posted by uncouth on October 19, 2008, at 9:33:04
Topics like this are way too complicated to armchair quarterback. Even to say one drug does something to a D2 receptor and another does something else to it is extremely oversimplified. There is just so much we don't know. Even the above types of ways of thinking about things is probably only a fraction of what is actually going on. What we know is mostly theory, not fact, and much of it is based on mice or rats, not the same as humans, and the particular ways of measuring things in humans is riddled with flaws and assumptions that pile up on top of one another.
I don't recall where it is, but surfing at pubmed a couple months ago I saw a study where a dopamine agonist was added to an antipsychotic. I forget what the symptoms were or why the agonist was needed. In any case, the symptoms were fixed and there was no loss of efficacy of the antipsychotic. So, in this case, the two went together well, did their respective jobs without interfering with each other. In our simplified way of thinking that doesn't make sense. But again, it is my opinion there is so much more going on than a simple D2/D3 picture.
It is the best we have and it is our nature to try to make sense of things. But in the end, the actual realworld result of consuming something is all that matters.
Personal trial is the only way to find out.
This is the end of the thread.
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