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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by atmlady on January 20, 2008, at 13:14:59
In reply to Dopamine, useful and whos tried it?, posted by Mikez on January 20, 2008, at 6:48:33
Hello, Mikez - I just switched from Welbutrin to the DA agonist Trivastal this week and am feeling great so far. Over a period of three days I ramped down the wellbutrin from 450mg to zero and ramped up the Trivastal from 50mg at night to 50mg at breakfast and 50mg at about 3pm. Not only did I not experience any withdrawal from the pretty abrupt discontinuance of wellbutrin, I experienced none of the expected nausea, anxiety or extreme sleepiness from the Trivastal.
What Trivastal does do for me is mildly stimulate me. I feel a calm alertness - no racing thoughts, no anxiety. Maybe because I am already so used to dopamine overdrive from the Wellbutrin I was on? Anyway, I feel a bit calmer, am sleeping better and can even take a nap during the day if I want, but I don't have to. Maybe that is from the absence of the NE boost I used to get from the wellbutrin? Not sure.
I am not physically stimulated - I don't experience the scalp chills, the dry mouth, the appetite suppression (darn) that I would on a stimulant, but I do have some motivation now - I went to the gym twice this week, cleaned the house, got some errands run. Not a whirlwind of activity like I might be with a stimulant, but not a lump on the couch, which I was with the wellbutrin.
As for the inability to feel emotions - I know what you mean. I often thought of myself as Dr Spock. Many times I would be intellectually happy, as in everything is going my way so I must be happy, but I couldn't feel it. I think this is the main thing that hurts me socially, because I'm just not on the same wavelength as other people - I try to act happy because I'm happy, really I am, but I just don't feel it and I know it and they know it any everyone is uncomfortable for a reason they can't put their finger on. Lexapro is the only thing that ever made me FEEL happiness, so you see I am a serotonin girl. But I refuse to accept the weight gain and anorgasmia, so I do without SSRI's- I'm used to not being happy anyway.
But to get back on the subject, if Lexapro / serotonin makes me feel happiness, what I think I might be experiencing with Trivastal is joy. Friday, first day of Trivastal only, I was running errands in the car and was actually singing along to the songs on the radio! Seriously (and I'm always SO serious), Dr Spock does not sing to the radio, no way!! And then Three Dog Night's "Shambala" came on and a got this RUSH of .... joy is the only word that explains it. I almost wept from the feeling and thought OMG, is this what joy is?!?!?!?! I think I might understand how the folks taking Mirapex become addicted to gambling, if this is what they feel when they win at Blackjack! Oh My.
Mind you, I am not feeling like this at every second. It's just occasionally. This Trivastal seems very mild all around - Mirapex may be more powerful.
My original plan was to experiment with Ixel (an SNRI) because I knew I needed serotonin, and I bought the Trivastal to augment it just in case I missed the dopamine effects from the wellbutrin. But the Ixel has not yet arrived (arg) and there was the Trivastal, calling to me from the cabinet and I thought why not see what all the fuss is about? I'm astonished that it actually worked! I feel good enough right now to hope that maybe Trivastal and a lightbox will do the trick for me for now. Still early, though. If the Ixel does ever arrive I'm sure I'll want to at least try it out.
Hope this info helps; and again, as to the sleepiness, like I said it stimulates me mildly, and with a cup of coffee or tea it's a real pick me up.
Posted by Mikez on January 20, 2008, at 17:43:20
In reply to Me, I'm now exclusively on Trivastal LA, posted by atmlady on January 20, 2008, at 13:14:59
..
Posted by elanor roosevelt on January 23, 2008, at 22:58:04
In reply to Re: Thanx ATM lady for the great response! (nm), posted by Mikez on January 20, 2008, at 17:43:20
I am also using Trivastal
I am not having a glowing response but some very core issues have changed
i experience a bit more pleasure: taste, music
sometimes i get a quick glimpse of a sense of future
Posted by atmlady on January 24, 2008, at 7:36:27
In reply to Re: Thanx ATM lady for the great response!, posted by elanor roosevelt on January 23, 2008, at 22:58:04
Yes, I do get the sense that this drug's effects are not powerful, but rather mild and probably it works best on mood when used with something else. I do recall that Mishal was on a few other things when he wrote about how great he felt on Trivastal. As if Trivastal gave a little boost to his overall cocktail that helped him experience pleasure more. Are you on anything else right now? I just started Ixel this morning, along with my Trivastal, and am experiencing quite a powerful zip right now!
Posted by Tony P on January 24, 2008, at 11:34:13
In reply to Dopamine, useful and whos tried it?, posted by Mikez on January 20, 2008, at 6:48:33
> DA agonists..good/bad?
>
> I may ask my doc for mirapex tomorrow as an augmenter. I have major depression with some ocd.
>
> Basically to summarize ...
> 1. I respond very bad to noradrenaline, which is why i cancelled my tricyclic experiment..however i noticed i had a normal sex drive which im assuming is the dopamine.
>
> Im a serotonin guy through and through however I never get the full remission and ability to 'feel' emotions. Im thinking dopamine agonist may be the missing piece of the puzzle..however..im confused abit about the side effects. Im almost sure it will normalize my libido however, will it.. decrease appetite? (do not want this as im a guy), and act as a 'stimulant' (cause trouble sleeping..do not want this)
>
> I have read alot of reviews and found people actually said it made them sleepy on askapatient so that is why im a bit confused.
>
> Can anyone shed some light on dopamine?
> THANX
>
I am also convinced that dopamine is essential to balanced A/D effect, at least for me. I'm also hypersensitive to NorAd enhancers. I take Requip (ropinirole) 1.5 mg/day in addition to Remeron. There was a Can. J. Psych. pilot project article a couple of years back (I can dig out the ref. if anyone wants it) with a _very_ small sample using Requip with several diffrent ADs, and most people experienced improvement.I experienced slight drowsiness with .75 mg for the first couple of months, but .5 mg per dose during the day was OK enough that I felt safe driving. No problem at all with drowsiness now.
I am confused because I too thought dopamine was a stimulant (the "pleasure" transmitter, the one invoked by cocaine and amphetamines and all those dangerous things -- I suspect this "bad company" may be part of the reason it's downplayed in depression management), but most of the meds which are a direct dopamine agonist seem to have drowsiness as a side effect. I should go on the new Neurotransmitters board and see if anyone can explain this paradox.
Meanwhile, coffee is also a mild dopamine enhancer, and oh, that espresso tastes g-o-o-od!!
Tony
Posted by clipper40 on January 24, 2008, at 20:27:08
In reply to Me, I'm now exclusively on Trivastal LA, posted by atmlady on January 20, 2008, at 13:14:59
So great to hear how well you're doing on the Trivistal!!! I was afraid it would be too noradrenergic for me but it doesn't seem to give you that effect at all. You don't seem to have the racing heart (is your heart rate at all faster on it?) or the anxiety etc. from it. I just might have to try this one soon because I have no motivation at all.
Ixel was the other one I was interested in but it sounds like it is definitely giving you the typical norepinephrine effects that I need to avoid or am I misinterpreting your comment about the zip it's giving you?
Anyway, thanks for posting about all of this! It's very helpful to me and probably many others as well.
Posted by atmlady on January 26, 2008, at 0:12:52
In reply to Re: Me, I'm now exclusively on Trivastal LA » atmlady, posted by clipper40 on January 24, 2008, at 20:27:08
Hi, Clipper - No racing heart with the Trivastal, and now that I've added Ixel, still no racing heart. But when I was on wellbutrin yes, racing heart at 300mg and again even more so at 450mg. Not sure, but I suspect I'm getting less NE stimulation on the Ixel as compared to WB, which would explain my improved sleep as well as the the non-racing heart.
If you are sensitive to NE I'd eschew the Ixel, but the Trivastal I think would be OK for you. On it's own for depression I don't think it's that effective - I think it works its wonders in concert with other ADs.
Posted by trx resistant on January 26, 2008, at 2:23:48
In reply to Re: Me, I'm now exclusively on Trivastal LA » clipper40, posted by atmlady on January 26, 2008, at 0:12:52
I would encourage to read everything you can here about EMSAM. transdermal patch -bypass gut, no diet restrictions at 6mg dose. If you feel too high, just peel it off.
Worked really fast for me, less than a couple of days to feel up and I was wearing cement shoes at the bottom of the ocean! took about 8 weeks to tinkering with right dose for me. Now at 1/2 6mg patch for 9 hours per day.
Pure pleasure, slight dificulty getting to sleep but that's because I feel so good and I'm out doing so much. Weight loss for me, no emotional
eating.
DOWNSIDE: I FEEL SO HAPPY I'M SCARED IT'S TOO GOOD TO BE TRUE!
Posted by clipper40 on January 26, 2008, at 2:30:51
In reply to Re: Me, I'm now exclusively on Trivastal LA » clipper40, posted by atmlady on January 26, 2008, at 0:12:52
I'd be taking the Trivastal in addition to Effexor or an SSRI so it should work.
Thanks so much for your help.
Posted by clipper40 on January 26, 2008, at 2:38:03
In reply to Re: Me, I'm now exclusively on Trivastal LA, posted by trx resistant on January 26, 2008, at 2:23:48
That's on my list to try as well but I'm worried about the sleeping part. I've been taking doxepin for years to keep me asleep all night. Don't think I could take it with EMSAM though.
Posted by clipper40 on January 26, 2008, at 2:49:53
In reply to Re: Me, I'm now exclusively on Trivastal LA » clipper40, posted by atmlady on January 26, 2008, at 0:12:52
Also, I wouldn't be taking it so much for depression but more to help with motivation. I'm probably dysthymic now so I could use a little bit of a lift, but the major problem is absolutely no drive.
Posted by atmlady on January 26, 2008, at 11:08:54
In reply to Re: Me, I'm now exclusively on Trivastal LA, posted by trx resistant on January 26, 2008, at 2:23:48
Hello, TRX - It's funny you should mention EMSAM because that's exactly my plan B, since it seems like I need a boost on all three neurotransmitters. So if I start to experience sexual side effects with the ixel/trivastal combo I am thinking EMSAM. How are you dealing with the dietary restrictions? Or are you doing well enough at the lower dose that you don't have to worry about that?
Posted by trx resistant on January 27, 2008, at 2:06:27
In reply to Re: Me, I'm now exclusively on Trivastal LA » trx resistant, posted by clipper40 on January 26, 2008, at 2:38:03
> That's on my list to try as well but I'm worried about the sleeping part. I've been taking doxepin for years to keep me asleep all night. Don't think I could take it with EMSAM though.
I take 10-15 mg of Ambien. Aorks just fine when I need it. I found that since I'm so much more active socailly and out and about, I don't even need the Ambien, so I'm trying to taper off.
Posted by trx resistant on January 27, 2008, at 2:11:10
In reply to Re: Me, I'm now exclusively on Trivastal LA » atmlady, posted by clipper40 on January 26, 2008, at 2:49:53
> Also, I wouldn't be taking it so much for depression but more to help with motivation. I'm probably dysthymic now so I could use a little bit of a lift, but the major problem is absolutely no drive.
As far as I know clinically speaking, that IS DEPRESSION!!!!!!!!!! As well as for me, personally, I just wanted to die and get it over with. Now I have joy and want to feel everything again, sweetness, less sadness (sadness is part of life but not life in total)Like that old ad, I have a new lease on life!
Posted by clipper40 on January 27, 2008, at 2:27:20
In reply to Re: Me, I'm now exclusively on Trivastal LA, posted by trx resistant on January 27, 2008, at 2:11:10
"As far as I know clinically speaking, that IS DEPRESSION!!!!!!!!!!"
Not necessarily. It's very possible to have good mood but no motivation. Just ask anyone taking an SSRI! But no matter what you call it, it's not a desirable state to be in. I'm glad you're doing so well on EMSAM. You certainly sound wonderful! I hope it lasts forever.
Posted by deniseuk190466 on January 27, 2008, at 4:41:58
In reply to Re: Me, I'm now exclusively on Trivastal LA, posted by trx resistant on January 27, 2008, at 2:06:27
Hi,
I'm glad you are having such a great reaction to Ensam. You must feel like you are on a different planet now to the one you were one before :-)
However, I'm just wondering if you had tried Nardil or Parnate or any other MAOI before trying Ensam?
Thanks.....Denise
Posted by trx resistant on January 28, 2008, at 3:14:31
In reply to Re: Me, I'm now exclusively on Trivastal LA » trx resistant, posted by clipper40 on January 27, 2008, at 2:27:20
If you feel this way, lacking motivation more than normal, I would consider EMSAM. I tried all the SSRI's and got into trouble because pdoc kept cranking up dose, no response to speak of, then seizures.
Thank you, I, too, hope it keeps working until my life is stable and I need nothing, which I'm told could be possible.
Posted by trx resistant on January 28, 2008, at 3:17:27
In reply to To trx resistant, posted by deniseuk190466 on January 27, 2008, at 4:41:58
pdoc was going to try parnate when I found EMSAM on this board (thanks to you, all) and I printed everything and researched myself. We thought we would try this first because little to no side effects and no weight gain (yeah).
Posted by ripanrico on February 4, 2008, at 22:04:25
In reply to Re: Me, I'm now exclusively on Trivastal LA, posted by trx resistant on January 27, 2008, at 2:06:27
I got some Trivastal from bbonlinepharmacy and I have not noticed any energizing effects. Does anyone have any expeience with this pharmacy? Also does anyone know a pharmacy that not only sells Trivastal affordably but also will have authentic products?
Posted by elanor roosevelt on February 4, 2008, at 23:52:01
In reply to Trivastal: affordable and reputable pharmacy?, posted by ripanrico on February 4, 2008, at 22:04:25
your doctor can prescribe trivastal in the usa
if he/she chooses to i think
mine chose noti didn't get energized
but did feel a bit more pleasure
Posted by deniseuk190466 on February 5, 2008, at 15:08:19
In reply to Re: To trx resistant, posted by trx resistant on January 28, 2008, at 3:17:27
Thanks for responding. I've already tried Nardil and didn't respond to it very well at all so I'm guessing Ensam wouldn't work for me either.
Glad you are doing well on it though.
Denise
Posted by trx resistant on February 6, 2008, at 2:26:42
In reply to Re: To trx resistant, posted by deniseuk190466 on February 5, 2008, at 15:08:19
Thanks for the good wishes. But are you sure that Nardil is exactly the same drug? If is not exactly the same, what have you got to lose? After 9 years of trying everything, I just got lucky cause I tried the next thing on the list.
Hope you find something to help,as well.
Posted by Tony P on February 9, 2008, at 4:39:00
In reply to Re: Me, I'm now exclusively on Trivastal LA, posted by trx resistant on January 28, 2008, at 3:14:31
> If you feel this way, lacking motivation more than normal, I would consider EMSAM. I tried all the SSRI's and got into trouble because pdoc kept cranking up dose, no response to speak of, then seizures.
SSRI's and I don't get along very well either, although Lexapro (Cipralex) was tolerable.
I don't think the EMSAM patch is available in Canada yet, but my oral selegeline is really helping with motivation and energy. I was already taking Remeron (SNRI) and Requip (DA), and selegeline on-label here is officially recommended for boosting the effectiveness of dopamine agonists such as Requip, but presumably it has some degree of balanced MAOI effect on all the big 3, so it should improve the effectiveness of both meds.
10 mg/day oral of selegeline is about right for me, I tried 20 but was getting quite jittery and shaky, (especially after my usual morning coffee!)
Trivastal doesn't seem to be available in Canada, I might experiment with it if I find a reliable overseas source, but while I don't mind the expense and the occasional polite note from Customs & Health Canada, it's extremely frustrating when something simply never arrives. I once got caught short when I was taking tianeptine from Europe regularly and exclusively as my AD; it had always arrived reliably within about 10 days, then one month it just never came - so I was suddenly without any A-D at all. That was when I went on Lexapro for a while, as it's supposed to have the fastest action (and lowest S/E profile) of all the SSRIs.
Thank goodness for my old pdoc who let me experiment with meds from the web, suggest new things to try, and in fact commended me for doing the research, (not without expressing occasional migivings however!) and then prescribed them if they were effective and available in Canada. He really, really wanted me to give Effexor a longer trial and go to higher doses than I was willing to (caused much too much anxiety for me), but in the end I persuaded him to let me go with my present regime. I just hope my new pdoc will be as open.
Tony
Posted by diego777 on January 26, 2009, at 15:37:02
In reply to Me, I'm now exclusively on Trivastal LA, posted by atmlady on January 20, 2008, at 13:14:59
Hey guys,Not sure if you can list this info on the website, but I was wondering if you could tell me where I could find/buy trivastal. (I live in the USA.) I've tried to find it online, but the online pharmacies that sell it seem reeeaally sketchy.
Any advice or leads? Thanks!
Posted by desolationrower on January 26, 2009, at 20:34:43
In reply to Re: Me, I'm now exclusively on Trivastal LA, posted by diego777 on January 26, 2009, at 15:37:02
we aren't to mention this here. there are forums where people who buy drugs online discuss this sort of thing, you'll have to find one of those. gluck
-d/r
This is the end of the thread.
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