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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by paulbwell on January 21, 2010, at 9:27:40
Hey PBlers!
After taking a year off MPD after 5 years of ups and downs with the generic 20mgIR 4x daily, with a turn for the worse i decided to go back to the only AD that has worked in 15 years. Ramping up to 60mgs Fluoxetine, i felt more stable and balanced than i can remember, however after a year the dreaded demotivation, blaaaas set in. Instead of giving up on it i reintroduced MPD, But brand name Ritalin SR20mg tabs, which i have found to be the most effective MPD tabs and only have to be taken 2x a day.
Well after settling on 2, 20mgSR tabs 2x a day combined with the Fluox, things have been better than i can remember and i feel about as well as i can remember feeling, so well in fact that i'm contemplating returning to University to do a masters in Film studies. An added bonus is the decreased use of benzo needed, althought scripted 30mgs Diazepam daily, some times i don't take any!.
It feels so good to be back again after the being in the wilderness.
Don't give up folks, the sun will come out again-hang in there.
Posted by Phillipa on January 21, 2010, at 11:07:39
In reply to SSRI+Stimulant-anyone?, posted by paulbwell on January 21, 2010, at 9:27:40
Hey I'd wondered where you had been. Can I be the star in your movie? Just kidding glad your're feeling good. Love Phillipa
Posted by Maxime on January 21, 2010, at 16:43:22
In reply to SSRI+Stimulant-anyone?, posted by paulbwell on January 21, 2010, at 9:27:40
Glad to hear it Paul! I am experiencing the same with Parnate!
Posted by MoonageDaydream on January 21, 2010, at 17:48:40
In reply to SSRI+Stimulant-anyone?, posted by paulbwell on January 21, 2010, at 9:27:40
I was on Prozac & Dexedrine for years. I think SSRI+Stimulant combinations are great if you have ADD and Depression. They sort of balance each other out. SSRIs sometimes cause apathy and amotivational symtpoms with long term use by decreasing dopaminergic transmission. Stimulants alone tend to cause anxiety in those prone to it (and a lot of people with depression are). You sound like you're doing really well, that's fantastic. Especially if its allowing you to reduce you Valium dose.
Posted by rjlockhart04-08 on January 21, 2010, at 20:33:28
In reply to Re: SSRI+Stimulant-anyone?, posted by MoonageDaydream on January 21, 2010, at 17:48:40
hey!
what have been up to lately?
Prozac increases some amounts of amphetamines because of metabolities. Plus having serotonin being stimulated by stimulants...it increases the antidepressant effect. It doesnt do it with Ritilin.
Are your taking Dexedrine? sleeping ok?
Posted by rjlockhart04-08 on January 21, 2010, at 20:59:27
In reply to SSRI+Stimulant-anyone?, posted by paulbwell on January 21, 2010, at 9:27:40
are you making motion pictures?
Posted by paulbwell on January 22, 2010, at 2:27:19
In reply to Re: SSRI+Stimulant-anyone?, posted by rjlockhart04-08 on January 21, 2010, at 20:33:28
> hey!
>
> what have been up to lately?
>
> Prozac increases some amounts of amphetamines because of metabolities. Plus having serotonin being stimulated by stimulants...it increases the antidepressant effect. It doesnt do it with Ritilin.Hey rj
I thought amphets didn't influence serotonin much, eccept at VERY high doses and methamph of course with 5ht release action.
>
> Are your taking Dexedrine? sleeping ok?aaaaaai was only scripted Dexamp for 1 month 3 years ago, until my GP freaked out and switched back to MPD. I was not taking Fluoxetine during this time, so have no experience of Dex+Zac interactions as you do, RU still taking Dex Spans?
I sleep better when the stims wear off than on benzos, as i'v taken them for so long now.
Posted by paulbwell on January 22, 2010, at 2:31:18
In reply to Re: SSRI+Stimulant-anyone?, posted by rjlockhart04-08 on January 21, 2010, at 20:59:27
> are you making motion pictures?
I majored in Film TV and Media studies at Uni, and have spent more time n front of the camera, in various TV, film, ads.
Posted by rjlockhart04-08 on January 22, 2010, at 13:51:05
In reply to Re: SSRI+Stimulant-anyone? » rjlockhart04-08, posted by paulbwell on January 22, 2010, at 2:31:18
No, i'm going back to Vyvanse, which really didnt work that well for me. It's still d-amphetamine, but it's released slowly.
M-amphetamine, yea your right releases some serotonin at high doses, that's also why it wear's out the brain.
Posted by rjlockhart04-08 on January 22, 2010, at 13:54:02
In reply to Re: SSRI+Stimulant-anyone? » rjlockhart04-08, posted by paulbwell on January 22, 2010, at 2:27:19
well that's good, I took commerical intro at a acting studio, but it didnt last long, i just took a break and didnt go back to it.
Prozac at higher doses I've noticed blaaa's you out. It's effective as antidepressant, but it's anti-OCD properties at higher doses make life blaa...
Better at 20-40mg
Posted by MoonageDaydream on January 22, 2010, at 16:26:22
In reply to Re: SSRI+Stimulant-anyone?, posted by rjlockhart04-08 on January 22, 2010, at 13:54:02
RJ- I definitely agree with Prozac being better at lower doses, at least for me. I found 10 mg was the optimal dose for me. At 20 mg it made me really unmotivated and emotionally numb, along with other side effects. And even at 10 mg it had a very noticeable antidepressant effect with much less side effects. I also took Celexa in the past at a low dose and didn't notice any additional benefit from higher doses. Sometimes less is more.
Posted by paulbwell on January 24, 2010, at 21:01:52
In reply to Re: SSRI+Stimulant-anyone?, posted by MoonageDaydream on January 22, 2010, at 16:26:22
> RJ- I definitely agree with Prozac being better at lower doses, at least for me. I found 10 mg was the optimal dose for me. At 20 mg it made me really unmotivated and emotionally numb, along with other side effects. And even at 10 mg it had a very noticeable antidepressant effect with much less side effects. I also took Celexa in the past at a low dose and didn't notice any additional benefit from higher doses. Sometimes less is more.
Some folks need only 5mg Prozac for good AD effect. Had been taking 40-60 for the past year, and to be honest it really seems more like a mood stabiliser, like a low level mood equaliser than a true AD BUT then Ritalin came back.
I took a year and a half off as i was experiencing diminishing returns, that was with generic 10mgIR tabs which lasted like~1 hour sometimes. But recently being scripted, Name brand Novartis Ritalin SR20s, which last a smooth 8 hours and are far superior to the generic IR tabs, i'd have to rate my mood as being a consistant 70-80 out of 100 now. I guess i had Dopamine supression from the Zac.
I'v tried 7 ADs
-Prozac
-Citalopram (3 trials!!)
-Paxil (3 trials!!)
-Serzone
-Effexor
-Imipramine
-St Johns Wort
and Ritalin beats them all for me, even over Dextroamp, combined with the balancing of Prozac, it feels like i no longer have a need for a Doctor (cept for meds course) and it's a wonder full freeing feeling.Good luck all.
Posted by Tony P on January 30, 2010, at 18:41:23
In reply to Re: SSRI+Stimulant-anyone? » MoonageDaydream, posted by paulbwell on January 24, 2010, at 21:01:52
Modafinil (Provigil, Alertec - Rx) or Adrafinil (non-RX in many countries) are really good stimulant adjuncts to SSRIs & even SNRIs in my experience. I believe they boost both NE and DA. They are safer than amphetamine-related meds (including Ritalin) and -- a big plus -- don't cause insomnia.
See also my recent post under "Re: SSRI Apathy Syndrome (Anhedonia)???".
This is the end of the thread.
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