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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by OculusFervoris on January 11, 2014, at 17:45:15
Hello to everyone on the board. I would like to ask for your opinions and ideas about this guy's story.
He is a 29yr old male. As a child, had problems with appetite, treated with cyproheptadine, and attention, untreated. Also, had cyclothymia since childhood. First major depressive episode was at 16yr, with atypical symptoms, esp. loss of energy. Got better with sertraline, took it for 7yrs. Changed to bupropion because of delayed orgasm. Bupropion gave a large boost of energy and attention. With sertraline discontinued, he experienced brain zaps for months, which decreased slowly. Discontinued bupropion, was med free for 2yrs. Had another episode, similar to first, tried a lot of meds, with these results:
- St. John's Wort, tryptophane: mood actually worsened
- escitalopram: mood dropped after a single dose
- tianeptine: worked fine, decreased anxiety, but no stimulant effect
- moclobemide: worked perhaps the best
- lamotrigine: greatly reduced anxiety, but did not stop mood cycling; however, decreased length of dysthimic periods
- buspirone: extremely strong brain zaps for several hours after single dose, perfectly reproducible
- reboxetine: no mood effect, but delayed orgasm with decoupling of orgasm and ejaculation (weird!)To sum up: opposite response to SSRI and tryptophan, but not to MAOI, and buspirone reliably causes brain zaps.
Any ideas on how to explain these symptoms? Thanks in advance.
Posted by Dr. Bob on January 14, 2014, at 23:57:30
In reply to Weird serotoninergic effects, any ideas?, posted by OculusFervoris on January 11, 2014, at 17:45:15
Posted by SLS on January 17, 2014, at 6:25:21
In reply to Weird serotoninergic effects, any ideas?, posted by OculusFervoris on January 11, 2014, at 17:45:15
Perhaps going with an anti-glutamate, pro-dopamine treatment would help.
Lamictal
minocycline
N-acetylcysteine (NAC)
Abilify
Wellbutrin
- Scott
Posted by OculusFervoris on January 29, 2014, at 21:12:24
In reply to Re: Weird serotoninergic effects, any ideas? » OculusFervoris, posted by SLS on January 17, 2014, at 6:25:21
Thanks for your reply! Definitely sounds interesting. What doses would you have in mind for NAC and Abilify?
Also, I haven't been able to find any reports on psychiatric use of minocycline. Is there an interaction with another med that can be used?
This is the end of the thread.
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