![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by AlexCanada on June 19, 2014, at 21:12:36
Hi. After over 20+ meds including Parnate, paxil, TCAS (could not tolerate the anx), Ritalin, Dexedrine, modafinil, and dozen+ anti-deps I have had most success with parnate, paxil and especially Ritalin and Dexedrine when it comes to dealing with poor motivation, low emotion, empty dull mindless mood, slow mindedness, poor cognition. Some short term benefits from gabapentin as well especially for emotion.
L-dopa mucuna (herbal form of L-dopa) meanwhile has had remarkable effects on positive kind, loving emotions, enhanced empathy, and appreciation of others. So remarkable in fact that it really showed me how negative and tactless I have been under the past decade of melancholic depression + hypothyroid.
L-dopa mucuna does not necessarily play well with meds though. I am currently on Cymbalta 30mg + small modafinil, + small Ritalin, + small gabapentin, +magnesium/calcium/d3/zinc combo + 1.5mg valium (trying to withdrawl from it). L-dopa mucuna is supposed to produce dopamine as well as testosterone but the herbal benefits do not last usually and mood eventually may feel sour after few weeks and/or lack of interest.
What might be worth a try? Requip? I tried Mirapex many years ago and cannot recall what it did to me aside from me not being pleased with it. Though it might have just been a bad combination with whatever else I was taking.
Any other dopamine based options? Supposedly D2 stimulation/production enhancex oxytocin the love molecule. This might be responsible for the greatly enhanced empathy and feelings of Kindness onto others.
I miss this priceless feeling. I used to be an immensely loving and very emotional person before Accutane poisoning caused severe melancholic depression in me.
I want my emotions back, I want more clear headedness, I want a thirst for life rather than feeling ''nothing'' most of the time.
Posted by poser938 on June 19, 2014, at 22:46:08
In reply to Best Dopamine meds for Apathy, Emotions?, posted by AlexCanada on June 19, 2014, at 21:12:36
5ht2C antagonism seems to nourish the Dopamine system.
Cyproheptadine used to help me in so many ways with pretty much anything that has to do with Dopamine. such as motivation, pleasure, energy, etc...
http://www.ncbi.nlm.nih.gov/pubmed/15668911
or it might benefit you to combine something that has 5ht2c antagonism with a normal Dopamine increasing med.
Posted by AlexCanada on June 20, 2014, at 2:05:04
In reply to Re: Best Dopamine meds for Apathy, Emotions?, posted by poser938 on June 19, 2014, at 22:46:08
> 5ht2C antagonism seems to nourish the Dopamine system.
>
> Cyproheptadine used to help me in so many ways with pretty much anything that has to do with Dopamine. such as motivation, pleasure, energy, etc...
>
> http://www.ncbi.nlm.nih.gov/pubmed/15668911
>
> or it might benefit you to combine something that has 5ht2c antagonism with a normal Dopamine increasing med.What other meds have 5ht2c antagonism? I see my doctor later today. Hopefully I can give him some decent suggestions. He prescribes me just about anything within reason.
I will look up Cypro. Thanks so much
Posted by AlexCanada on June 20, 2014, at 4:41:09
In reply to Re: Best Dopamine meds for Apathy, Emotions? » poser938, posted by AlexCanada on June 20, 2014, at 2:05:04
> > 5ht2C antagonism seems to nourish the Dopamine system.
> >
> > Cyproheptadine used to help me in so many ways with pretty much anything that has to do with Dopamine. such as motivation, pleasure, energy, etc...
> >
> > http://www.ncbi.nlm.nih.gov/pubmed/15668911
> >
> > or it might benefit you to combine something that has 5ht2c antagonism with a normal Dopamine increasing med.
>
> What other meds have 5ht2c antagonism? I see my doctor later today. Hopefully I can give him some decent suggestions. He prescribes me just about anything within reason.
>
> I will look up Cypro. Thanks so muchthe cypro... did you take it with Ritalin or vyvanse or any other dopa med?
is it commonly sedating or possibly activating?
anti histamine makes me think it might be sedating?
please let me know, I will mention this and vyvanse and Valdoxan which is a 5ht2c anti dep,
Posted by poser938 on June 20, 2014, at 5:37:26
In reply to Re: Best Dopamine meds for Apathy, Emotions? » AlexCanada, posted by AlexCanada on June 20, 2014, at 4:41:09
Theres also Buspar, which is more typically used for mood than Cyproheptadine is. And Buspars 5ht1a partial agonism has been shown to increase Dopamine as well.
Though 5ht1a agonism has never been good for me personally. it actually seems to do the opposite for me, it feels like it decreases Dopamine. But it might work well for you. Some take it to relieve SSRI sexual dysfunction... though it actually decreases my libido.but, Buspar or Cyproheptadine might just synergise well wiith other, more typical Dopamine increasing meds.
Posted by Lamdage22 on June 20, 2014, at 5:56:44
In reply to Re: Best Dopamine meds for Apathy, Emotions?, posted by poser938 on June 20, 2014, at 5:37:26
I have apathy like a mofo and there is nothing that i can do about it.
Posted by poser938 on June 20, 2014, at 8:08:54
In reply to Re: Best Dopamine meds for Apathy, Emotions?, posted by Lamdage22 on June 20, 2014, at 5:56:44
What do you mean theres nothing you can do about it? No dopamine increasing meds work for you?
Posted by Lamdage22 on June 22, 2014, at 6:59:15
In reply to Re: Best Dopamine meds for Apathy, Emotions?, posted by poser938 on June 20, 2014, at 8:08:54
> What do you mean theres nothing you can do about it? No dopamine increasing meds work for you?
I have schizophrenia..
The only thing dopaminergic i could take would be Abilify or Brexpiprazole. The problem though is, that Abilify gives me Akathisia and Brexpiprazole is not on the market yet.
I like the schizophrenia hypothesis of "too much dopamine in some places and too little dopamine in others". That actually makes sense to me.
Posted by tom2228 on June 22, 2014, at 9:01:04
In reply to Best Dopamine meds for Apathy, Emotions?, posted by AlexCanada on June 19, 2014, at 21:12:36
> Hi. After over 20+ meds including Parnate, paxil, TCAS (could not tolerate the anx), Ritalin, Dexedrine, modafinil, and dozen+ anti-deps I have had most success with parnate, paxil and especially Ritalin and Dexedrine when it comes to dealing with poor motivation, low emotion, empty dull mindless mood, slow mindedness, poor cognition. Some short term benefits from gabapentin as well especially for emotion.
>
> L-dopa mucuna (herbal form of L-dopa) meanwhile has had remarkable effects on positive kind, loving emotions, enhanced empathy, and appreciation of others. So remarkable in fact that it really showed me how negative and tactless I have been under the past decade of melancholic depression + hypothyroid.
>
> L-dopa mucuna does not necessarily play well with meds though. I am currently on Cymbalta 30mg + small modafinil, + small Ritalin, + small gabapentin, +magnesium/calcium/d3/zinc combo + 1.5mg valium (trying to withdrawl from it). L-dopa mucuna is supposed to produce dopamine as well as testosterone but the herbal benefits do not last usually and mood eventually may feel sour after few weeks and/or lack of interest.
>
> What might be worth a try? Requip? I tried Mirapex many years ago and cannot recall what it did to me aside from me not being pleased with it. Though it might have just been a bad combination with whatever else I was taking.
>
> Any other dopamine based options? Supposedly D2 stimulation/production enhancex oxytocin the love molecule. This might be responsible for the greatly enhanced empathy and feelings of Kindness onto others.
>
> I miss this priceless feeling. I used to be an immensely loving and very emotional person before Accutane poisoning caused severe melancholic depression in me.
>
> I want my emotions back, I want more clear headedness, I want a thirst for life rather than feeling ''nothing'' most of the time.
>
>"poor motivation, low emotion, empty dull mindless mood, slow mindedness, poor cognition"
I would like to add that these symptoms aren't specific to dopamine -- adding despiramine to my combination (which *does* include other dopamine meds) has helped with several of these. Many of the meds you listed, i.e., Parnate, Ritalin, Dexedrine, have strong effects on norepineprhine as well. And these 2 are not the only way to achieve amelioration of these symptoms either -- for example, you could pump someone full of dopamine and norepineprhine but if their serotonin is horribly low they likely won't want to do much still, or enjoy it. But you said you have tried TCAs, okay.
And D2 receptor agonism is not always as pleasurable as it sounds. It can be significantly agitating for some people.
Though I do know what you're talking about with the emotions and clear headedness. I have found Desoxyn to be one of the best meds for these purposes. It has more of an emphasis on dopamine compared to other amphetamines and methylphenidates, and fewer side effects in my case. Speaking of, have you tried Focalin instead of Ritalin?
I have spent much of the past year feeling a lot like you describe, and TMS -- bear in mind I have only had 3 sessions -- is starting to do something that feels dopaminergic.
What are you doing about the thyroid?
Have you tried Lyrica? low-dose amisulpride?
"(pro)dopamine" meds I am taking:
Marplan 40mg
Desoxyn 22.5mg
Deplin 30mg
Mirapex ER 0.375mg
Abilify 9mgOne last thing, the Deplin. Yes it's a form of folate, but that shouldn't be underestimated. It is actually a "triamine modulator" in that it increases synthesis of serotonin, norepineprhine, and dopamine. Which in turn causes increased release, and as well Deplin may help replete neurotransmitter stores that are depleted by other meds, e.g. amphetamines, SSRIs. It has helped with my energy too.
Good luck to you.
Posted by phidippus on June 22, 2014, at 15:09:17
In reply to Best Dopamine meds for Apathy, Emotions?, posted by AlexCanada on June 19, 2014, at 21:12:36
Memantine is a d2 agonist and has been used to treat depression.
Eric
Posted by AlexCanada on July 18, 2014, at 6:58:55
In reply to Re: Best Dopamine meds for Apathy, Emotions?, posted by tom2228 on June 22, 2014, at 9:01:04
> > Hi. After over 20+ meds including Parnate, paxil, TCAS (could not tolerate the anx), Ritalin, Dexedrine, modafinil, and dozen+ anti-deps I have had most success with parnate, paxil and especially Ritalin and Dexedrine when it comes to dealing with poor motivation, low emotion, empty dull mindless mood, slow mindedness, poor cognition. Some short term benefits from gabapentin as well especially for emotion.
> >
> > L-dopa mucuna (herbal form of L-dopa) meanwhile has had remarkable effects on positive kind, loving emotions, enhanced empathy, and appreciation of others. So remarkable in fact that it really showed me how negative and tactless I have been under the past decade of melancholic depression + hypothyroid.
> >
> > L-dopa mucuna does not necessarily play well with meds though. I am currently on Cymbalta 30mg + small modafinil, + small Ritalin, + small gabapentin, +magnesium/calcium/d3/zinc combo + 1.5mg valium (trying to withdrawl from it). L-dopa mucuna is supposed to produce dopamine as well as testosterone but the herbal benefits do not last usually and mood eventually may feel sour after few weeks and/or lack of interest.
> >
> > What might be worth a try? Requip? I tried Mirapex many years ago and cannot recall what it did to me aside from me not being pleased with it. Though it might have just been a bad combination with whatever else I was taking.
> >
> > Any other dopamine based options? Supposedly D2 stimulation/production enhancex oxytocin the love molecule. This might be responsible for the greatly enhanced empathy and feelings of Kindness onto others.
> >
> > I miss this priceless feeling. I used to be an immensely loving and very emotional person before Accutane poisoning caused severe melancholic depression in me.
> >
> > I want my emotions back, I want more clear headedness, I want a thirst for life rather than feeling ''nothing'' most of the time.
> >
> >
>
> "poor motivation, low emotion, empty dull mindless mood, slow mindedness, poor cognition"
>
> I would like to add that these symptoms aren't specific to dopamine -- adding despiramine to my combination (which *does* include other dopamine meds) has helped with several of these. Many of the meds you listed, i.e., Parnate, Ritalin, Dexedrine, have strong effects on norepineprhine as well. And these 2 are not the only way to achieve amelioration of these symptoms either -- for example, you could pump someone full of dopamine and norepineprhine but if their serotonin is horribly low they likely won't want to do much still, or enjoy it. But you said you have tried TCAs, okay.
>
> And D2 receptor agonism is not always as pleasurable as it sounds. It can be significantly agitating for some people.
>
> Though I do know what you're talking about with the emotions and clear headedness. I have found Desoxyn to be one of the best meds for these purposes. It has more of an emphasis on dopamine compared to other amphetamines and methylphenidates, and fewer side effects in my case. Speaking of, have you tried Focalin instead of Ritalin?
>
> I have spent much of the past year feeling a lot like you describe, and TMS -- bear in mind I have only had 3 sessions -- is starting to do something that feels dopaminergic.
>
> What are you doing about the thyroid?
>
> Have you tried Lyrica? low-dose amisulpride?
>
> "(pro)dopamine" meds I am taking:
> Marplan 40mg
> Desoxyn 22.5mg
> Deplin 30mg
> Mirapex ER 0.375mg
> Abilify 9mg
>
> One last thing, the Deplin. Yes it's a form of folate, but that shouldn't be underestimated. It is actually a "triamine modulator" in that it increases synthesis of serotonin, norepineprhine, and dopamine. Which in turn causes increased release, and as well Deplin may help replete neurotransmitter stores that are depleted by other meds, e.g. amphetamines, SSRIs. It has helped with my energy too.
>
> Good luck to you.
>
>Thanks for the response. I may have found a source for Agomelatine.
The Deplin is it available via prescription? I'm not sure how to get it. Difficult to find information on it. I really would like to try it.
I got some blood test results back. Turns out my cortisol levels are extremely low. This means low adrenal function. Further testing in few weeks...
Lot of apathy, brain fog, cognitive block, slow thinking, low energy, very poor interest, low emotion. Vyvanse helps to an extent but there is def some stimulation anxiety which accompanies it. It helps for motivation, energy, and somewhat for cognition but the fog is still usually heavy.
Magnesium seems to improve mood, make me more emotionally reactive but sometimes causes more intense headaches than the ones I often have.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.