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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Prefect on December 28, 2016, at 21:21:51
I apologize for posting this here rather than the supplements section, but I've noticed far more traffic here and really need to tap into the immense knowledge of patrons on this site to make some timely decisions.
I'm currently considering switching from Luvox to maybe a SNRI as a core med, or other meds that increase activity of norepinephrine and dopamine. But switching a med is a big move (been on Luvox 20 yrs) and until I pick the next alternative (thinking maybe Effexor or Wellbutrin) I want to take a crack at some supplements that sort of do the same thing really quickly as a litmus test for my current thinking.
So far I've come up with Tyrosine. I have two questions:
1. Yesterday I was mentally foggy, took 500 mg of L-Tyrosine and nothing happened. Correct me if I'm wrong but this supplement isn't one that takes time (unlike fish oil or something) for an outcome, right? If the dosage was correct, should I not have felt something yesterday?
2. Are there other supplements you think are better options for increasing Norephinephrine and dopaminergic activity than Tyrosine?
Thanks
Posted by Christ_empowered on December 28, 2016, at 21:30:29
In reply to Norepinephrine and Dopamine Litmus Tests, posted by Prefect on December 28, 2016, at 21:21:51
Hi. I'm not an expert on amino acids, but I think DL-phenylalanine, taken on an empty stomach, can be helpful in depression, in part by stimulating NE and dopamine.
I don't think a 1 day test run is a sufficient trial, but I could be wrong. The test dose approach works with amphetamines and Ritalin, but I don't know if it applies to supplements.
Hope things work out OK for you.
Posted by linkadge on December 29, 2016, at 9:34:16
In reply to Re: Norepinephrine and Dopamine Litmus Tests, posted by Christ_empowered on December 28, 2016, at 21:30:29
Tyrosine should work fairly quickly. Usually it works quickly and with long term use sometimes tolerance can develop (rather than the other way around).
Surprisingly, some studies suggest that Wellbutrin actually inhibits dopamine release (probably by acting as a nicotinergic receptor antagonist). So, it may or may not be the best option for testing a catecholamine theory.
Other options include stimulants NRI's (nortriptyline, desipramine, atomoxetine). If you chose an SNRI, try one with a pronounced effect on norepinephrine. For example, Cymbalta is a more balanced SNRI (whereas Effexor is much more serotonin selective). Levomilnacipran (fetzima) or milnacipran may be options too.
How dose coffee affect you?
Linkadge
Posted by Prefect on December 29, 2016, at 9:47:50
In reply to Re: Norepinephrine and Dopamine Litmus Tests, posted by linkadge on December 29, 2016, at 9:34:16
I haven't had coffee for a long time because it seems to make my head feel like I have a headache-less migraine. I know that sounds strange, but it feels like blood flow to certain parts of my head has changed and my ears ring, but I don't get any smarter or stimulated. But I get more heart action, just no mood elevation.
Strong black tea (steeped for half an hour) on the other hand makes me feel well for about an hour or two, which I have every morning. I've wondered if that's because of the caffeine or the high amount of L-Theanine in black tea.
Posted by Prefect on December 29, 2016, at 10:28:27
In reply to Re: Norepinephrine and Dopamine Litmus Tests, posted by linkadge on December 29, 2016, at 9:34:16
BTW you said Tyrosine should work fairly quickly. The same should follow with 5-HTP right, ie, I should feel the effect on that day? That's another supplement I'm going to try and if it works it means I should actually be working on serotonin instead and my Luvox isn't really working.
Posted by linkadge on December 29, 2016, at 16:58:27
In reply to Re: Norepinephrine and Dopamine Litmus Tests » linkadge, posted by Prefect on December 29, 2016, at 10:28:27
Well, you should notice some effect right away. Depression can be tricky in that it may not always resolve immediately after 'correcting' a neurotransmitter imbalance.
It really depends on what your symptoms are. On paper, things like anhedonia should respond to dopaminergic substances. However, it doesn't always work that way.
Which ssris have you tried? Different SSRIs have can have a significantly different feel.
Linkadge
Posted by Prefect on December 29, 2016, at 19:45:03
In reply to Re: Norepinephrine and Dopamine Litmus Tests, posted by linkadge on December 29, 2016, at 16:58:27
I have an anxiety disorder, but I've always felt it's a secondary condition to a syndrome (some type of stupid new age disease) I've had for 20 years, which involves morning mental fog, IBS like GI problems, chronic nasal stuffiness (low norepinephrine?) going back to the week I quit smoking, overt daytime sleepiness, lightheadedness, awakening from long hypnogogic dreams drenched in sweat and confused, etc. For years I was misdiagnosed with Chronic Fatigue Syndrome, but I can exercise and have no body weakness, which throws that diagnosis out the window.
I feel if I can energize my brain the anxiety will also resolve. I can't say I've suffered much from depression.
I've only ever been on Luvox.
Posted by linkadge on December 30, 2016, at 7:11:57
In reply to Re: Norepinephrine and Dopamine Litmus Tests » linkadge, posted by Prefect on December 29, 2016, at 19:45:03
Hmm....
Luvox may either not be sufficiently helping those symptoms or, alternatively, it may be exacerbating some of them.
Many of the SSRIs can affect sleep quality as well as affect energy / motivation issues. They can also exaserbate GI / IBS problems as they activate 5-ht3 receptors in the gut.
If you wanted a small change, you might ask to change to sertraline (Zoloft). Zoloft has some impact on the dopamine transporter, which may be better for energy / motivation that luvox. Prozac too, tends to be more energizing.
If you wanted a larger change, you could try switching to something like nortriptyline. It can be good for depression / anxiety and sleep and will probably induce less fog, daytime sleepiness, and GI issues.
You might even ask to 'augment' with nortriptyline and possibly try some sort of cross taper if you're on too much of either.
Wellbutrin is another option, but it may have a greater tendency to worsen anxiety than nortriptyline. In general, its good for depression, but not so much anxiety.
Another thoutgh is that the anxiety is related to gaba and not serotonin / norepinephrine at all.
Linkadge
Posted by phidippus on October 7, 2017, at 14:31:33
In reply to Norepinephrine and Dopamine Litmus Tests, posted by Prefect on December 28, 2016, at 21:21:51
supplements suck.
Try adding Ritalin.
Eric
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