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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
Posted by ed_uk on October 7, 2005, at 14:53:19
In reply to Re: Parnate to Selegiline, last 5 months » Optimist, posted by KaraS on October 6, 2005, at 21:05:04
Hi K
What drugs/doses are you on at the moment? Are they helping?
~Ed
Posted by ed_uk on October 7, 2005, at 14:54:43
In reply to Re: Parnate to Selegiline, last 5 months... » ed_uk, posted by Optimist on October 5, 2005, at 1:34:25
Hi Opt!
Citalopram 60mg is helping my anxiety but I'd like to increase the dose to 80-100mg because I'm still having some 'breakthrough' anxiety issues.
Kind regards
~Ed
Posted by KaraS on October 8, 2005, at 3:15:39
In reply to Re: Parnate to Selegiline, last 5 months » KaraS, posted by ed_uk on October 7, 2005, at 14:53:19
> Hi K
>
> What drugs/doses are you on at the moment? Are they helping?
>
> ~Ed
Hi Ed,I miss our chats. I've been taking the beta blockers regularly, 12.5 mg. doxepin regularly and 5 mg. of Dexedrine not as regularly. The beta blockers prevent the spikes in pulse rate which I usually like but they haven't made one bit of difference in my depression and they haven't eliminated the anxiety either. (If I try to drop the doxepin the anxiety comes back big time.) The one thing I don't like about the atenolol is that it prevents coffee from waking me up and energizing me. The Dexedrine provides a nice calming feeling but no help for concentration or for motivation. I'm a freak. I'm so bummed.
Now I'm working on increasing my magnesium and vitamin D intake.
How are you doing?
K
Posted by ed_uk on October 8, 2005, at 12:01:31
In reply to Re: Parnate to Selegiline, last 5 months » ed_uk, posted by KaraS on October 8, 2005, at 3:15:39
Hi K,
>I miss our chats.
Me too. I haven't been spending as long on the computer lately because I've been working 6 days a week. I still visit babble daily though :-) I'm doing ok but have been having some anxiety lately. I'd like to increase my citalopram to 80-100mg.
>12.5 mg doxepin
Is that the best dose for you? Does it acheive the optimum balance between the 'fogginess' of high doses and the reduced anxiolytic effect of low doses?
In general, doxepin should be taken at approximately the same time each day. 9.30pm is often a good time.
>The beta blockers prevent the spikes in pulse rate which I usually like but they haven't made one bit of difference in my depression and they haven't eliminated the anxiety either.
Atenolol is essentially a cardiovascular drug. It doesn't generally have any beneficial psych effects apart from the control of tachycardia, palpitations and chest 'discomfort'.
Are you still taking atenolol 12.5mg?
>The Dexedrine provides a nice calming feeling but no help for concentration or for motivation. I'm a freak. I'm so bummed.
You really need to try taking Dexedrine at a range of doses. 5mg might not be enough. Stimulants can have qualitatively different effects at different doses.
Ed xx
Posted by Optimist on October 8, 2005, at 12:19:55
In reply to Re: Parnate to Selegiline, last 5 months » Optimist, posted by KaraS on October 6, 2005, at 21:05:04
Hi Kara and Ed,
I've been playing around a bit with the DLPA and 5-HTP dosages, trying to find a middle ground. I do notice myself being more irritable with the DLPA. I'm not noticing a whole lot greater amount of energy and motivation though really. Caffeine seems to be much more efficatious in that regard.
I'm also trying to cut down my caffeine intake. I've been taking upwards of 800mg a day, usually 400mg bid, in morning and late afternoon/after dinner. It's wonderful for my depression and motivation/energy, but I think it's a "robbing Paul to pay Peter" type process. I have a feeling that's it's contributing to my problems over the long term. It's the same with amphetamines. It's just difficult to get off it when I'm so dependent on it to function.
Selegiline 5mg
DLPA 1000mg - 2000mg per day(earlier in day)
5-HTP 100mg - 200mg per day(mostly in evening)Brian
Posted by KaraS on October 8, 2005, at 14:21:49
In reply to Re: Parnate to Selegiline, last 5 months » KaraS, posted by ed_uk on October 8, 2005, at 12:01:31
> Hi Ed,
>
> Me too. I haven't been spending as long on the computer lately because I've been working 6 days a week. I still visit babble daily though :-) I'm doing ok but have been having some anxiety lately. I'd like to increase my citalopram to 80-100mg.
Would that dosage make you too lazy or complacent? Are you still enjoying the work?
> >12.5 mg doxepin
>
> Is that the best dose for you? Does it acheive the optimum balance between the 'fogginess' of high doses and the reduced anxiolytic effect of low doses?
I really need to go to 25 mg. It helps with the depression. 12.5 mg. just covers anxiety in my usual circumstances. I don't have energy or desire to have conversations until I get to 25 mg. I need the increase to help me sleep as well. I haven't wanted to increase because of the Dexedrine since I"ll probably be increasing that dosage as well.
> In general, doxepin should be taken at approximately the same time each day. 9.30pm is often a good time.
Yeah, I try to take it within 2 hours of the last time I took it. Going for an earlier time is better though. I think I'll gradually take it earlier in the evening.
> >The beta blockers prevent the spikes in pulse rate which I usually like but they haven't made one bit of difference in my depression and they haven't eliminated the anxiety either.
>
> Atenolol is essentially a cardiovascular drug. It doesn't generally have any beneficial psych effects apart from the control of tachycardia, palpitations and chest 'discomfort'.
That certainly has been my experience. I do know of someone else he put on atenolol who is doing better because of decreased anxiety but I don't know any more than that about him.
> Are you still taking atenolol 12.5mg?Yes. 6.25 mg. twice a day. I've had to wake up early and function on a temporary job the last few days so I've only taken it once a day. That way coffee can help me wake up in the morning. Counter-productive I know but I needed that caffeine boost.
> >The Dexedrine provides a nice calming feeling but no help for concentration or for motivation. I'm a freak. I'm so bummed.
>
> You really need to try taking Dexedrine at a range of doses. 5mg might not be enough. Stimulants can have qualitatively different effects at different doses.
Yeah, I guess that's the next step. I'm not optimistic though. Would increasing the doxepin to 25 mg. be dangerous with more Dexedrine (assuming that I take the atenolol religiously)? Might Desoxyn work where Dexedrine hasn't? I doubt it but just thought I'd get your opinion.Kara
xxx
Posted by KaraS on October 8, 2005, at 14:35:50
In reply to Re: Selegiline DLPA update, posted by Optimist on October 8, 2005, at 12:19:55
> Hi Kara and Ed,
>
> I've been playing around a bit with the DLPA and 5-HTP dosages, trying to find a middle ground. I do notice myself being more irritable with the DLPA. I'm not noticing a whole lot greater amount of energy and motivation though really. Caffeine seems to be much more efficatious in that regard.
>
> I'm also trying to cut down my caffeine intake. I've been taking upwards of 800mg a day, usually 400mg bid, in morning and late afternoon/after dinner. It's wonderful for my depression and motivation/energy, but I think it's a "robbing Paul to pay Peter" type process. I have a feeling that's it's contributing to my problems over the long term. It's the same with amphetamines. It's just difficult to get off it when I'm so dependent on it to function.
>
> Selegiline 5mg
> DLPA 1000mg - 2000mg per day(earlier in day)
> 5-HTP 100mg - 200mg per day(mostly in evening)
>
> Brian
Motivation is the hardest part - esp. if you want it without increased irritability. I can't seem to get that even with stimulants. Caffeine is the only thing that has helped me in that respect. Didn't you have some luck in the past with Wellbutrin? Have you checked out the Macuna Pruriens discussion on this board now?
Posted by ed_uk on October 8, 2005, at 16:51:28
In reply to Re: Selegiline DLPA update, posted by Optimist on October 8, 2005, at 12:19:55
Hi Brian,
Caffeine is generally counter-productive for me. It increases my energy (very slightly) for about an hour then leaves me feeling remarkably fatigued for several hours. I think I'm better off without it!
Kind regards
~Ed
Posted by ed_uk on October 8, 2005, at 17:02:44
In reply to Re: atenolol and Dexedrine trials » ed_uk, posted by KaraS on October 8, 2005, at 14:21:49
Hi K
>Would that dosage make you too lazy or complacent?
I don't think so because I enjoy my job. I don't really need to motivate myself because I like working in a pharmacy. I doubt I'll go back to uni to be honest. I don't have the drive.
>I really need to go to 25 mg.
You should :-) I don't think there's any reason to be concerned. 25mg is still a low dose. Anyway, you're on a beta blocker to control your heart rate.
Perhaps you should try a range of different TCAs. Doxepin might not be the best TCA for you. So many choices: amitriptyline, imipramine, nortriptyline, clomipramine, desipramine etc. Mirtazapine is also worth considering. If you can take doxepin without gaining too much weight, mirtazapine might not be any worse!
>Might Desoxyn work where Dexedrine hasn't?
Perhaps. I think you'll probably find a better solution though.
Ed xx
Posted by KaraS on October 9, 2005, at 1:51:21
In reply to Re: atenolol and Dexedrine trials » KaraS, posted by ed_uk on October 8, 2005, at 17:02:44
> Hi K
>
> >Would that dosage make you too lazy or complacent?
>
> I don't think so because I enjoy my job. I don't really need to motivate myself because I like working in a pharmacy. I doubt I'll go back to uni to be honest. I don't have the drive.
Maybe someday you will have more drive. Either way I'm glad you're doing something you enjoy.
> >I really need to go to 25 mg.
>
> You should :-) I don't think there's any reason to be concerned. 25mg is still a low dose. Anyway, you're on a beta blocker to control your heart rate.
Is the concern that the dox and the Dex will stimulate the heart too much or that it will throw off the rhythm? Would the atenolol take care of both of these?
> Perhaps you should try a range of different TCAs. Doxepin might not be the best TCA for you. So many choices: amitriptyline, imipramine, nortriptyline, clomipramine, desipramine etc. Mirtazapine is also worth considering. If you can take doxepin without gaining too much weight, mirtazapine might not be any worse!I've tried amitriptyline and nortriptyline. I'll probably be trying desipramine next.
> >Might Desoxyn work where Dexedrine hasn't?
>
> Perhaps. I think you'll probably find a better solution though.I don't think a better solution exists for me. Nothing will give me motivation if increasing dopamine makes me sedated.
k
xx
Posted by ed_uk on October 9, 2005, at 16:31:25
In reply to Re: atenolol and Dexedrine trials » ed_uk, posted by KaraS on October 9, 2005, at 1:51:21
Hi K,
>Is the concern that the dox and the Dex will stimulate the heart too much or that it will throw off the rhythm? Would the atenolol take care of both of these?
Mainly that it might increase your heart rate too much. Atenolol should take care of this.
>Nothing will give me motivation if increasing dopamine makes me sedated.
Dexedrine might motivate you at the right dose. On the other hand, perhaps a different class of dopaminergic drug (eg. Abilify) might help. Desipramine + atenolol could work well.
>amitriptyline
Do I recall that you took quite a high dose and didn't like the side effects?
~Ed xx
Posted by Optimist on October 10, 2005, at 21:48:01
In reply to Re: Selegiline DLPA update » Optimist, posted by KaraS on October 8, 2005, at 14:35:50
Hi Kara,
Yes, I did have some luck with Wellbutrin. I was taking at the end 450mg a day of the SR, and noticed an improvement with energy, keeping my room clean, etc... I'll have to look at some of my old posts regarding it's efficacy. I don't think it was a real heavy hitter in terms of AD effect, although I did get a good jump on it when I first started it, which I heard is not all uncommon. Many people get a big stimulant effect the first couple weeks I've read.
Yes I have checked out the Mucuna thread, and have researched it in the past. I was trying to find some in the area where I lived before with no avail, then gave up when I started Parnate due to the MAOi restrictions. Honestly though I think the restrictions are highly over-rated, at least for me. I started out very carefully, but after much experimentation I realized I could eat old cheddar cheese, tap beer, soya sauce, sausage, tyrosine, and caffeine with hardly any change in blood pressure. I have a bp cuff at home and would regularily check it after a meal. That was at 100mg Parnate a day which is a pretty hefty dose.
I think I've abandoned the DLPA for now as it's causing a little too much anxiety for my liking with little to no benefits. The 5mg of Selegiline is very mild and I hardly if at all notice I'm taking anything.
I'm sorta weighing my options now, and wondering what future course I should take. I'm currently doing not too badly at the moment but am scared s-less for when november comes when I usually spiral downwards for no apparent reason. I have no prior life events during this time that would predispose me to these depressions, but a 10 year pattern indicats that it will most likely happen again. November and may seem to be my worst months of the year for whatever reason.
Perhaps some lithium, and adding wellbutrin again, or lithium and parnate combined would be better. I'm thinking lithium's hyperglycemic tendency may cancel out parnate's hypoglycemic properties. We'll see
Or lithium/parnate/wellbutrin, or lithium/parnate/dextroamphetamine. That would probably be a while down the road as I believe going one med at a time to determine efficacy is better, then adjusting with add-ons later as needed.
Brian
> Motivation is the hardest part - esp. if you want it without increased irritability. I can't seem to get that even with stimulants. Caffeine is the only thing that has helped me in that respect. Didn't you have some luck in the past with Wellbutrin? Have you checked out the Macuna Pruriens discussion on this board now?
>
>
>
Posted by KaraS on October 10, 2005, at 22:32:44
In reply to Re: atenolol and Dexedrine trials » KaraS, posted by ed_uk on October 9, 2005, at 16:31:25
> Hi Ed,
>
> >Is the concern that the dox and the Dex will stimulate the heart too much or that it will throw off the rhythm? Would the atenolol take care of both of these?
>
> Mainly that it might increase your heart rate too much. Atenolol should take care of this.
Good, then I won't worry about it.
> >Nothing will give me motivation if increasing dopamine makes me sedated.
>
> Dexedrine might motivate you at the right dose. On the other hand, perhaps a different class of dopaminergic drug (eg. Abilify) might help. Desipramine + atenolol could work well.
Maybe but 2 dopaminergic supplements along with Ritalin, selegiline and now the Dexedrine have sedated me. I'll have to try other dosages of the Dexedrine before I give up on it though. Abilify is something to consider as well. At one point I was thinking desipramine might work but there have been so many people (including yourself) who didn't receive any motivation from desipramine. Cymbalta has plenty of effect on NE yet people on it often complain about the apathy. I doubt desipramine will do more for me than an SSRI. I'm just not feeling terribly hopeful right now.
> >amitriptyline
>
> Do I recall that you took quite a high dose and didn't like the side effects?I tried a lower dose too. It was a lot like doxepin but more sedating for me.
K
xx
Posted by KaraS on October 10, 2005, at 22:42:33
In reply to Re: Selegiline DLPA update » KaraS, posted by Optimist on October 10, 2005, at 21:48:01
Hi,
Definitely can't hurt to add in a mood stabilizer. That might just be the magic bullet.
Sounds like you have your work cut out for you with all of those trials but I believe you're getting closer and closer to what will work best for you.
I think you're very lucky about the diet. Some people are lucky and some cheat the smallest amount and pay for it big time. My friend took only 15 mg. of selegiline and then ate some cheddar cheese and she got extremely ill. She didn't know what hit her as her doctor had never told her about hypertensive crises. Can you imagine?
Good luck and keep us posted on how your trials are going.
K
> Hi Kara,
>
> Yes, I did have some luck with Wellbutrin. I was taking at the end 450mg a day of the SR, and noticed an improvement with energy, keeping my room clean, etc... I'll have to look at some of my old posts regarding it's efficacy. I don't think it was a real heavy hitter in terms of AD effect, although I did get a good jump on it when I first started it, which I heard is not all uncommon. Many people get a big stimulant effect the first couple weeks I've read.
>
> Yes I have checked out the Mucuna thread, and have researched it in the past. I was trying to find some in the area where I lived before with no avail, then gave up when I started Parnate due to the MAOi restrictions. Honestly though I think the restrictions are highly over-rated, at least for me. I started out very carefully, but after much experimentation I realized I could eat old cheddar cheese, tap beer, soya sauce, sausage, tyrosine, and caffeine with hardly any change in blood pressure. I have a bp cuff at home and would regularily check it after a meal. That was at 100mg Parnate a day which is a pretty hefty dose.
>
> I think I've abandoned the DLPA for now as it's causing a little too much anxiety for my liking with little to no benefits. The 5mg of Selegiline is very mild and I hardly if at all notice I'm taking anything.
>
> I'm sorta weighing my options now, and wondering what future course I should take. I'm currently doing not too badly at the moment but am scared s-less for when november comes when I usually spiral downwards for no apparent reason. I have no prior life events during this time that would predispose me to these depressions, but a 10 year pattern indicats that it will most likely happen again. November and may seem to be my worst months of the year for whatever reason.
>
> Perhaps some lithium, and adding wellbutrin again, or lithium and parnate combined would be better. I'm thinking lithium's hyperglycemic tendency may cancel out parnate's hypoglycemic properties. We'll see
>
> Or lithium/parnate/wellbutrin, or lithium/parnate/dextroamphetamine. That would probably be a while down the road as I believe going one med at a time to determine efficacy is better, then adjusting with add-ons later as needed.
>
> Brian
>
> > Motivation is the hardest part - esp. if you want it without increased irritability. I can't seem to get that even with stimulants. Caffeine is the only thing that has helped me in that respect. Didn't you have some luck in the past with Wellbutrin? Have you checked out the Macuna Pruriens discussion on this board now?
> >
> >
> >
>
>
Posted by Ktemene on October 12, 2005, at 8:49:26
In reply to Re: Selegiline DLPA update, posted by Optimist on October 8, 2005, at 12:19:55
Hi Brian,
I’ve had some of the same reactions to meds that you have had. For me also Vitex is the herb that helps the most. (And caffine has always been a life-saver for me.) I have been taking 5mg selegiline for about 18 months, and I think it is very helpful, but it does not resolve my depression altogether. A few months ago my pdoc and I decided to add Wellbutrin at a low dose (because selegiline can cause Wellbutrin to become more concentrated in the blood). For me the combination of 150mg Wellbutrin + 5 mg selegiline is better than selegiline alone. Like you, I had tried Wellbutrin some time ago, and increased the dose to the maximum, 450mg a day. At that very high dosage level I began to have side effects, e.g. neck aches, memory problems. And so my pdoc took me off Wellbutrin. But at a low dose with selegiline it is working pretty well. I used to take DLPA with selegiline but I have backed off that recently because of the anxiety and proneness to anger it seems to exacerbate. A couple of herbs that have helped me with anxiety and anger are Holy Basil and Kava Kava. (Someone recommended to me the New Chapter Supercritical Holy Basil, and that is what I use. Maybe other brands are good, I just haven’t tried them.) There is some evidence that both Holy Basil and Kava Kava have some dopamine related activity. Most of the meds and herbs that have helped me affect the dopamine system. Taurine is another supplement that seemed to help keep me stable, and fish oil has helped in the same way. Most recently the thing that has helped me the most with motivation and energy is SAM-e (the butanedisulfonate form). I started taking 1600mg SAM-e in August and noticed an increase in energy and motivation within a couple of weeks. The effect is so noticeable now that I am decreasing the dosage of SAM-e because I am so energetic that it is fueling my anger. (To augment the SAM-e I also take B vitamins (esp. folate, B6 & B12), 750mg TMG and 1000mg methionine.) But I am hopeful that the right SAM-e dosage is what is needed for selegiline and Wellbutrin to have their full effect and put my depression into full remission. I have been waiting to find out whether the selegiline patch will ever make it to market. If it does, I will certainly try that. But if it does not, and the oral selegiline/Wellbutrin/SAM-e combination poops out, I am going to try Parnate.
Have you ever tried SAM-e? How about Remeron? (If antihistamines work for you, Remeron might be a good candidate. Remeron has a huge antihistamine effect.) I’d be interested in hearing about your experiences with other supplements and meds.
Ktemene
Posted by Optimist on October 12, 2005, at 13:55:55
In reply to Re: Selegiline DLPA update » Optimist, posted by Ktemene on October 12, 2005, at 8:49:26
Hi Ktemene!
Thanks for your post. It was very insightfull. I have never heard of anyone else getting relief from Vitex. It's interesting to see someone else with the same reaction. I've heard of others reports that it acts as an aphrodesiac, most likely due to it's pro-dopamine and lowered prolactin effects.
I actually just started taking Wellbutrin SR again today hoping that it would fuel some extra energy and motivation. I was considering going off selegiline, but may try your conconction and see how that goes.
I've officically given up on the DLPA due to it's anxiety elevation and irritability. There's no smoothness to it at all. I got the same feeling on tyrosine.
The supplements I'm currently taking are:
B5 4000mg
B6 (p-5-p)100mg
B12 1000mcg
Folic acid 1000mcg
TMG 6000mg
Calcium 1000mg
Magnesium 500mg
Vitamine D 1000IU
Vitamin C (Calcium Ascorbate) 600mg
Vitamin E 800IU
Iodine 1000mcg
Acetyl-L-Carnitine 2000mg
Acetyl-L-Cysteine 500mg
Vitex 120mg (per day I think, 3 capsules)
5-HTP 100-200mg
Caffeine 400-800mgThe iodine tends to help my back and relieve the muscle tension associated with it. The B5 is for adrenal health and to help clear up my acne. The TMG also seems to help my back. The 5-HTP seems to center me quite a bit and relieve any kind of stressed alarm reaction. I tend to feel more grounded and cool, if that makes any sense.
I have tried sam-e before and seemed to experience a worsening of my back problems. It may have not been related, so I'll have to check it again. I also tried methionine and was having some nasty sulfur burps and I think it was making my back worse as well. The MSM I've tried before seemed to not agree well with me and my joints, and since sam-e and methionine are also sulfur based perhaps that's why I had a negative reaction. I seem to react well to the TMG though so improved methylation seems to be a step in the right direction. Perhaps I'll try another trial with the sam-e to see how it works.
I take so many different supplement at one time it's hard to tell what's doing what sometimes. My discarded supplement list is gigantic. A lot of trial and error based on whatever theory du jour is in vogue with me at that particular time.
Sam-e is also extremely expensive. Your 1600mg per day must cost upwards of 300 bucks a month I'd think. I already spend around 400 bucks a month on supplements/drugs so it doesn't leave much extra.
I have not tried remeron. I've heard it is quite sedating which is the opposite of what I need. I sleep like a baby and always have... never had insomnia in my life so I'm not sure what use it may have.
I haven't tried Kava Kava or Holy Basil. That's something worth looking in to... I've went up to 12 grams of EPA/DHA of fish oil for extended periods of time and haven't noticed much of anything if at all. I've used good quality brands as well.
The drugs I've tried so far are: Effexor XR, Prozac, Wellbutrin SR, Parnate, Selegiline, Adderall XR, and Lamotrigine. I think that's it... oh wait moclobemide as well. It was like a placebo at 1200mg per day.
I had a robust response to the Parnate but it pooped out quite dramatically once allergy season hit. I also had bad hypoglycemia on it as well which tends to magnify my anxiety and depression.
Prozac 20mg was wonderful for my hypoglycemia but I was experiencing some sexual dysfunction on it and perhaps apathy... I'd had to look back on some previous posts.
The Adderal XR was good for energy and motivation but it seems to invoke anxiety to some degree and I felt worse off in social situations. It felt less smooth for me than caffeine. I'm thinking dexedrine would have been a better choice.
I'm curious... if your current regimand is working well now, if it poops out would it not be better to add a mood stabilizer instead of switching to a different med? Perhaps there are some cyclical bipolar characteristic which are contributing to the poop out. I believe there are different variations of bipolar where you can cycle between depressed and normal mood states, just like dysthymia has been indicated as a possible bipolar hybrid.
I was thinking of switching back to a Prozac/Wellbutrin combo and adding some lithium to increase there efficacy, although I may hold off on that and try the wellbutrin/selegiline/5-HTP combo plus lithium. The 5-HTP alone may be enough to support the serotonin side of things without having to delve back in to an SSRI. Lithium I believe also has serotonin increasing properties which may be helpful.
I'm sort of confused as to whether selegiline is causing problems with hypoglycemia with me. My tinnitus seems to be getting worse perhaps. I would like to not give up on the selegiline too quickly though as I have not given it a fair trial yet. It's only when it's combined with DLPA that it tends to increase anxiety I think.
How's that for a novel? :) I'm sure I could ramble on quite a bit more but since I'm at work I'll cut it short here.
Brian
> Hi Brian,
>
> I’ve had some of the same reactions to meds that you have had. For me also Vitex is the herb that helps the most. (And caffine has always been a life-saver for me.) I have been taking 5mg selegiline for about 18 months, and I think it is very helpful, but it does not resolve my depression altogether. A few months ago my pdoc and I decided to add Wellbutrin at a low dose (because selegiline can cause Wellbutrin to become more concentrated in the blood). For me the combination of 150mg Wellbutrin + 5 mg selegiline is better than selegiline alone. Like you, I had tried Wellbutrin some time ago, and increased the dose to the maximum, 450mg a day. At that very high dosage level I began to have side effects, e.g. neck aches, memory problems. And so my pdoc took me off Wellbutrin. But at a low dose with selegiline it is working pretty well. I used to take DLPA with selegiline but I have backed off that recently because of the anxiety and proneness to anger it seems to exacerbate. A couple of herbs that have helped me with anxiety and anger are Holy Basil and Kava Kava. (Someone recommended to me the New Chapter Supercritical Holy Basil, and that is what I use. Maybe other brands are good, I just haven’t tried them.) There is some evidence that both Holy Basil and Kava Kava have some dopamine related activity. Most of the meds and herbs that have helped me affect the dopamine system. Taurine is another supplement that seemed to help keep me stable, and fish oil has helped in the same way. Most recently the thing that has helped me the most with motivation and energy is SAM-e (the butanedisulfonate form). I started taking 1600mg SAM-e in August and noticed an increase in energy and motivation within a couple of weeks. The effect is so noticeable now that I am decreasing the dosage of SAM-e because I am so energetic that it is fueling my anger. (To augment the SAM-e I also take B vitamins (esp. folate, B6 & B12), 750mg TMG and 1000mg methionine.) But I am hopeful that the right SAM-e dosage is what is needed for selegiline and Wellbutrin to have their full effect and put my depression into full remission. I have been waiting to find out whether the selegiline patch will ever make it to market. If it does, I will certainly try that. But if it does not, and the oral selegiline/Wellbutrin/SAM-e combination poops out, I am going to try Parnate.
>
> Have you ever tried SAM-e? How about Remeron? (If antihistamines work for you, Remeron might be a good candidate. Remeron has a huge antihistamine effect.) I’d be interested in hearing about your experiences with other supplements and meds.
>
> Ktemene
>
>
>
Posted by ed_uk on October 15, 2005, at 15:17:32
In reply to Re: atenolol and Dexedrine trials » ed_uk, posted by KaraS on October 10, 2005, at 22:32:44
Hi K,
How are you doing? Did you increase the doxepin to treat your anxiety? Did you try a higher dose of Dex?
>>Is the concern that the dox and the Dex will stimulate the heart too much or that it will throw off the rhythm?
>Good, then I won't worry about it.
:-)
>At one point I was thinking desipramine might work but there have been so many people (including yourself) who didn't receive any motivation from desipramine.
I've never taken desipramine, it's not marketed here. I have tried lofepramine though, another noradrenergic TCA.
Perhaps a noradrenergic drug is just what you need. Noradrenergic drugs can increase energy and reduce ADD symptoms. If a dopaminergic drug is not what you need, perhaps a noradrenergic drug will be the answer.
Still, I *definitely* think you should experiment with various doses/regimens of Dexedrine before moving on to a different type of drug.
>Cymbalta has plenty of effect on NE yet people on it often complain about the apathy.
.....but that's because it's a potent SRI. Desipramine isn't an SRI, it's very different to Cymbalta.
>amitriptyline
What dose did you try? I can take up to 25mg (at night) without side effects. I can't tolerate higher doses.
It would be helpful for you to try a range of different TCAs. Nortriptyline, imipramine etc.
~ed
Posted by KaraS on October 15, 2005, at 22:28:02
In reply to Re: atenolol and Dexedrine trials » KaraS, posted by ed_uk on October 15, 2005, at 15:17:32
> Hi Ed,
>
> How are you doing? Did you increase the doxepin to treat your anxiety? Did you try a higher dose of Dex?
I still haven't increased the Dex yet. I've been working the last couple of weeks and have needed to be sharp (ironic, isn't it?). I don't know how people do drug trials while they're working when you don't know what effect the drugs may have on you (or you do know but you can't afford to be sedated or cognitively dulled).
> >At one point I was thinking desipramine might work but there have been so many people (including yourself) who didn't receive any motivation from desipramine.
>
> I've never taken desipramine, it's not marketed here. I have tried lofepramine though, another noradrenergic TCA.
Yes, I remembered that but was too lazy to look up the name of the drug. I know that it metabolizes to desipramine so you might as well have been taking desipramine, right? And it didn't do a thing for your energy level or to fight your apathy as I remember. Did you try it at any point without an SSRI? If so, did it increase your energy or motivation at all then?
> Perhaps a noradrenergic drug is just what you need. Noradrenergic drugs can increase energy and reduce ADD symptoms. If a dopaminergic drug is not what you need, perhaps a noradrenergic drug will be the answer.
I suppose it can't hurt to try it. I will bring desipramine up with my doctor next time I see him.
> Still, I *definitely* think you should experiment with various doses/regimens of Dexedrine before moving on to a different type of drug.
I agree. I have tried it at lower levels but nothing higher than 5 mg. Maybe a higher dosage would work. It makes sense for that to be the next trial, don't you think? Do you see a problem with higher dosages of Dex along with 25 mg. of doxepin (assuming I'm taking the atenolol of course)?
> >Cymbalta has plenty of effect on NE yet people on it often complain about the apathy.> .....but that's because it's a potent SRI. Desipramine isn't an SRI, it's very different to Cymbalta.
True but you'd think that the NE in Cymbalta would have at least some effect even with all of the SE involved.
> >amitriptyline
>
> What dose did you try? I can take up to 25mg (at night) without side effects. I can't tolerate higher doses.
I think I told you that the first time I tried it was at the 75 mg. level. That was unbelievable. Is it any wonder I go so slowly now considering some of the bad advice I've gotten in the past? But I later tried it at 10 mg. and 25 mg. and still found it to be more sedating than the doxepin at the same levels.
> It would be helpful for you to try a range of different TCAs. Nortriptyline, imipramine etc.ok
Thanks,
K
xx
Posted by ed_uk on October 16, 2005, at 11:06:35
In reply to Re: atenolol and Dexedrine trials » ed_uk, posted by KaraS on October 15, 2005, at 22:28:02
Hi K,
>I still haven't increased the Dex yet. I've been working the last couple of weeks and have needed to be sharp (ironic, isn't it?). I don't know how people do drug trials while they're working when you don't know what effect the drugs may have on you (or you do know but you can't afford to be sedated or cognitively dulled).
I think you should try it next weekend!
>Did you try it at any point without an SSRI? If so, did it increase your energy or motivation at all then?
Yes, I took it alone for about 8 months. My motivation was quite good but it didn't control my anxiety.
>Do you see a problem with higher dosages of Dex along with 25 mg. of doxepin (assuming I'm taking the atenolol of course)?
I think you'll be fine :-)
>I think I told you that the first time I tried it was at the 75 mg. level
AFAIK, the manufacturer still recommends a starting dose of 75mg!
~Ed xx
>
Posted by KaraS on October 16, 2005, at 20:42:51
In reply to Re: atenolol and Dexedrine trials » KaraS, posted by ed_uk on October 16, 2005, at 11:06:35
> Hi K,
>
> >I still haven't increased the Dex yet. I've been working the last couple of weeks and have needed to be sharp (ironic, isn't it?). I don't know how people do drug trials while they're working when you don't know what effect the drugs may have on you (or you do know but you can't afford to be sedated or cognitively dulled).
>
> I think you should try it next weekend!
What do you think - 7.5 mg?
> >Did you try it at any point without an SSRI? If so, did it increase your energy or motivation at all then?
>
> Yes, I took it alone for about 8 months. My motivation was quite good but it didn't control my anxiety.
No kidding. That's really encouraging.
> >Do you see a problem with higher dosages of Dex along with 25 mg. of doxepin (assuming I'm taking the atenolol of course)?
>
> I think you'll be fine :-)great
> >I think I told you that the first time I tried it was at the 75 mg. level
>
> AFAIK, the manufacturer still recommends a starting dose of 75mg!
Really? How dumb and counterproductive.
K
xx
Posted by ed_uk on October 17, 2005, at 14:11:25
In reply to Re: atenolol and Dexedrine trials » ed_uk, posted by KaraS on October 16, 2005, at 20:42:51
Hi K,
>What do you think - 7.5 mg?
Yes, then 10mg.
>That's really encouraging.
I got 100% in some exams when I was on lofepramine 210mg (alone).
>Really? How dumb and counterproductive.
Indeed!!
~ed xx
Posted by KaraS on October 22, 2005, at 0:23:14
In reply to Re: atenolol and Dexedrine trials » KaraS, posted by ed_uk on October 17, 2005, at 14:11:25
> Hi K,
>
> >What do you think - 7.5 mg?
>
> Yes, then 10mg.
Sounds good. I wish I could do it now but I've been temping and can't afford to be zoned out or any slower mentally now. Once this is over, I'll start on the Dex trial again.
>
> >That's really encouraging.
>
> I got 100% in some exams when I was on lofepramine 210mg (alone).
>Wow, that's amazing and so encouraging. Couldn't you have added something for the anxiety that would have left you with that kind of motivation while still keeping your anxiety under control?
Right now only caffeine helps me with energy and focus but if I take the atenolol, then the caffeine does nothing for me at all. I wonder if that would be the case with desipramine. I guess I'll have to try it to find out, eh?
Talk to you later.
K
xxx
Posted by ed_uk on October 22, 2005, at 16:00:55
In reply to Re: atenolol and Dexedrine trials » ed_uk, posted by KaraS on October 22, 2005, at 0:23:14
Hi K,
>Couldn't you have added something for the anxiety that would have left you with that kind of motivation while still keeping your anxiety under control?
I haven't discovered such a drug!
>Right now only caffeine helps me with energy and focus but if I take the atenolol, then the caffeine does nothing for me at all.
Perhaps you should stop the atenolol for now. If you're not taking the Dex, why take the atenolol?
~ed xx
Posted by KaraS on October 22, 2005, at 22:01:05
In reply to Re: atenolol and Dexedrine trials » KaraS, posted by ed_uk on October 22, 2005, at 16:00:55
> Hi K,
>
> >Couldn't you have added something for the anxiety that would have left you with that kind of motivation while still keeping your anxiety under control?
>
> I haven't discovered such a drug!
That does make things a bit difficult, doesn't it?
> >Right now only caffeine helps me with energy and focus but if I take the atenolol, then the caffeine does nothing for me at all.
>
> Perhaps you should stop the atenolol for now. If you're not taking the Dex, why take the atenolol?
Makes sense. As it is I'm only taking it once a day so that I can get the benefit of caffeine during the day.K
xx
Posted by Amigan on October 16, 2008, at 11:27:20
In reply to Re: Selegiline DLPA update » Optimist, posted by ed_uk on October 8, 2005, at 16:51:28
To anyone who had success with the MAOI + DLPA combination:
I would appreciate it if you tell me which brand of DLPA you were/are using. I failed with Solgar DLPA but perhaps it just has to do with my idiosyncrasy.
This is the end of the thread.
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