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too much dopamine? mirapex + dexedrine

Posted by brender on November 20, 2003, at 13:22:32

Hi, I'm hoping someone out there who has taken mirapex or who understands the neurochemistry can give me some advice.

I have bipolar and ADD and have come close to stability on 1800mg/day neurontin, a small dose of lithium, and 20mg dexedrine/day. However, I do sometimes experience intense depression--actually more like a mixed bipolar episode--in the week before my period, which usually goes away when I get my period. This has gotten pretty scary in recent months and I'm afraid of launching myself from PMS/PMDD into a full-blown manic episode. My doctor prescribed mirapex, .25mg 3 times a day in the ten days before my period. He said to skip the dexedrine while I'm taking it because they are both dopamine agonists.

Here's the problem--the first day that I took the mirapex as prescribed, I was so tired I was unable to talk on the phone or even sit up to watch TV, but I also wasn't able to sleep. It was an extremely uncomfortable state to be in. The same thing happened the next day, but after the second dose and the realization that I couldn't function like this, I decided to take my regular dose of 7.5mg dexedrine. I could still barely function or think. So the next time I split the pill in half and took .125mg mirapex. I was still non-functional. However, if I take the half mirapex (.125mg) + the full dose of dexedrine(7.5mg), I'm OK, although still a little groggy. I'm just wondering if I'm overloading myself on dopamine this way. And if I do go too far, can I cause permanent damage?

I have a very narrow tolerance for stimulants: too little is worse than none at all, and too much makes me sick. 7.5mg of dexedrine is absolutely the most dexedrine I can tolerate at once. I know everyone is different, so maybe no one can answer my question. I know I should consult my doctor, but I called and he hasn't called back. Based on my experience, he probably won't, and I don't see him again for three months.

The other question is about the drowsiness--I read about the drowsiness and "sleep attacks" associated with mirapex. I haven't passed out in the middle of a sentence, but I definitely have excessive daytime drowsiness. Has anyone else experienced this on mirapex? Are the two associated--i.e. if you get drowsy, are you likely to have narcoleptic attacks? Does it go away in time? I called the pharmacy and they said that the drowsiness side effect *might* go away in 7 to 10 days. This doesn't seem very helpful if I am only supposed to take it 10 days a month. I assume I will get all the initial side effects every time I restart.

I would just stop taking it but I've been depressed anyway and as my period approaches I can sense it getting worse. I think the mirapex might be helping, although I'm still depressed, but mostly I'm desperate.

Oh, and most anti-depressants are out for me; I become intensely manic on the smallest dose. I'm also allergic to lamictal.




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