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Dr. Bob is Robert Hsiung, MD,
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Posted by linkadge on July 4, 2010, at 12:18:03
In reply to Re: mirapex » inanimate peanut, posted by Conundrum on July 4, 2010, at 0:52:36
For me, using an SSRI seems to prevent tollerance (to some extent) to the ritalin. Actually, I have been using chlorpheniramine which is an antihistamine with affinity for the serotonin transporter.
The problem is when I use the long acting SSRI's I get dysphoria. Chlorpheniramine is relatively short acting, and has effects on depression itself in animal models.
I take 1-2mg in the evenining which helps sleep, with little/no hangover. It also seems to help keep the ritalin working the next day.
Chlorpheniramine has some muscarinic antagonism which could (theoretically) augment the dopaminergic effect of the ritalin.
Linkadge
Posted by Brainbeard on July 5, 2010, at 4:34:39
In reply to Re: mirapex, posted by linkadge on July 4, 2010, at 12:18:03
Mirapex and all other synthetic dopamine agonists, except Servier's Trivastal (piribedil), can cause sudden sleep attacks, even while driving a car - you can check the case reports on Pubmed. I regard this as a serious drawback. Mirapex has also been associated with hypersexuality and obsessive gambling.
The ergot-derived dopamine agonists, like cabergoline, all carry the risk of heart valve damage, except for lisuride.
If you're looking for a truly, seriously dopaminergic med, you're looking for an amphetamine.
Posted by Conundrum on July 5, 2010, at 8:29:30
In reply to Re: mirapex, posted by Brainbeard on July 5, 2010, at 4:34:39
I know your not the first one to mention amphetamine, I think Rjlockhart did as well. (hope i remembered is username right). However it causes more release of norepinephrine and serotonin, so its hard to get a subjective idea of what you are actually feeling when you take an amphetamine. I think ritalin would be a closer bet, since it binds more to dopamine than norepinephrine reuptake sites, which is the opposite of amphetamines and doesn't inhibit the uptake of serotonin.
I know that ritalin binds more to the dopamine transporter than dextroamphetamine, but I'm sure amphetamines RELEASE more of both catecholamines.
I mean if you really wanna get the definitive dopaminergic drug you're gonna have to try amineptine. Its closest to pure dopamine reuptake inhibitor of which I am aware. It uses your own brains dopamine, so its not going to make you very compulsive like a agonist which acts more potently than the natural stuff. It has a long half life so its not as addictive as amphetamines and I belive it is dosed once a day. Also it doesn't block the D2 receptor like antipyschotics, so it shouldn't cause tardive symptoms. You could probably develop tics like with ritalin however.
Posted by linkadge on July 5, 2010, at 8:51:36
In reply to Re: mirapex » Brainbeard, posted by Conundrum on July 5, 2010, at 8:29:30
The amphetamines do release the catecholamines unlike ritalin, but they are also functional inhibitors of monoamine transporters. Don't they cause the tranporter to work in reverse or something, in essence preventing reuptake and enhancing release.
Linkadge
Posted by Brainbeard on July 5, 2010, at 13:14:36
In reply to Re: mirapex » Brainbeard, posted by Conundrum on July 5, 2010, at 8:29:30
Ritalin/methylphenidate has strong noradrenergic effects too.
I have used amineptine and it is a very, very subtle drug, at least in normal therapeutic doses. It doesn't have a long half-life; the half-life of the drug itself is less than an hour, and the half-life of the metabolites is about 2.5 hours. The effects on the brain probably last much longer.
Personally, I find dextro-amphetamine a much cleaner drug than Ritalin/methylphenidate.
Posted by Conundrum on July 5, 2010, at 20:24:59
In reply to Ritalin, Amineptine And Dextro-Amphetamine., posted by Brainbeard on July 5, 2010, at 13:14:36
> Ritalin/methylphenidate has strong noradrenergic effects too.
>
> I have used amineptine and it is a very, very subtle drug, at least in normal therapeutic doses. It doesn't have a long half-life; the half-life of the drug itself is less than an hour, and the half-life of the metabolites is about 2.5 hours. The effects on the brain probably last much longer.
>
> Personally, I find dextro-amphetamine a much cleaner drug than Ritalin/methylphenidate.
>
>
Could you explain what you mean by dextroamphetamine being cleaner than ritalin? It doesn't increase heart rate and cause palpitations as must as ritalin? Perhaps the increase in serotonin smooths it out a bit? The only thing ritalin ever did for me was make my heart beat faster and talk kind of fast at high doses. I wouldn't say it was a pleasant effect. Normal doses did less than the occasion cup of sumatra.I wonder if amphetamine working as a substrate on norepinephrine transporters causes the release of dopamine as well as norepinephrine?
Also could you describe more your experience with amineptine? What were its effects? If it were available would you keep taking it? Its interesting that you said it was subtle and yet it has been removed from world markets.
Posted by rjlockhart04-08 on July 5, 2010, at 21:37:52
In reply to Re: what antidepressant works strong on dopamine? » rjlockhart04-08, posted by Conundrum on July 3, 2010, at 13:07:21
thank you all for posting. ... i've got to go throug and read...
I will ask my doctor about Robextine.
Posted by Bob on July 5, 2010, at 22:54:26
In reply to Re: mirapex, posted by Brainbeard on July 5, 2010, at 4:34:39
> Mirapex and all other synthetic dopamine agonists, except Servier's Trivastal (piribedil), can cause sudden sleep attacks, even while driving a car - you can check the case reports on Pubmed. I regard this as a serious drawback. Mirapex has also been associated with hypersexuality and obsessive gambling.
>
> The ergot-derived dopamine agonists, like cabergoline, all carry the risk of heart valve damage, except for lisuride.
>
> If you're looking for a truly, seriously dopaminergic med, you're looking for an amphetamine.
Why is Trivastal the only one not asociated with sleep attacks?
Posted by Brainbeard on July 6, 2010, at 5:55:25
In reply to Re: mirapex » Brainbeard, posted by Bob on July 5, 2010, at 22:54:26
> Why is Trivastal the only one not asociated with sleep attacks?
>
>I don't know!
Posted by Brainbeard on July 6, 2010, at 9:08:07
In reply to Re: Ritalin, Amineptine And Dextro-Amphetamine. » Brainbeard, posted by Conundrum on July 5, 2010, at 20:24:59
>> Could you explain what you mean by dextroamphetamine being cleaner than ritalin?
It's a subjective experience. Ritalin gives me a kind of brain fog. It feels rough to my brain. Dextro-amphetamine doesn't.
Dextro-amphetamine only touches serotonin in higher doses, not in usual therapeutic doses.
Amineptine is hard to describe. It can produce very mild euphoria. Motivation, a bit of focus. It also increased my anxiety.
It was removed from the market since it can be 'abused' in high doses.
Posted by former poster on July 9, 2010, at 15:28:25
In reply to Re: Ritalin, Amineptine And Dextro-Amphetamine., posted by Brainbeard on July 6, 2010, at 9:08:07
It's sad that a life saving med like this is banned because of "potential for abuse".
Posted by ed_uk2010 on July 10, 2010, at 1:21:21
In reply to Is Amineptine still available anywhere? » Brainbeard, posted by former poster on July 9, 2010, at 15:28:25
> It's sad that a life saving med like this is banned because of "potential for abuse".
Thing is, it wasn't just that. There were reports of severe liver damage and other toxicity which contributed to the withdrawal of amineptine.
Posted by sigismund on July 10, 2010, at 3:47:24
In reply to Re: Is Amineptine still available anywhere? » former poster, posted by ed_uk2010 on July 10, 2010, at 1:21:21
>There were reports of severe liver damage and other toxicity which contributed to the withdrawal of amineptine.
I feel so much safer knowing that there are people up there looking out for me, especially since the euphoric effect was so subtle.
Like David Bowie wrote
'Drink to the men who protect you and I
Drink drink drink your glass raise your glass high
It's not the side effects of the cocaine....'
Posted by jade k on July 10, 2010, at 15:34:57
In reply to Re: Ritalin, Amineptine And Dextro-Amphetamine., posted by Brainbeard on July 6, 2010, at 9:08:07
Awesome combo! Anyone live to tell about it?
But really, has anyone had good result for MDD with amineptine? Where would one get it?
Has amineptine been augmented with Dex? Or would that be too much?
I am dopamine deficient at the moment, wondering if I have any options other than MAOI's.
Wellbutrin and such don't cut it. Can't take SSRI's etc.
Well thanks for any help!
~Jade
Posted by Conundrum on July 10, 2010, at 16:52:40
In reply to Re: Ritalin, Amineptine And Dextro-Amphetamine. » Brainbeard, posted by jade k on July 10, 2010, at 15:34:57
Amineptine vs. Desipramine
Can anyone who has taken both of these drugs explain the effects they had for them? I'll take experiences with reboxetine and even nortriptyline even though its not as selective as desipramine.
Since norepinephrine and dopamine are similarly related and the norepinephrine transporter is involved in the metabolism of dopamine in certain regions of the brain, I would think there would be some overlap in subjective experiences of NRIs and amineptine.
Posted by jade k on July 10, 2010, at 23:04:00
In reply to Amineptine vs. Desipramine, posted by Conundrum on July 10, 2010, at 16:52:40
> Amineptine vs. Desipramine
>
> Can anyone who has taken both of these drugs explain the effects they had for them? I'll take experiences with reboxetine and even nortriptyline even though its not as selective as desipramine.
>
> Since norepinephrine and dopamine are similarly related and the norepinephrine transporter is involved in the metabolism of dopamine in certain regions of the brain, I would think there would be some overlap in subjective experiences of NRIs and amineptine.Hi Conundrum,
I was thinking the same thing :-)
Now that I'm here, I was wondering if anyone came up with a good combo between the 3 dopamine meds we were discussing?
Amineptine, Ritalin, and Dexedrine I believe.For example, anything that could be combined with Amineptine? Btw-Is this similar to Wellbutrin?
Sorry to bother you..again..its just your wealth of knowledge. Its staggering. And thanks for the help, as always.
~Jade
Posted by Conundrum on July 10, 2010, at 23:13:49
In reply to Re: Amineptine vs. Desipramine, posted by jade k on July 10, 2010, at 23:04:00
Even if you procured amineptine, it is ridiculously expensive, so unless you are rich its not realistic for everyday use. It would be nice if it were available. I'm aware of people using ritalin and amphetamines together, not at the same time but one early in the day and another one later on.
Amineptine is probably nothing like wellbutrin. I've never tried amineptine, but wellbutrin is a weird drug and definitely does more than block the reuptake of norepinephrine and dopamine. I can't tolerate it, but I can tolerate ritalin which is a NDRI.
Posted by jade k on July 10, 2010, at 23:31:14
In reply to Re: Amineptine vs. Desipramine » jade k, posted by Conundrum on July 10, 2010, at 23:13:49
Nope, not rich, just lookin for something to WORK!
Wellbutrin never did anything for me, but I know its supposed to be dopaminergic, is that the right word? SSRI's and sarotonin are not my friends. I've only done well on Parnate, and the stims. Well, geuss my pdoc will have to earn his keep this week. (he's good actually).~Jade
Posted by Brainbeard on July 12, 2010, at 5:10:28
In reply to Re: Amineptine vs. Desipramine » Conundrum, posted by jade k on July 10, 2010, at 23:31:14
One way to potentiate dopaminergic drugs is to combine them with selegiline, the MAO-B inhibitor (at doses of 10mg or below), BUT this is very dangerous when you take too much of the dopaminergic add-on. Potentiation is estimated to be five-fold at least at the Bluelight forum. I've combined 10mg of selegiline with only 5mg of Ritalin and the boost lasted all day, but it was too jittery for my taste.
Posted by SLS on July 12, 2010, at 5:43:39
In reply to Potentiating Dopaminergic Drugs, posted by Brainbeard on July 12, 2010, at 5:10:28
> One way to potentiate dopaminergic drugs is to combine them with selegiline, the MAO-B inhibitor (at doses of 10mg or below), BUT this is very dangerous when you take too much of the dopaminergic add-on. Potentiation is estimated to be five-fold at least at the Bluelight forum. I've combined 10mg of selegiline with only 5mg of Ritalin and the boost lasted all day, but it was too jittery for my taste.
Do you ever allow your CNS to establish a homeostatic equilibrium by adhering to a single treatment regime for an extended period of time? The one time that I achieved remission, I did not see optimal results until I had been treated for 3 months.
- Scott
Posted by Brainbeard on July 12, 2010, at 5:58:12
In reply to Re: Potentiating Dopaminergic Drugs » Brainbeard, posted by SLS on July 12, 2010, at 5:43:39
> Do you ever allow your CNS to establish a homeostatic equilibrium by adhering to a single treatment regime for an extended period of time?
Good question. Short answer: no. But perhaps my new p-doc can make a change here.
Posted by SLS on July 12, 2010, at 6:30:48
In reply to 'Give The Meds A CHANCE, For Pete's Sake!', posted by Brainbeard on July 12, 2010, at 5:58:12
> > Do you ever allow your CNS to establish a homeostatic equilibrium by adhering to a single treatment regime for an extended period of time?
> Good question. Short answer: no. But perhaps my new p-doc can make a change here.I hope you find something that works. Perhaps having confidence in your new doctor will help.
- Scott
Posted by Brainbeard on July 12, 2010, at 13:14:27
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!' » Brainbeard, posted by SLS on July 12, 2010, at 6:30:48
> I hope you find something that works. Perhaps having confidence in your new doctor will help.
>
>
> - ScottThanks. I guess that could help indeed.
-The Beard
Posted by SLS on July 12, 2010, at 13:46:57
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!', posted by Brainbeard on July 12, 2010, at 13:14:27
> > I hope you find something that works. Perhaps having confidence in your new doctor will help.
> Thanks. I guess that could help indeed.
With your level of knowledge and understanding, any doctor will certainly be challenged. Respect and confidence in them may not come easily for you. That's okay, though. I think the right doctor will earn your respect and confidence. It just might require an open mind to start with.
My doctor is interested in using magnetic treatments for me. Have you been presented with rTMS as an alternative? I have my doubts, but I will probably pursue it if I don't respond adequately to the addition of Nardil. I've never combined it with lithium before, so we'll see. I really should give it another 4 weeks to see what direction things go in.
Nardil 90mg
nortriptyline 150mg
Lamictal 100mg
Abilify 10mg
lithium 300mg
- Scott
Posted by Brainbeard on July 12, 2010, at 14:24:50
In reply to Re: 'Give The Meds A CHANCE, For Pete's Sake!', posted by SLS on July 12, 2010, at 13:46:57
> With your level of knowledge and understanding, any doctor will certainly be challenged. Respect and confidence in them may not come easily for you. That's okay, though. I think the right doctor will earn your respect and confidence. It just might require an open mind to start with.
Right in our first encounter, I mentioned the Luvox-clomipramine combination, and he immediately remarked that such a combo is a rational one because of Luvox' lowering of blood levels of desmethylclomipramine, the noradrenergic metabolite that probably doesn't contribute to the drug's anti-OCD potential. Just the fact that he knew about this interaction by head was enough for him to gain my trust in his being grounded in pharmacotherapy.
>
> My doctor is interested in using magnetic treatments for me. Have you been presented with rTMS as an alternative?No, I haven't.
> Nardil 90mg
> nortriptyline 150mg
> Lamictal 100mg
> Abilify 10mg
> lithium 300mgWow, you've got quite a cocktail. How is the Abilify working out?
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Dr. Bob is Robert Hsiung, MD,
[email protected]
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