Posted by andys on September 20, 2001, at 9:50:38
In reply to Re: dopamine drugs or supplements, posted by ChrisK on September 17, 2001, at 4:29:38
Again, thanks for all the great responses, here’s the answers to your questions:
RESPONSE TO GROUCH: WHICH ANTI-DEPRESSANTS TRIGGERED HYPOMANIA?
I have included other classes too, like calcium channel blockers)…
Serious hypomania: prozac, Zoloft, risperidone, SAMe (nutritional supplement),
Medium hypomania: paxil, Ritalin, tiagibine, verapimil, nimodipine, vivactil, wellbutrin, ECT (shock therapy), Neurontin (at high dose, very paradoxical).
No hypomania, but unsuccessful, due to side effects or no response:
Parnate, Nardil, effexor, buspar
Drugs that worked: desyrel (trazodone), but like mirapex, I only felt benefits AFTER I quit. I may consider Serzone, it’s supposed to be “a cleaner trazodone”. Moclobemide (helped for 6 months).GROUCH: AMISULPRIDE’S QUESTIONABLE SYNERGISM WITH MIRAPEX:
Man, you know your neurons! Sounds like I’ll skip amisulpride, too tricky. With your great input, I’m heading toward the conclusion that I should stick with a tolerable low dose of mirapex (especially for it’s D3 agonism), hoping to get synergism with my current drugs: stick with seroquel (for it’s D2 agonism, and wonderful sleep qualities), stick with Dexedrine, and raise my lamictal (which I intended to do anyway).GROUCH: DEXEDRINE SYMPTOMS:
Dexedrine gives me a mild mood lift (beyond that of just a CNS stimulant), and has pulled me out of a depression in the past. My pdoc (who is somewhat anti-dexedrine), insists it’s mood destabilizing, but it is NOT, and I get no crash from it (I tell my doc it’s an important piece of info. that I tolerate the stimulants (Dexedrine, phentermine) so well, but that antidepressants trigger mania. Someday, biopsychiatry will understand what that means). (An earlier brilliant pdoc started me on Dexedrine, to reduce coffee intake, which I agreed with him is VERY mood destabilizing for me). Although he told me Dexedrine was dopaminergic, I’ve never found anything in print.ANOTHER DOPAMINERGIC RESPONSE- THRILL SPORTS
The brilliant pdoc I mentioned above also said my mood lift from thrill sports also indicates I respond to dopamine. A true thrill sport (windsurfing, kitesurfing, skiing) gives me a BIG antidepressant hit (but very unstable, invariably transitions to hypo/anxiety, requiring klonopin). Normal exercising (bicycling, running, etc) doesn’t give this dramatic response, so it’s the thrill aspect that does it. (I offer this, in case others get this thrill response, it may be a marker for good response to dopamine).
MITCH: CYTOMEL AND STIMULANTS:
First, define rapid cycling. The PDR defines it as 4 switches a YEAR! (doesn’t seem very rapid to me). I ask, because a true rapid-cycler is considered to be a different “species”, with some different (but evolving) rules, like not treating with antidepressants, but with mood stabilizers (anti-convulsants and atypical antipsychotics). I’m not saying it’s universally true, but sure applies to me, and sounds like you need to think more in that direction too.
I ran a web site for 2 years, for ultra-rapid cycling, gathering info. on treatments that worked, and found no pattern (of any particular meds that worked). Oh, well…
The fact that we both tolerate stimulants without triggering mania is officially considered “paradoxical”, but may also be a function of rapid cyclers being a different “animal”.
Part of the evolving theory of rapid cyclers is that they are more likely to have “multiple malfunctions” going on (bipolar/endocrine/thyroid/hypoglycemia, etc), which would explain why they can be notoriously hard to treat. One theory is that rapid-cyclers may have sub-clinical thyroid disorder (or some other un-measurable thyroid disfunction). Therefore, they’re treated with thyroid meds, even if their thyroid test show normal. Thyroid is boosted with cytomel (increases T3), or synthroid (increases T4). I didn’t respond to synthroid, but get a definite activation from cytomel .25 mg.), taken with my wakeup meds (Dexedrine and lamictal). But a very successful therapy that is emerging is to take both synthroid and cytomel, to raise your overall thyroid level to the high-side of normal (even if it was originally normal). I have heard of great benefits from this, and intend to try it, after I exhaust the dopamine issues.
As far as stimulants, I’d say replace Adderall, if it makes you panicky. But my experience is limited, I tried Ritalin (didn’t like it for many reasons), and phentermine (a long explanation in my earlier message, but couldn’t tolerate, due to insomnia). Thanks for the great pergolide vs. mirapex comment, hopefully, others will add their comments too.
ANY COMMENTS ON PERGOLIDE VS. MIRAPEX?
Does anyone else have any comments on pergolide’s benefits over Mirapex? It’s definitely the sedation/lethargy side effect of Mirapex that’s in the way of getting a more dramatic response from Mirapex. I’ll go research it, but in the meantime, any comments on it’s benefits/ side effect tolerability/ preference for D3 agonism?
poster:andys
thread:78856
URL: http://www.dr-bob.org/babble/20010917/msgs/79147.html