Posted by Dr. Kramer on April 2, 2002, at 8:20:51
In reply to dexedrine augmentation of ssri's , posted by dennison on April 1, 2002, at 14:22:44
> Dr.Kramer hello --Appreciate your helping us!!!:):)........................ MY ? Ssri's and psychostimulant combinations!!! There exist many reports not necessarily double blind studies but, nonetheless a good deal of reports of individuals being treated with psychostimulants to help augment ssri's relieve residual anergia and daytime somnolence, that are pretty impressive. Yet here's the quandry, many laboratory studies have shown ssri's to negate the psychomotor aspects of psychostimulants. Release of dopamine into nucleus accumbens etc wasn't blunted, nonetheless psychomotor effects were reduced to baseline, no behavior effect was generated. The negation of the psychomotor enhancing effects therefore, was obviously somehow down stream of the dopamine post synaptic receptors --reciprocal diminution by enhanced serotonin functioning of some manner............................. Since I've been offerred the option to begin combination of any psychostimulant plus antidepressant, I'm somewhat speculative of just what is the most likely manifestation, psychomotor aspect will be negated or will it indeed be significant , as my greatest impairment currently concerns lethargy and day time drowsiness........................................ I'm currently taking parnate an maoi - thus the dreaded withdrawal and washout period awaits me--:). Thus I'm a bit weary of jumping off bridge before I know where I'm going to land,so to speak!! In otherwords, I don't want to deceive myself into thinking grass is greener on otherside off fence,if indeed that is unlikely to be the case. ....................... Tried effexor and prozac in past both made me extremely apathetic and very tired and constant lethargy, so the psychostimulant would be an essential aspect of the medication regiment. Wellbutrin tried as monotherapy - only produced some agitation but still fatique and somnolence "daytime" were very prominent. Cylert I've been on for quite some time it has little effect, but has prominent side effects,liver tests no big deal all ok -. Ritalin for a few days was not very effective, dexedrine though I tried, response was very good and experienced no side effects whatsoever............................. Guess my ? is dexedrine plus ssri, is this likely to work in your opinion, desimpramine is an option but I'm a bit reluctant to take a tricyclic because of prominent side effects . Ok thanks Dr. Kramer hope this presentation isn't too fragmented :) --probably a bit disorganized though:) but I figurred was best to get postup and not try to get wording perfect or I'd probably never get it done. :):)........... Thanks in advance DR. Kramer.............P.S. sorry about all the dots but my paragraphs always disappear so I use them as a spacer:)
I think it's worth a try. Remember, the studies you are citing show no psychomotor deviation from BASELINE with the combination, and that's really all you want: to maintain normal psychomotor status. Hopefully the stimulant will put you back in the middle.
poster:Dr. Kramer
thread:101313
URL: http://www.dr-bob.org/babble/20020402/msgs/101436.html