Posted by Ritch on January 27, 2003, at 23:10:53
In reply to Re: fighting anhedonia by increasing reward pathway, posted by hok on January 27, 2003, at 14:44:37
> thanks for the input so far, everyone.
>
> just touching on some of the points that people have brought up so far...
>
> Yes, I have tried Buspar. It had a minor effect on my mood and motivation. On the negative side, it caused more irritability than it was worth.
>
> As for the MAOIs, I have never tried one of the A-types. Considering that I am an atypical depressive, this would seemingly make sense. My doctor and I tend to believe that the MAOIs will probably help my mood better than some of my past SSRI treatments. In the bigger picture though, my extreme sensitivity to most meds to increasing my atypical symptoms of tiredness, cravings, brain fog, and low libido make MAOIs a poor candidate.
>
> Right now, I am content with my combo of nicotine, caffeine, omega-3, lots of vitamins, and low dose of Lexapro. As I mentioned, nicotine seems to be the best component of this combo. It's the best thing for curing my brain fog and increasing my concentration and mood. The primary reasons...
> 1. and the most ovbvious: boosts NE, dopamine, and acetylcholine, as well as its effect on MAO.
> 2. The inhalation medium allows for frequent onset and steady-state administration of its effect -- unlike with most oral means. This is importance considering I'm such a poor metabolizer (PM) and rebound effects have been a big issue.
>
> Eventually, if I try to quit, my best method of replacement might just be small dosages of the MAOI-B selegine (2-3 times daily) added to phenylamine.
>
> Other things I'm going to try...
>
> DHEA (known to help boost dopamine levels and energy). I tried it about a year ago and it helped. Although it did bring with it some minor hostility and irritability. Since then I have rearranged my med combo, and so a retrial might be in order. Along the same lines, I might even consider a small dose of Testosterone therapy as an option.
>
> Even more on the radical side of things down the line, I'd be open to exploring any of the opiates as an option, since many potentiate dopamine release. Any ideas there (e.g., buprenorphine, oxycodone)?
>
> And no, I haven't tried NADH or Siberian Ginseng yet (though I've tried the regular version), but I'm up for a trial of anything.
>
> Everybody's input has been extremely helpful, so any other suggestions would be welcome.
>
> HK
>
Have you ever tried or considered sibutramine (Meridia)? That's what I am going to bring up with my pdoc this week as a substitute for Effexor. It has far more noradrenergic and dopaminergic activity. It bombed clinical trials for depression, but its metabolite is in clinical trials now for ADHD and looks hopeful. I've got ADHD and bipolar and if I can find an effective treatment for ADHD that doesn't make me hypomanic (perhaps a "weak" antidepressant such as sibutramine), or increase anxiety (like stims), AND has some serotonergic activity (which Straterra lacks), it might just work. I like the idea of selegiline a lot-however pdoc won't go for it, perhaps the patch though.
poster:Ritch
thread:137341
URL: http://www.dr-bob.org/babble/20030125/msgs/137871.html