Posted by Ame Sans Vie on September 2, 2003, at 12:04:44
In reply to ritalin, etc, posted by loolot on September 2, 2003, at 2:46:28
> Is ritalin very addictive, though? I worry that I am getting more and more addicted to the dopamine and norepinephrine (I have those nasty involuntary tics now).
One can develop a dependency to Ritalin or any of the amphetamines after a few weeks of continual use. But if you genuinely need them and plan on continuing to take them, dependency shouldn't be an issue. "Addiction" is a term loosely thrown around to refer to dependency *or* addiction, which are two very different things. Dependency simply means that your body and/or mind relies on the drug to function properly (e.g. a diabetic on insulin; a cancer patient on fentanyl; a mentally ill person on stimulants). Addiction, on the other hand, is more accurately described as a combination of dependency and abuse. The addict compulsively seeks out higher and higher doses of the drug just to stave off withdrawal symptoms and/or get high, regardless of any negative consequences (e.g. a heroin junkie, an alcoholic). So, in a nutshell -- yes, you will become dependent on a stimulant after several weeks of regular use, but it is not difficult to slowly taper off the drug should you ever decide you don't need it any more. Stimulants are only addicting if you abuse them.
However, you mentioned involuntary tics? From what? Wellbutrin? Stimulants will make those tics worse... perhaps you should consider another medication if the Wellbutrin is causing the tics. A combination of Strattera or Edronax and a dopamine agonist may work very well for you, but of course I'm just shooting in the dark here. :-) For what it's worth though, I've found dopamine agonists to be absolutely wonderful at increasing drive, motivation, libido, confidence, and decreasing depression. Mirapex and Requip are (arguably) the best for this purpose, as they have a higher affinity for the D3 receptor than other DA agonists currently marketed -- the D3 receptor is postulated to be responsible for the decrease in depression, confidence boost, and increased motivation especially. Both Mirapex and Requip also target D2 and D4 receptors (to a lesser degree), and I believe that it's the D2 receptor that is implicated in increased/decreased libido.
> Is this stuff dangerous for longterm use? Will I keep needing higher amounts over time?
Stimulants, especially the amphetamines, are very safe provided that one doesn't abuse them. Their safety record can be demonstrated by the fact that they were among the earliest antidepressants (along with opium and its derivatives), and have been used for many years quite safely. In fact, there were some drugs that used to be manufactured, and marketed for depression, that contained a combination of an amphetamine and a barbiturate. Dexamyl (dextroamphetamine + amobarbital) was one; Desbutal (dextromethamphetamine + pentobarbital) was another. Ritalin (methylphenidate, not an amphetamine) may be slightly more dangerous due its very strong peripheral effects (i.e. effects on heart rate, blood pressure, etc.). This can lead to cardiovascular problems if taken long-term, so I would stick with the amphetamines personally.
As for whether you'll develop tolerance to them, it has been my experience that you will not. I've taken amphetamines off and on for years, never developing any kind of tolerance. Yes, the initial "high" that you get from them will disappear, but in all likelihood, their DA/NE release and reuptake inhibition effects will remain and continue to be helpful. Though this is totally subjective, it may help if I tell you that I found Ritalin to be absolutely awful -- like drinking wayyyy too much coffee. Adderall (dextroamphetamine + levoamphetamine + racemic amphetamine) was all right, but it had some of those same peripheral effects Ritalin did, albeit at a lesser degree. Dexedrine (dextroamphetamine) and Desoxyn (methamphetamine) have both been great for me. No peripheral effects that I can detect, and I'm the type of person who can drink half a cup of weak coffee and be absolutely wired, lol. I've settled on Dexedrine as it seems to be a bit more helpful with my symptoms of ADD than Desoxyn, though Desoxyn seemed more energizing.
poster:Ame Sans Vie
thread:256231
URL: http://www.dr-bob.org/babble/20030902/msgs/256326.html