Posted by scott-d-o on December 17, 2003, at 21:58:30
In reply to Re: Shaky hands - how to explain to people?, posted by PhoenixGirl on December 17, 2003, at 20:00:34
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> I haven't tried any dopaminergic drugs, unless you include Ritalin. I developed a tolerance to it after about 3 months, though.
> Selegiline is a drug I'm considering. My doctor is hesitant to try it because it's technically an MAOI. But I would like to try it because it works differently than anything I've tried before, and it might help my barely-existent libido.
> Do you have any suggestions about dopaminergic meds?Hi PhoenixGirl,
I would recommend dropping at least one of the three NAergic meds (I would probably keep the Provigil and drop the other two), and add a *low-dose* of an antipsychotic such as amisulpride. This should have the effect of both reducing depression, anxiety and fatigue and increasing motivation and confidence. Amisulpride and sulpiride are the only two antipsychotics I know of that work *only* at dopamine receptors. However, if you are in the USA, neither of these meds are FDA approved so you will have to order it from a pharmacy overseas once you get your prescription.
If this is too much of a hassle, there are many others that are available that might work just as well, ask your pdoc about it. You probably developed tolerance to the Ritalin because your dopamine autoreceptors became supersensitive thus causing hardly any dopamine to be released, which eventually renders the reuptake inhibition from the Ritalin almost useless. A *low-dose* of an antipsychotic will antagonise these receptors which forces dopamine to be released into the synapse.
I believe that I have a dopamine dysfunction as well and I had the same thing happen to me with stimulants. At first it would give a great antidepressant effect with no anxiety but after continued use I would get nothing but an increase in anxiety due to this dopamine autoreceptor supersensitivity. However, 100mg/d of sulpiride has been wonderful for me. I believe you could benefit from this as well.
Best of luck to you.
scott
poster:scott-d-o
thread:289864
URL: http://www.dr-bob.org/babble/20031213/msgs/291142.html