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Re: SLS - Scott, question for you...

Posted by undopaminergic on May 15, 2008, at 19:31:33

In reply to Re: SLS - Scott, question for you... » undopaminergic, posted by michael on May 12, 2008, at 15:39:34

>
> > I found sulpiride (at low doses) to be more stimulating than methylphenidate (=MPH; at high doses), especially with regard to motivation. However, in the long run, MPH has been more useful because tolerance to it can be addressed with dose escalation so that limited efficacy is maintained up to two months or more.
> >
>
> What doses of sulpiride and MPH were you using/comparing?
>

Sulpiride from about 100 up to 600 mg a day, generally divided into three doses, and methylphenidate from 36 to 108 mg a day (or slightly more) in the form of extended release tablets roughly corresponding to three repeated doses of immediate release MPH.

> Why has the MPH been more useful for you? (...you indicate that the sulpiride was more stimulating - which would seem to indicate that sulpiride was more useful...?)
>

Tolerance develops to both drugs; with MPH, dose increases are useful to retain effectiveness for longer periods of time; this is in contrast to sulpiride, which is most stimulating at low doses, and less so at higher doses - above 600 mg or so - where the postsynaptic dopamine D2-recpeptor blockade will begin to predominate over the enhanced DA release resulting from blockade of presynaptic D2-autoreceptors. In other words, MPH has been more useful in the long term, although sulpiride was more stimulating at its best - before tolerance set in.

> > Several people have found memantine to be effective against stimulant tolerance, and also to have antidepressant and stimulant effects of its own. I'm currently experimenting with it, and it looks promising. I had temporary excellent results with amantadine (memantine without the two methyl-groups) also.
> >
>
> I'd be interested in hearing how your experiments with memantine go...
>

So far so good - my experience is still limited, especially since I was using a SSRI during much of my period of memantine use, and this affects the results: SSRIs dampen the dopaminergic effects of other drugs. To this point, memantine has been particularly useful for attention, insomuch that I'm more in tune with my sensory input and surroundings - I normally experience low grade depersonalisation and derealisation, and tend to "live inside my head". I've also noticed that I perceive challenges and obstacles as smaller and less discouraging while on memantine.

> And I am curious regarding what kind of excellent results you experienced with the amantadine... and what doseages of amantadine were you using?
>

I've tested amantadine on a number of occasions, and at various doses, but only one of the trials has been successful. The peak response was intense, featuring a hypomanic-like flight of ideas - not quite euphoria, but pleasant, yet at the same time overwhelming. I calmed myself with a dose of 5-hydroxytryptophan (5-HTP), and remained in "remission" for a week or two, slowly returning to baseline. During remission, motivation, initiative, cognition, insight, confidence and several other qualities were excellent. My successful trial of amantadine generally involved the use of doses of 50 mg at a time, two to three times daily.

> Have you looked into abilify?
>

Not seriously, but it's one of many drugs that I may look into, if needed, at some future point.

>
> In any case, thanks for your feedback - you've given me a couple of things to think about.
>

I'm glad to hear it was well received, and thank you for your interest.


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