Posted by sowhysosad on March 31, 2009, at 22:30:18
I'm currently weening off imipramine with a view to starting a new med in mid-May, which is most likely to be an SSRI.
Prior to the imipramine I'd been taking escitalopram (Lexapro/Cipralex) for 3 1/2 years. I then suffered awful akathisia when I switched to sertraline back in the autumn, although I suspect this was caused by me absent-mindedly tripling the dose one day (by taking the old dose AM/new dose PM).
Slight problem with returning to SSRI's: I have a movement disorder in my jaw which my neuro agrees may be due to depleted dopamine in the basal ganglia caused initially by the escitalopram, but persisting with the other serotonergic meds.
To rectify the deficiency and get relief from my depression I'm contemplating either:
1) adding NADH supplements to fluoxetine, or
2) giving sertraline another go, as it has significant activity for boosting dopamine according to Ken Gillman (http://www.psychotropical.com/SSRIs_Sertraline.shtml)(FYI: they don't prescribe Bupropion for depression in the UK, and an MAOI's not an option as increased norepinephrine makes me feel terrible - hence ditching the imipramine. I'm also certain neither the pdoc nor the neuro will prescribe any other dopaminergic drugs either.)
So, a couple of questions:
*Have you or anyone you know managed to return to an SSRI which has previously caused akathisia, avoiding a recurrence and achieving remission from depression?
*Given that fluoxetine appears to increase the concentration of dopamine in the prefrontal cortex in a region-specific manner (http://www.ncbi.nlm.nih.gov/pubmed/11919662), would adding NADH overly augment dopamine in this region and cause over-stimulation, anxiety or similar? Do you have any experience of using a fluoxetine + NADH combo?
I don't have any other conditions apart from depression and SSRI's are normally pretty effective for me.
poster:sowhysosad
thread:887980
URL: http://www.dr-bob.org/babble/20090330/msgs/887980.html