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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by tecknohed on December 22, 2005, at 4:38:10
Or has anyone found it useless?
Dosages?
Diagnosis?Thanks.
Posted by Tomatheus on December 23, 2005, at 2:28:05
In reply to Anyone have success with PREGNENOLONE?, posted by tecknohed on December 22, 2005, at 4:38:10
Tecknohed,
I experimented with pregnenolone when I was taking Wellbutrin and lithium, and I found it to have a moderate but relatively short-lasting antidepressant effect. Pregnenolone was one of dozens of supplements that I used to try to give myself a boost while on the Wellbutrin-lithium combo (I was partially responsive, but still struggled with depression to the extent that it was causing moderate - and occasionally severe - impairment in my daily activities), and it was one of the better supplements that I tried.
As far as my diagnosis and primary symptoms go, I have struggled with depression on an almost nonstop basis for the last six years. I was originally diagnosed with dysthymia, but I was rediagnosed as bipolar following the mood cycling I had in response to Paxil. Once I reached 60mg of Paxil, I basically cycled from mild hypomania to severe depression (with no euthymia in between) in "episodes" that lasted three to four days. Aside from that trial and a brief trial of Prozac, I've never had any (hypo)manic symptoms, not even while on non-SSRI antidepressants. The mood stabilizers I've taken so far have not been very helpful, but then again, even the non-SSRIs that I've taken have not done much to alleviate my depressive symptoms. I'm currently on Nardil monotherapy; I've been on it for 11 1/2 weeks, and I've been at 75mg for the last two weeks. I typically notice some slight improvement lasting for about two weeks after each dose increase, but other than that, I've basically felt mostly depressed while on the Nardil. I think I am finally getting some partial responsiveness on 75mg (that's not a result of the dose increase), but I'll see how it goes. So, there's my diagnostic and symptomatic explanation. I still prefer to look at it as an ongoing depression because that's the problem that I've struggled with both before meds and during most of my med trials (with the exception of some mild intermittent hypomania while on SSRIs), but feel free to look at it however you'd like.
At any rate, when I began experimenting with pregnenolone, I took one 50mg capsule daily. It boosted my mood and energy levels almost immediately, and the boost usually lasted for several hours (I would estimate 6-8 hours) or sometimes longer. On some occasions, it gave me enough of a boost that my depression was only slightly noticeable and caused virtually no functional impairment. When I tried sticking to this regimen daily, I seemed to develop a tolerance after several days (I think about five to seven, but I can't remember for sure; it was a while ago). After a while, I began rotating it with other supplements, taking it either alone or in combination with other supplements every few days. Basically, I just took as many supplements as I felt I needed every time moderate to severe depression was interfering with my ability to get crucial work done (remember that I was also still taking both Wellbutrin and lithium at the time). This turned out to be a disastrous way of managing my depression, and I wouldn't recommend it (especially in the long term), but that's another story. I did sometimes exceed the recommended pregnenolone dose of 50mg/day (I occasionally took two to three 50mg capsules a day on days when I felt extremely depressed), and it sometimes provided a better antidepressant effect without triggering hypomania or causing any other adverse effects. No matter how much pregnenolone I took, I didn't notice any feminizing hormonal effects (I'm a guy) or any other effects whatsoever other than an antidepressant effect.
As you may know, pregnenolone has reportedly been used with some success in treating memory problems, fatigue, and depression (Brownstein, 2004). It is known as a "mother hormone" because it is the precursor to all adrenal hormones, some of which include progesterone, DHEA, hydrocortisone, testosterone, and the estrogens (Brownstein, 2004). I actually think that there's a good possibility that pregnenolone "works" on depression by reducing MAO-A levels, possibly by increasing estrogen levels. This is really just a hypothesis of mine based on a little bit of research I've done, so please don't think I'm trying to pass my MAO-A idea off as an irrefutable fact. It is, however, one of several topics that I've sort of been researching and want to investigate further soon. So far, I have come across the abstract of one study that found that estrogen administration to rats (5mg/pellet) reduced MAO-A activity in the hypothalamus by 28 percent and in the amygdala by 21 percent (Holschneider et al., 1998). Another research article's abstract suggested that there is evidence that estrogens influence MAO levels (Chakravorty & Halbreich, 1997). Pregnenolone, like estrogen and the other adrenal hormones that are derived from pregnenolone, declines with age (Brownstein, 2004). Conversely, MAO-A levels increase with age (Hotamisligil & Breakfield, 1991). So, although the research I've done doesn't provide 100 percent conclusive evidence that pregnenolone exerts its antidepressant effects by reducing MAO-A levels (via estrogen), there is some evidence to support my hypothesis. Maybe there's even more, but I haven't really felt up to doing much research lately, unfortunately. Plus, I've got other things I've been putting off that I need to do, but that's enough rambling for me, at least for now.
I've read that you're taking Nardil (and I think you said you still are). Even though I haven't taken any supplements to try to augment Nardil (aside from melatonin, which worsened my depression), I don't think pregnenolone should pose a huge problem, as long as you go with the suggested dose. It may reduce MAO-A levels, but even if that is the case, remember that pregnenolone levels, estrogen levels, and even MAO-A levels vary from person to person. There is no specific MAOI warning on pregnenolone, but it does say to check with your doctor if you're taking prescription medications, so just take that info for what it's worth.
Tomatheus
==
REFERENCES
Brownstein, D. (2004). Testimony on biologically identical hormone therapy: House subcommittee on human rights and wellness. Retrieved from http://reform.house.gov/UploadedFiles/brownstein%20testimony.pdf
Chakravorty, S. G., & Halbreich, U. (1997). The influence of estrogen on monoamine oxidase activity. Psychopharmacology Bulletin, 33, 229-33.
Holschneider, D. P., Kumazawa, T., Chen, K., & Shih, J. C. (1998). Tissue-specific effects of estrogen on monoamine oxidase A and B in the rat. Life Sciences, 63, 155-60.
Hotamisligil, G. S. & Breakfield, X. O. (1991). Human monoamine oxidase A gene determines levels of enzyme activity. American Journal of Human Genetics, 49, 383-92.
Posted by tecknohed on December 23, 2005, at 20:03:56
In reply to Re: Anyone have success with PREGNENOLONE? » tecknohed, posted by Tomatheus on December 23, 2005, at 2:28:05
Thanks Tomatheus for such an informative post.
Your story mirrors mine in many ways, except mine revolves more around social phobia. Depression is there though, often lingering in the background ('especially' lately).Yes I am on Nardil, currently 75mg/day. Have been for 2 years apart from temp 6 week Marplan trial. Nardil is the one I intend on staying with indefinitely, or for as long as poss. I also take Provigil (modafinil) 500mg/day. It completely takes away any tiredness and similar side effects from Nardil and has a mild mood lifting effect of its own, but without any other effects good or bad, so is an ideal addon.
Back to the supplements, I currently take Idebenone 300mg/day. Take note, as this has DEFINITELY enhanced the Nardil. From what I can tell, it seems to have a good serotonin effect. When I first started at 150mg/day it was very strong and I had definite excess serotonin symptoms, but they faded quite quickly. It's now settled and seems to make the Nardil 'brighter', smoother even.
As for the Pregnenolone, it arrived today so I've taken my first dose of 50mg. And yes, I feel something already! It feels activating and brightens my mood too! Great timing, as I needed something like this to help me get through the Christmas period. I've dropped the Idebenone to 150mg/day too, just in case.
There is a slight headache, probably from an interaction with Nardil. But nothing serious.I'll keep posting my progress.
Posted by Tomatheus on December 24, 2005, at 3:58:18
In reply to Re: Anyone have success with PREGNENOLONE? » Tomatheus, posted by tecknohed on December 23, 2005, at 20:03:56
Tecknohed,
Thanks for your reply. I'll get back to you soon.
Merry Christmas and Happy Holidays!
Tomatheus
Posted by Tomatheus on December 24, 2005, at 14:09:03
In reply to Re: Anyone have success with PREGNENOLONE? » Tomatheus, posted by tecknohed on December 23, 2005, at 20:03:56
Tecknohed,
Thanks again for your message. I'm actually getting back to you a lot sooner than I thought I would. As I mentioned in my first post, depression has definitely been my biggest problem, as it has been quite debilitating and persistent for the last six years of my life. Although I have never discussed social anxiety/phobia with my pdoc, I have always suspected that I might have a touch of it. I've always been relatively introverted, and those around me are usually pretty quick to point out that I come across as being relatively shy and quiet. I was even named the quietest guy in my high school graduating class, if that's any kind of indication. Of course, those who are the really the quietest would never qualify for such a distinction because they don't end up getting to know enough people to be voted the quietest. So, I guess I was the quietest person who talked to people but still had a quiet demeanor, or something like that. But that's another issue. As far as social phobia/anxiety is concerned, I really don't tend to see it as a kind of "fear" in my case, but it might actually be there, at least to an extent. I will say that I've basically been at least relatively introverted my entire life, but it was never something that seemed to interfere much with my functioning. Maybe it did, though, at least partially. After the depression struck, I eventually convinced myself that something was seriously wrong (but not quickly enough).
I think I mentioned in my first post that I am also on 75mg/day of Nardil, and I have now been there for two weeks and four days. I'm not getting what I would consider to be a robust antidepressant response, but I do think that it is finally starting to help with my condition. I think I am definitely less depressed and tired during the day than I was when I taking 60mg/day, and even though I'm not quite getting the response that I would like, I'm more functional than I've been, and I really don't feel nearly as depressed as I did when I wasn't taking any meds. This effect obviously might not last (but I do think I'm past the period of mood elevation that I tend to get right after I increase the dose), but I would say right now that Nardil is probably the best single med that I've ever taken. I'm going to give it another 2-3 weeks before I decide (along with my pdoc) whether I should stay at 75mg/day or go up to 90mg/day. And if I go up to 90mg, I'll then give it a few weeks to see how I feel on that dose before I try augmenting it with anything. I might also try Provigil (depending on how tired I feel), and I'm going to see what else I can find out about Idebenone. That's one supplement that I've never tried or even heard about, and I don't think it's available at most U.S. health-food stores. If I decide that I want it, however, I should be able to order it online no problem, assuming that it's legal :). It's encouraging to hear that it's helped augment your Nardil response.
Anyway, it's great to hear that you're getting a good response from pregnenolone, and I hope the activating and mood-brightening effects persist for at least a few days (of course, I hope they persist longer, but it would be really nice if you could at least get a good response for the holidays). I know that you said that your headache is nothing serious, but it does become more bothersome, I would try opening the pregnenolone capsule (assuming that it's a capsule) and dumping some of it out, which would essentially put you at a lower dose. But of course, if it's not a problem, you might as well stay where you are and enjoy pregnenolone's effects for as long as they last.
Tomatheus
> Thanks Tomatheus for such an informative post.
> Your story mirrors mine in many ways, except mine revolves more around social phobia. Depression is there though, often lingering in the background ('especially' lately).
>
> Yes I am on Nardil, currently 75mg/day. Have been for 2 years apart from temp 6 week Marplan trial. Nardil is the one I intend on staying with indefinitely, or for as long as poss. I also take Provigil (modafinil) 500mg/day. It completely takes away any tiredness and similar side effects from Nardil and has a mild mood lifting effect of its own, but without any other effects good or bad, so is an ideal addon.
>
> Back to the supplements, I currently take Idebenone 300mg/day. Take note, as this has DEFINITELY enhanced the Nardil. From what I can tell, it seems to have a good serotonin effect. When I first started at 150mg/day it was very strong and I had definite excess serotonin symptoms, but they faded quite quickly. It's now settled and seems to make the Nardil 'brighter', smoother even.
>
> As for the Pregnenolone, it arrived today so I've taken my first dose of 50mg. And yes, I feel something already! It feels activating and brightens my mood too! Great timing, as I needed something like this to help me get through the Christmas period. I've dropped the Idebenone to 150mg/day too, just in case.
> There is a slight headache, probably from an interaction with Nardil. But nothing serious.
>
> I'll keep posting my progress.
This is the end of the thread.
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