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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Scott L. Schofield on March 18, 2000, at 14:16:41
Mazindol (Mazinor) is drug that is a potent reuptake inhibitor of both norepinephrine (NE) and dopamine (DA). Its primary indication is for the management of obesity. Infrequently, it has been used to treat depression.
Has anyone ever tried mazindol for depression?
Thanks.
- Scott
Posted by Barbara Roberts on March 18, 2000, at 22:02:21
In reply to Mazindol (Mazinor) for depression? Anyone?, posted by Scott L. Schofield on March 18, 2000, at 14:16:41
> Mazindol (Mazinor) is drug that is a potent reuptake inhibitor of both norepinephrine (NE) and dopamine (DA). Its primary indication is for the management of obesity. Infrequently, it has been used to treat depression.
>Aha! You are a man after my very heart! I NEVER use drugs for depression that increase appetite! To put on the weight is too depressing in itself! And besides, a girl has got to look good! Especially when you have on a hot pink cast on your right hand and arm for 3 months! But you suggested this to me before and I knew I had heard of it before that, (my ex is a pharmacist) and could not place it!
You must be an angel in disguise!
Thanks again!
B.
Posted by saint james on March 19, 2000, at 0:05:00
In reply to Mazindol (Mazinor) for depression? Anyone?, posted by Scott L. Schofield on March 18, 2000, at 14:16:41
> Mazindol (Mazinor) is drug that is a potent reuptake inhibitor of both norepinephrine (NE) and dopamine (DA). Its primary indication is for the management of obesity. Infrequently, it has been used to treat depression.
>
> Has anyone ever tried mazindol for depression?
>
> Thanks.
james here....I am weary of all weight loss meds. They seem to be too potent in their reuptake. Redux and another non-amphetamine wieght loss med have been shown to cause the same changes that MDMA causes. Too much of a good thing.
In terms of weight loss, we know diet pills don't work. I've been on Dexadrine for years, one quickly gets used to the supression of appetite and if you continue to up the dose you will soon be called a speed freak. IF you suppress the appeitite you get rebound at nite and eat everything in the house. The higher the dose the more you eat. You cannot avoid this as you cannot stay on diet pills 24/7 and still be sane. On my normal dose of dex I have a normal appitite.
The problem with all stims is that at some point
they will deplete your body of neurotransmitters(NT's).While AD's hold or delay the deactivation of NT's, stims make more NT's available and at some point the well runs dry.To me the safest route is to go with the stims that have been out the longest, i.e. amphetamine (Dexadrine, Adderal, ect) Amphetamine has been with us since the 1920's. Taken at correct doses it is a very safe med, no flipper kids, ect. Very effective AD for some people. Amphetamine and AD's potentiate each other, often meaning you can take less of each. Try lower doses than used in ADD; start with 5 mgs/day in a slow release formulation like Dexadrine Spansule or Adderal; Dex being the cheaper. I feel it is best to start with stims + an AD; in myself if I take dex alone I do fine for a while but then get depressed.
However, i have no ideas to offer in getting a doc to try any of this for depression w/o ADD.
Most will not even think about it until all AD's and combos are tried.james
Posted by Scott L. Schofield on March 19, 2000, at 14:03:16
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by saint james on March 19, 2000, at 0:05:00
Hi James.
I wanted to point out a few differences between the stimulants you mentioned and both amineptine and mazindol.Do you have any experience with Cylert (pemoline)?
> > Mazindol (Mazinor) is drug that is a potent reuptake inhibitor of both norepinephrine (NE) and dopamine (DA). Its primary indication is for the management of obesity. Infrequently, it has been used to treat depression.> > Has anyone ever tried mazindol for depression?
> I am weary of all weight loss meds. They seem to be too potent in their reuptake. Redux and another non-amphetamine wieght loss med have been shown to cause the same changes that MDMA causes. Too much of a good thing.Mazindol (Mazinor) is a reuptake inhibitor of dopamine (DA) and norepinephrine (NE), as are the amphetamines and Ritalin (methylphenidate). Unlike the amphetamines and Ritalin, mazindol does not promote the release of DA. In this respect, mazindol is more like the antidepressant, amineptine. Amineptine is also an inhibitor of both NE and DA, and is considered particularly effective in treating anergic depressions. Unfortunately, it has been taken off the market worldwide.
> In terms of weight loss, we know diet pills don't work. I've been on Dexadrine for years, one quickly gets used to the supression of appetite and if you continue to up the dose you will soon be called a speed freak. IF you suppress the appeitite you get rebound at nite and eat everything in the house. The higher the dose the more you eat. You cannot avoid this as you cannot stay on diet pills 24/7 and still be sane. On my normal dose of dex I have a normal appitite.In addition to its initial effect to suppress appetite, mazindol also increases the basal metabolism rate (BMR) to promote thermogenesis. This is accomplished through the activation of brown adipose tissue (BAT) to burn off extra fat. You burn more energy, even while you sit on your butt watching re-runs of the Honeymooners. In addition, mazindol seems to increase (improve) the sensitivity of insulin receptors. The result is a decrease in the release of insulin and a reduction in the amount of glucose withdrawn from the blood stream to be stored as fat. Patients on a reduced-calorie diet who take mazindol lose more weight than those who maintain the same diet but do not take mazindol. Any loss of appetite suppression does not prevent the efficacy of mazindol treatment. Some of the studies I have seen show it to remain moderately effective long-term. Although tolerance to appetite suppression does occur, it seems to persist to some degree in about 50% of cases.
> The problem with all stims is that at some point they will deplete your body of neurotransmitters(NT's).While AD's hold or delay the deactivation of NT's, stims make more NT's available and at some point the well runs dry.I'm not sure that the well runs dry so much as the postsynaptic neuron just gets sick and tired of listening to the presynaptic neuron cry "wolf!". (postsynaptic receptor downregulation - desensitization).
Dexedrine, Adderal, and Ritalin have all been shown to cause dopamine depletion in the striatum, but not in the limbic system (at least, not that I could find). The striatum is responsible for locomotion, while the limbic system is involved in mood, energy, motivation, libido, and memory. If the experimental data is valid, the psychostimulants would not cause DA depletion in those dopaminergic pathways of the brain thought to be involved in depression. Mazindol does not seem to cause dopamine depletion anywhere. That it lacks the DA-releasing properties of the other stimulants may account for this.
> To me the safest route is to go with the stims that have been out the longest, i.e. amphetamine (Dexadrine, Adderal, ect) Amphetamine has been with us since the 1920's. Taken at correct doses it is a very safe med, no flipper kids, ect. Very effective AD for some people. Amphetamine and AD's potentiate each other, often meaning you can take less of each. Try lower doses than used in ADD; start with 5 mgs/day in a slow release formulation like Dexadrine Spansule or Adderal; Dex being the cheaper. I feel it is best to start with stims + an AD; in myself if I take dex alone I do fine for a while but then get depressed.I am not too crazy about Adderal. Adderal is a preparation of dextroamphetamine and methamphetamine in combination. Methamphetamine (and MDMA) not only cause dopamine depletion, but also damage DA neurons via neurotoxic oxidative free-radicals. In addition, methamphetamine and MDMA promote the release of serotonin (5-HT), and produce serotonin depletion. Both have also been implicated in the neurotoxic damaging of 5-HT neurons. But it feels so good.
Does anyone have a lifetime supply of amineptine that they would like to donate to a worthy cause?
Thanks.
- Scott
Posted by AndrewB on March 19, 2000, at 14:33:07
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by Scott L. Schofield on March 19, 2000, at 14:03:16
Scott,
Thanks for the very informative post. Again I learned a lot.
My information says that amineptine is a reuptake blocker of dopamine and has no NE activity. The D2 receptor of the striatum are involved with anxiolytic effects
AndrewB
Posted by Scott L. Schofield on March 19, 2000, at 16:20:26
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by AndrewB on March 19, 2000, at 14:33:07
> Scott,
>
> Thanks for the very informative post. Again I learned a lot.
>
> My information says that amineptine is a reuptake blocker of dopamine and has no NE activity. The D2 receptor of the striatum are involved with anxiolytic effects
Hi.
Considering how long amineptine has been around for, there isn't a whole lot of stuff written about it. Most of the literature I came across a while back (too long) always labelled it as being a DA/NE reuptake inhibitor. I notice that the more recent abstracts cited on Medline describe it as being a selective DA reuptake inhibitor.
I couldn't find any study addressing amineptine pharmacology that I would place confidence in. I at least found one that used numbers. It reported that the potency of amineptine to inhibited NE reuptake was about 1/4 of that for DA. My guess is that if it does affect NE, the difference is probably greater than that.
- Scott
>
> AndrewB
Posted by saint james on March 19, 2000, at 17:24:40
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by Scott L. Schofield on March 19, 2000, at 14:03:16
> I am not too crazy about Adderal. Adderal is a preparation of dextroamphetamine and methamphetamine in combination. Methamphetamine (and MDMA) not only cause dopamine depletion, but also damage DA neurons via neurotoxic oxidative free-radicals. In addition, methamphetamine and MDMA promote the release of serotonin (5-HT), and produce serotonin depletion. Both have also been implicated in the neurotoxic damaging of 5-HT neurons. But it feels so good.
>
> Does anyone have a lifetime supply of amineptine that they would like to donate to a worthy cause?
>
> Thanks.
>
>
James hereAdderal contains no Methamphetamine ! Just D, L-ampheatmine, each as 2 salts.
j
Posted by saint james on March 19, 2000, at 17:43:21
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by Scott L. Schofield on March 19, 2000, at 14:03:16
> In addition to its initial effect to suppress appetite, mazindol also increases the basal metabolism rate (BMR) to promote thermogenesis. This is accomplished through the activation of brown adipose tissue (BAT) to burn off extra fat. You burn more energy, even while you sit on your butt watching re-runs of the Honeymooners. In addition, mazindol seems to increase (improve) the sensitivity of insulin receptors. The result is a decrease in the release of insulin and a reduction in the amount of glucose withdrawn from the blood stream to be stored as fat. Patients on a reduced-calorie diet who take mazindol lose more weight than those who maintain the same diet but do not take mazindol
James here....
This is true of any diet pill, but long term the amount of weight loss is not significant. The weight loss is greater is the first few weeks, then decreases. How long were the long term studies ?
I am waiting for a diet pill that is specific to weight loss issues w/o being a stim.
j
Posted by dom on March 19, 2000, at 21:44:29
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by saint james on March 19, 2000, at 0:05:00
> > Mazindol (Mazinor) is drug that is a potent reuptake inhibitor of both norepinephrine (NE) and dopamine (DA). Its primary indication is for the management of obesity. Infrequently, it has been used to treat depression.
> >
> > Has anyone ever tried mazindol for depression?
> >
> > Thanks.
>
>
> james here....
>
> I am weary of all weight loss meds. They seem to be too potent in their reuptake. Redux and another non-amphetamine wieght loss med have been shown to cause the same changes that MDMA causes. Too much of a good thing.
>
> In terms of weight loss, we know diet pills don't work. I've been on Dexadrine for years, one quickly gets used to the supression of appetite and if you continue to up the dose you will soon be called a speed freak. IF you suppress the appeitite you get rebound at nite and eat everything in the house. The higher the dose the more you eat. You cannot avoid this as you cannot stay on diet pills 24/7 and still be sane. On my normal dose of dex I have a normal appitite.
>
> The problem with all stims is that at some point
> they will deplete your body of neurotransmitters(NT's).While AD's hold or delay the deactivation of NT's, stims make more NT's available and at some point the well runs dry.
>
> To me the safest route is to go with the stims that have been out the longest, i.e. amphetamine (Dexadrine, Adderal, ect) Amphetamine has been with us since the 1920's. Taken at correct doses it is a very safe med, no flipper kids, ect. Very effective AD for some people. Amphetamine and AD's potentiate each other, often meaning you can take less of each. Try lower doses than used in ADD; start with 5 mgs/day in a slow release formulation like Dexadrine Spansule or Adderal; Dex being the cheaper. I feel it is best to start with stims + an AD; in myself if I take dex alone I do fine for a while but then get depressed.
>
> However, i have no ideas to offer in getting a doc to try any of this for depression w/o ADD.
> Most will not even think about it until all AD's and combos are tried.
>
> james
In my experience, the combination of Stimulents and Wellbutrin continues its anorectic effects indefinitely.
Posted by JohnL on March 20, 2000, at 1:46:19
In reply to Mazindol (Mazinor) for depression? Anyone?, posted by Scott L. Schofield on March 18, 2000, at 14:16:41
My doctor talked to me about Tenuate or Ionomin. These are both antiobesity drugs. They are milder forms of modified amphetamines to reduce abuse potential. Tenuate structurally resembles Wellbutrin, but often works better than Wellbutrin. Ionomin structurally resembles Dexedrine. Though we don't here of these two being used much in depression, my doctor has used them with good results, especially when Wellbutrin failed or when a big-guns amphetamine was too abusive.
I was reading somewhere that two people taking Mirapex, another antiobesity drug, experienced relief from their depression after many failures of other meds. They weren't taking Mirapex for depression, but it was a happy side effect. Mirapex is a serotonin and norepinephrine reuptake inhibitor, probably similar to Effexor except with more anorexic effect.
Posted by Scott L. Schofield - Dummy on March 20, 2000, at 8:22:58
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by saint james on March 19, 2000, at 17:24:40
> > I am not too crazy about Adderal. Adderal is a preparation of dextroamphetamine and methamphetamine in combination. Methamphetamine (and MDMA) not only cause dopamine depletion, but also damage DA neurons via neurotoxic oxidative free-radicals. In addition, methamphetamine and MDMA promote the release of serotonin (5-HT), and produce serotonin depletion. Both have also been implicated in the neurotoxic damaging of 5-HT neurons. But it feels so good.
> Adderal contains no Methamphetamine ! Just D, L-ampheatmine, each as 2 salts.
Ouch.I don't know what the hell I was thinking. MAJOR misinformation.
I apologize profusely. Thanks for the correction.
- Scott
Posted by michael on March 20, 2000, at 12:29:57
In reply to Re: Mazindol (Mazinor), Tenuate, Ionomin, Mirapex, posted by JohnL on March 20, 2000, at 1:46:19
> My doctor talked to me about Tenuate or Ionomin. These are both antiobesity drugs. They are milder forms of modified amphetamines to reduce abuse potential. Tenuate structurally resembles Wellbutrin, but often works better than Wellbutrin. Ionomin structurally resembles Dexedrine. Though we don't here of these two being used much in depression, my doctor has used them with good results, especially when Wellbutrin failed or when a big-guns amphetamine was too abusive.
>
> I was reading somewhere that two people taking Mirapex, another antiobesity drug, experienced relief from their depression after many failures of other meds. They weren't taking Mirapex for depression, but it was a happy side effect. Mirapex is a serotonin and norepinephrine reuptake inhibitor, probably similar to Effexor except with more anorexic effect.
>
>I think Andrew (here) mentioned that he recently started mirapex to augment his other meds, with positive results....
Posted by Brandon on March 20, 2000, at 13:33:45
In reply to Re: Mazindol (Mazinor), Tenuate, Ionomin, Mirapex, posted by JohnL on March 20, 2000, at 1:46:19
>
> I was reading somewhere that two people taking Mirapex, another antiobesity drug, experienced relief from their depression after many failures of other meds. They weren't taking Mirapex for depression, but it was a happy side effect. Mirapex is a serotonin and norepinephrine reuptake inhibitor, probably similar to Effexor except with more anorexic effect.
>
>Mirapex (pramipexole) is a selective D2/D3 reuptake inhibitor used for the treatment of movement disorders in parkinson's. It's very selective and I dont believe it acts on either serotonin or norepenephrine.
Brandon
Posted by Scott L. Schofield on March 20, 2000, at 14:20:55
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by saint james on March 19, 2000, at 17:43:21
> > In addition to its initial effect to suppress appetite, mazindol also increases the basal metabolism rate (BMR) to promote thermogenesis. This is accomplished through the activation of brown adipose tissue (BAT) to burn off extra fat. You burn more energy, even while you sit on your butt watching re-runs of the Honeymooners. In addition, mazindol seems to increase (improve) the sensitivity of insulin receptors. The result is a decrease in the release of insulin and a reduction in the amount of glucose withdrawn from the blood stream to be stored as fat. Patients on a reduced-calorie diet who take mazindol lose more weight than those who maintain the same diet but do not take mazindol
> This is true of any diet pill, but long term the amount of weight loss is not significant. The weight loss is greater is the first few weeks, then decreases. How long were the long term studies ?
Why isn't thermogenesis mentioned more often when describing the mechanisms of action of amphetamine? I looked back on Medline to try to find more information about the clinical use of mazindol. The one study I found focusing on the "long-term" use of mazindol did not describe exactly how long they followed their test subjects for. The average amount of sustained weight loss was not substantial, about 7 Kg. I don't know how meaningful this is, since they didn't give any indication as to what the average weight of the subjects were before treatment.
> I am waiting for a diet pill that is specific to weight loss issues w/o being a stim.Had you tried Pondamin or Redux before the sh_t hit the fan? A friend of mine who works for a large brokerage firm described dramatic weight loss in some of her co-workers who had been on fen-phen. They seemed to keep it off. I haven't seen her recently to ask how they are doing, though. Does sibutramine offer comparable results given its actions on NE and 5-HT? I didn't realize how little definitive work has been published in this field. Maybe it's not as rewarding to report failure.
Is there any potential for leptin to be used clinically?
Has growth-hormone ever been used specifically for weight-loss?
The other thing that occurs to me is that a drug like topiramate can cause significant weight-loss. What's going on there?
I'm still hoping to hear from someone who has tried mazindol for depression. There are some published reports citing success. My main interest is to use it in the role of an augmenting agent, similar to the psychostimulants. I'm still trying to find something that would approach nomifensine or amineptine in its ability to inhibit the reuptake of dopamine and/or norepinephrine, and that has demonstrated any antidepressant properties.
- Scott
Posted by saint james on March 20, 2000, at 16:31:26
In reply to Re: Mazindol (Mazinor) for depression? Anyone?, posted by Scott L. Schofield on March 20, 2000, at 14:20:55
Why isn't thermogenesis mentioned more often when describing the mechanisms of action of amphetamine?
James here....
Personal experience tells me this happens on amphitamine and methamphatimine.
Sorry I have side tracked your original ? about
Mazindol and depression but one final point that will play to both issues. The diet pills have their effect by raising NT levels very high. I've taken all of the diet meds and I can tell up personally this is true. I also find they make me dysphoric where as amphetamine at normal doses 10-40 mgs/day produces no euphoria, just makes me focused for the first time. I feel the level at which NT's are amped up to by there diet pills is and has had sideeffects that are significant. Too much of a good thing.Scott, if you are looking for studies on amphetamine try www.maps.org . Maps funds studies into legit use for many psycoactives.
james
Posted by drugdoc on March 10, 2008, at 9:15:06
In reply to Re: Mazindol (Mazinor), Tenuate, Ionomin, Mirapex, posted by Brandon on March 20, 2000, at 13:33:45
The info posted about Mirapex is ALL wrong. It is a dopamine agonist that is selective for D2/D3 dopamine receptors, not an uptake inhibitor. It is NOT an antiobesity drug (used in Parkinson's disease and RLS). DA agonists have been suggested to have some antidepressant properties, but probably work less well than even currently approved drugs.
> >
> > I was reading somewhere that two people taking Mirapex, another antiobesity drug, experienced relief from their depression after many failures of other meds. They weren't taking Mirapex for depression, but it was a happy side effect. Mirapex is a serotonin and norepinephrine reuptake inhibitor, probably similar to Effexor except with more anorexic effect.
> >
> >
>
> Mirapex (pramipexole) is a selective D2/D3 reuptake inhibitor used for the treatment of movement disorders in parkinson's. It's very selective and I dont believe it acts on either serotonin or norepenephrine.
>
> Brandon
Posted by undopaminergic on March 19, 2008, at 11:59:26
In reply to Re: Mazindol (Mazinor), Tenuate, Ionomin, Mirapex » Brandon, posted by drugdoc on March 10, 2008, at 9:15:06
> The info posted about Mirapex is ALL wrong. It is a dopamine agonist that is selective for D2/D3 dopamine receptors, not an uptake inhibitor. It is NOT an antiobesity drug (used in Parkinson's disease and RLS). DA agonists have been suggested to have some antidepressant properties, but probably work less well than even currently approved drugs.
>It may depend on the particular type of depression. There is some evidence that pramipexole (Mirapex) is uniquely anti-anhedonic - sometimes too much so... there is an amusing article on compulsive gambling and hypersexuality that appeared in patients shortly after starting pramipexole or dose increases thereof, and then resolved after dose reduction or cessation. To a lesser extent, ropinirole, pergolide and other dopamine agonists were also implicated.
"Pathological Gambling Caused by Drugs Used to Treat Parkinson Disease"
Arch Neurol. 2005;62:1377-1381
(Freely downloadable last time I checked.)
This is the end of the thread.
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