![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by conundrum on December 5, 2009, at 9:15:12
Is it after the first dose or does it take time to build up its effect?
Posted by SLS on December 5, 2009, at 9:18:04
In reply to How fast do stimulants elevate mood?, posted by conundrum on December 5, 2009, at 9:15:12
> Is it after the first dose or does it take time to build up its effect?
For me, the effect was immediately after the first dose. I was somewhat improved for three days before I lost the improvement. Other people might have very different experiences.
- Scott
Posted by conundrum on December 5, 2009, at 9:20:45
In reply to Re: How fast do stimulants elevate mood?, posted by SLS on December 5, 2009, at 9:18:04
my pdoc and I did an experiment with 5 mgs ritalin twice a day and I noticed no mood boost. He wants me to try nefazodone, but first I tried 10 mgs in the morning all at once and notice no increase in mood or hedonia. I guess I was wrong that I'm dopamine deficient...
I hope something else brings back the color to this grey faded world.
Posted by SLS on December 5, 2009, at 10:23:53
In reply to Re: How fast do stimulants elevate mood? » SLS, posted by conundrum on December 5, 2009, at 9:20:45
> I hope something else brings back the color to this grey faded world.
I use the grey versus color analogy all of the time. I sometimes use the Wizard of Oz as an example of what it is like to emerge from depression. The movie starts off in a dreary black and white. Then, once the door of the farm house is opened, the kaleidoscope of intense colors of Oz fill the screen and the world changes.
- Scott
Posted by Phillipa on December 5, 2009, at 10:59:50
In reply to Re: How fast do stimulants elevate mood?, posted by SLS on December 5, 2009, at 10:23:53
That three days again. Phillipa
Posted by conundrum on December 5, 2009, at 12:46:26
In reply to Re: How fast do stimulants elevate mood? » SLS, posted by Phillipa on December 5, 2009, at 10:59:50
Huh?
Posted by conundrum on December 5, 2009, at 12:51:41
In reply to Re: How fast do stimulants elevate mood?, posted by SLS on December 5, 2009, at 10:23:53
SLS, what helped you get back into color?
My doc thinks I need an SNRI. Maybe he's right. Wellbutrin and Ritalin didn't help with mood at all and I've never tried an SNRI. I always though Ritalin and Wellbutrin increased norepinphrine anyways, and SSRIs didn't work so I didn't see the point in combining the two.
Posted by SLS on December 5, 2009, at 13:10:07
In reply to Re: How fast do stimulants elevate mood? » SLS, posted by Phillipa on December 5, 2009, at 10:59:50
> That three days again. Phillipa
Yes. I imagine that the key to my treatment-resistance lies in some biological process that takes three days to complete.
- Scott
Posted by bulldog2 on December 5, 2009, at 13:28:53
In reply to Re: How fast do stimulants elevate mood? » Phillipa, posted by SLS on December 5, 2009, at 13:10:07
> > That three days again. Phillipa
>
> Yes. I imagine that the key to my treatment-resistance lies in some biological process that takes three days to complete.
>
>
> - ScottI have the same problem with stimulants. After several days they cease to work. Sometimes an increase in dose will start them working again. But soon they don't work at any dose.
It could be that it's a problem with rapid tolerance and expulsion of the drug. Or maybe the body becomes depleted of the neurotransmitters that the stim works with. If one is depressed one theory is we're running low on certain neurotransmitters. So the stim exhausts what little we have left.
Have you ever tried a stim with an maoi? There would be more available material to work with.
or a drug such as memantine with the stim to prevent tolerance which worked for andrewb.
Posted by SLS on December 5, 2009, at 13:30:29
In reply to Re: How fast do stimulants elevate mood? » SLS, posted by conundrum on December 5, 2009, at 12:51:41
> SLS, what helped you get back into color?
Transiently, I have had this happen briefly with rapid-cycling, imipramine, and Nardil. I once had an extended response to a combination of Parnate and desipramine.
> My doc thinks I need an SNRI. Maybe he's right. Wellbutrin and Ritalin didn't help with mood at all and I've never tried an SNRI.You might want to ask your doctor if it would make any sense for you to remain on the Wellbutrin and combine it with one of the SNRIs or even Lexapro.
> I always though Ritalin and Wellbutrin increased norepinphrine anyways, and SSRIs didn't work so I didn't see the point in combining the two.
It is an attractive idea to think that we can design a treatment around what scientists speculate are the mechanisms of actions of drugs. Even with the myriad data that has been gleaned from studying mental illness, very little is understood as to how to assemble the pieces of the puzzle. The more you know, the more you appreciate how much you don't know. In other words, I don't think it would be a good idea to exclude an evidence-based treatment based upon a personal theory. Although there is now some light penetrating the black-box, I don't think that there is quite enough to avoid some measure of trial-and-error.
I had a partial response to a combination of Effexor and nortriptyline. Unfortunately, it was later discovered that I had been underdosed on the nortriptyline. I was taking only half of what I needed. If I don't feel much better than I do now on my current treatment, I would consider returning to the Effexor and nortriptyline at the appropriate dosages.
- Scott
Posted by SLS on December 5, 2009, at 13:45:54
In reply to Re: How fast do stimulants elevate mood? » SLS, posted by bulldog2 on December 5, 2009, at 13:28:53
> Have you ever tried a stim with an maoi? There would be more available material to work with.
Yes. Parnate 120mg + desipramine 200mg + Dexedrine 20-40mg.
> or a drug such as memantine with the stim to prevent tolerance which worked for andrewb.
My response pattern to adding memantine to Parnate and nortriptyline was another example of an improvement that lasted for only a few days.
Keep thinking for me...
:-)
- Scott
Posted by manic666 on December 5, 2009, at 14:20:01
In reply to Re: How fast do stimulants elevate mood? » bulldog2, posted by SLS on December 5, 2009, at 13:45:54
scott, the wizard of oz thing you have.once out my head i saw a pink toad with a yellow penis,i asked this guy the way to oz, an he said follow the yellow prick toad????????????
Posted by bulldog2 on December 5, 2009, at 14:28:28
In reply to Re: How fast do stimulants elevate mood? » bulldog2, posted by SLS on December 5, 2009, at 13:45:54
> > Have you ever tried a stim with an maoi? There would be more available material to work with.
>
> Yes. Parnate 120mg + desipramine 200mg + Dexedrine 20-40mg.
>
> > or a drug such as memantine with the stim to prevent tolerance which worked for andrewb.
>
> My response pattern to adding memantine to Parnate and nortriptyline was another example of an improvement that lasted for only a few days.
>
> Keep thinking for me...
>
> :-)
>
>
> - ScottIt seems as if genetics has given you a brain with certain hard wired thresholds. Seems like a game of chess to me. You make a move with meds and your brain makes a move to bring you back to your threshold. So how do we defeat genetics? We do know that certain combos have proved effective for a while. Is there a thread that you can discern in which you see a thread that these successful combos had certain things in common?
Posted by RocketMan on December 5, 2009, at 16:36:33
In reply to Re: How fast do stimulants elevate mood? » Phillipa, posted by SLS on December 5, 2009, at 13:10:07
> > That three days again. Phillipa
>
> Yes. I imagine that the key to my treatment-resistance lies in some biological process that takes three days to complete.
>
>
> - ScottHow about a new-wave med with an super-extended release formula that takes its half-life slightly beyond the 3 day threshold? If one were to time it so the half-life of 2 A/D's peaked at opposite times, we may have something? Then again, I could be totally out-to-lunch! again........
*Rick
Posted by Phillipa on December 5, 2009, at 20:25:45
In reply to Re: How fast do stimulants elevate mood? » SLS, posted by RocketMan on December 5, 2009, at 16:36:33
Rick this is to Scott too. Lots of brains working together to solve this and we will. Long acting prozac? Scott same thing happened with the Deplin remember? Google is on my list of activities and Scott you have pub med paid for articles right? Lets all work together and see if three days is more than a placebo response which I did think of today. Love to everyone Jan
Posted by Phillipa on December 5, 2009, at 21:05:00
In reply to Re: How fast do stimulants elevate mood? » SLS, posted by RocketMan on December 5, 2009, at 16:36:33
Another thought while eating okay if you take say a benzo the first time it acts fast right? And an antibiotic usually feel better I do in 24 hours. So the med would be important to. May be something to genetics or emotional components as I react to an ad the first dose? Only two didn't was the luvox and cymbalta? Narrow search criteria?
Posted by floatingbridge on December 9, 2009, at 0:01:38
In reply to Re: How fast do stimulants elevate mood? » SLS, posted by conundrum on December 5, 2009, at 9:20:45
Dexadrine turned the lights on for me, and yes, with it all the color. After awhile, it wasn't quite enough. I've added on strattera--though I am having some difficulty with dosing and timing, it's helped my mood more than dex alone.
Ritalin doesn't work for everyone. That does not mean another stim won't. However, I'm not advocating for dex--it may not work out long run for me--but I wouldn't rule out the dopamine key quite yet.
Good luck to you,
fb
> my pdoc and I did an experiment with 5 mgs ritalin twice a day and I noticed no mood boost. He wants me to try nefazodone, but first I tried 10 mgs in the morning all at once and notice no increase in mood or hedonia. I guess I was wrong that I'm dopamine deficient...
>
> I hope something else brings back the color to this grey faded world.
Posted by conundrum on December 9, 2009, at 10:12:26
In reply to Re: How fast do stimulants elevate mood? » conundrum, posted by floatingbridge on December 9, 2009, at 0:01:38
I might be able to try adderall but probably not dex.
Did you notice the color returning with the first dose?
Posted by conundrum on December 9, 2009, at 10:18:19
In reply to Re: How fast do stimulants elevate mood? » conundrum, posted by floatingbridge on December 9, 2009, at 0:01:38
Dex also increases NE and so does strattera. Maybe a healthy dose of NE and DA is what is needed.
Posted by floatingbridge on December 12, 2009, at 4:56:04
In reply to Re: How fast do stimulants elevate mood? » floatingbridge, posted by conundrum on December 9, 2009, at 10:12:26
.
>
> Did you notice the color returning with the first dose?Yes. I thought, "This must be what it's like to feel normal." That was a good week.
I'm really not sure about the dex and strattera for me. after a morning fiasco of taking them both at once, I've backed the strattera down to 20mg. per night.
fb
How are you doing?
Posted by conundrum on December 12, 2009, at 14:06:11
In reply to Re: How fast do stimulants elevate mood? » conundrum, posted by floatingbridge on December 12, 2009, at 4:56:04
Right now I'm not taking anything. My pdoc wanted me to take nefazodone, but I'm scared of the rare liver toxicity so I didn't get it filled. Also I'll be in Europe January and wouldn't be able to get my levels tested there if i decided to take it.
So right now I'm not taking any psych drugs which is nice because I can think much more clearly. I found ritalin even up to 30mgs a day did nothing for my mood or concentration so a DAT blocker is pretty useless as Wellbutrin failed before as well.
I'm gonna wait until after my vacation to initiate any new ADs. I might try a couple tabs of Adderall before I go as an experiment to see if need a drug that releases norepinephrine and dopamine.
Posted by Phillipa on December 12, 2009, at 21:09:48
In reply to Re: How fast do stimulants elevate mood? » floatingbridge, posted by conundrum on December 12, 2009, at 14:06:11
Is it possible you need no meds you sound like your're doing well solo? Phillipa
Posted by conundrum on December 13, 2009, at 1:32:37
In reply to Re: How fast do stimulants elevate mood? » conundrum, posted by Phillipa on December 12, 2009, at 21:09:48
I don't enjoy things like I used to or have motivation or drive. Even music doesn't sound as good as it used to and basically gave up playing guitar. I need something to make me feel normal emotions. I've felt like this for 6 years off meds and so now i'm hoping something helps with this anhedonia/motivation problem.
Posted by Phillipa on December 13, 2009, at 20:10:23
In reply to Re: How fast do stimulants elevate mood? » Phillipa, posted by conundrum on December 13, 2009, at 1:32:37
Yes you do. Phillipa
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.