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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Libby on June 13, 2000, at 11:57:30
I believe it was Andrew B. who posted that dopamine receptors were affected by anti-psychotic drugs like Zyprexa. What is affected by augmentation with amphetamine-like drugs like Dexedrine & ProVigil.
I feel good on Effexor/Zyprexa except that I feel
somewhat insulated... That is, I feel like I'm
floating on a cloud created by the meds... With
the Effexor alone, I have serious concentration
problems, regardless of dose...My husband and I have often joked that if the doc 1would just write me a prescription for speed, I'd be fine. It was a joke based in past efforts to self-medicate. Is it wrong (or dangerous) to assume
that this might be a good approach for me?
Posted by AndrewB on June 13, 2000, at 14:16:02
In reply to Augmentation with Amphetamine-like Drugs?, posted by Libby on June 13, 2000, at 11:57:30
Libby,Maybe somebody else can say whether your past history of stim abuse makes it a bad idea to use amphetamines. However, our drug(s) of abuse, those we self medicated with, while inappropriate for long term health and well being, can give us important clues as to which of our receptor systems and areas of the brain may be not working properly.
Street speed I believe affects the adrenal glands, norepinephrine (essentially alpha 1) receptors, and D2 dopamine receptors.
Provigil is not an amphetamine. It works, I think, mainly on the alpha 1 andrenergic receptor, supplementing the action of norepinephrine. So note that Provigil does one of the things street speed did for you. Because of the mode of action that Provigil uses, it does not cause the roller coaster ride of energy and emotion that amphetamines can be noted for. Provigil also won't (normally) cause the anxiety or addiction/abuse potential of amphetamines either. Drugs similar to Provigil- reboxetine, adrafinil, and too lesser extent Wellbutrin, also share these characteristics.
Certainly one option for you, without having to use stimulants, is to try one of the aforementioned drugs. Drugs like Provigil can often help concentration. Again these aren't speed, but they do one of the things speed does (that is, stimulate the alpha 1 adrenergic receptor) but in a better way. I personally think, before anybody tries Provigil or similar drugs, they should try over the counter naphazoline eye drops. These eye drops act in a few minutes on the alpha 1 receptor and quickly, I believe, tell a person whether or not they will respond to a drug like Provigil. For example if the eye drops suddenly focus your concentration, you know that a drug like Provigil has the potential to help you. For more info. on these eye drops see the post entitled, 'For those interested in reboxetine and adrafinil'.
BTW, the insulated feeling is associated with (too much) serotonergic action.
Also, if the alpha 1 stimulator class of meds (i.e. Provigil) doesn’t help your concentration, the next place to look at is dopaminergic options. But that is another story......and another day.
Let me ask you, for I am curious, how has Zyprexa improved your condition and what have been its side effects.
Andrewb
Posted by Libby on June 14, 2000, at 12:37:17
In reply to Re: Augmentation with Amphetamine-like Drugs?, posted by AndrewB on June 13, 2000, at 14:16:02
Andrew...
Thanks for the suggestion about the eye drops.
> Let me ask you, for I am curious, how has >Zyprexa improved your condition and what have >been its side effects.
I had been on Effexor XR, 150 mg, for several months. My main complaint was an inability to concentrate enough to work. I couldn't read a single paragraph. It wasn't like I could read the words, but didn't retain/comprehend. It was that I couldn't complete a paragraph without my mind wandering off into nowhere... I was waking several times a night and waking early, so I wasn't sleeping much.
At 5 mg, Zyprexa made me a zombie. At 2.5 mg,
it did seem to stablize my mood, which wasn't
necessarily a problem before, but the change was welcome. It also helped me sleep without night or early waking, and improved my ability to concentrate enough to read again.The only real downside for me was a massive weight gain - 20 pounds in two months. My doc has now doubled my dose of Effexor XR to 300 mg...
I can concentrate, but feel an amphetamine-like rush almost all day. My mood is good, but my motivation is very low, compared to a few months ago and the sleep problems have returned.
I was thinking that if something like Ritalin or ProVigil could help with concentration and I went back to 150 mg of Effexor, that might clear up all my problems.
Thanks again for the info...
L.
Posted by JohnL on June 15, 2000, at 3:10:32
In reply to Augmentation with Amphetamine-like Drugs?, posted by Libby on June 13, 2000, at 11:57:30
> My husband and I have often joked that if the doc 1would just write me a prescription for speed, I'd be fine. It was a joke based in past efforts to self-medicate. Is it wrong (or dangerous) to assume
> that this might be a good approach for me?Libby,
If you haven't already, you might want to check out the discussion on stimulants for depression in Dr Bob's 'Tips' section.
Personally I do not think it is wrong to consider a stimulant as monotherapy. It all depends on the person's chemistry (do they respond to it?); and their personality (will they abuse it?); and tolerance (is the acceptance of higher doses over time an acceptable trade for a normal productive life?). In the old days stimulants is all they had to treat depression. And even today they are powerful tools, either alone or in combinations. My doctor has had his greatest successes in combining stims with either Zyprexa or Risperdal.
The more popular choices I've seen a lot at this board are Ritalin, Adderall, Modafinil, and Adrafinil (overseas nonprescrip). Personal comparison will help identify the superior match for one's own unique chemistry.
Anyway, check out the 'Tips' section. It is interesting and sheds some light on this whole topic.
JohnL
Posted by ChrisK on June 15, 2000, at 6:13:54
In reply to Re: Zyprexa Effexor - answer for Andrew, posted by Libby on June 14, 2000, at 12:37:17
Libby,
I am far from perfect as far as concentration goes but I am %100 better than what I once was. Zyprexa helped the most because it helped get rid of obsessive thoughts. Then when I added Adderall things got even a little better. I take 7.5 mg of Zyprexa at night and sleep well but don't feel like a zombie during the day. It has worked great for me because I no longer obsess on suicide. I laso know it's still working because if I miss two doses for some reason I feel like crap.
Posted by Libby on June 16, 2000, at 11:08:21
In reply to Re: Zyprexa Effexor - » Libby, posted by ChrisK on June 15, 2000, at 6:13:54
Chris, you were able to use Zyprexa without gaining weight, right? Did you ever have problems with it or are you taking other drugs that might be helping you with the weight gain?
What AD are you taking with the Adderall & Zyprexa?Thanks.
L.
Posted by ChrisK on June 16, 2000, at 12:43:26
In reply to ChrisK question about Zyprexa/weight gain, posted by Libby on June 16, 2000, at 11:08:21
I had the weight gain that first comes along with Zyprexa but I was also taking Nortriptyline at the saame time. Through diet and eexcersize I am now taking some of the weight off. It's slow but it's coming off.
Since the original prescription I have switched AD's to Wellbutrin. I take 300 mg of the SR version in the morning along with 20 mg of Adderall. At night I take the Zyprexa and Naltrexone.
All in all it's not a bad cocktail. I'm not suicidally depressed like I had been. The only problem now is my apathy but at least I'm functional.
Hope this helps some.
Chris
This is the end of the thread.
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