![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by JohnL on August 19, 2001, at 6:24:16
For anyone having trouble with TRD, treatment resistant depression, a great combination to try is Prozac + Zyprexa + Adrafinil. Why exactly this combo works so well can be partially explained, but much of it is a mystery. Dosages that work for me are 20mg Prozac with breakfast, 300mg Adrafinil with breakfast, 5mg Zyprexa with dinner.
I see so many people here suffering and struggling with things like plain jane SSRIs, Buspar, Pindolol, MAOIs, and mood stabilizers of all kinds. I wonder why they and their doctors just don't go straight to the meds with the strongest time-tested track records, such as the three in this combo.
My observations and opinions on these three drugs are based on both anecdotal observations as well as clinical evidence and scientific studies. The scientific studies alone are so numerous it would be impossible to print them all here. Just keep in mind that whatever I say in this post, there is indeed ample scientific evidence to support it.
I have often wondered why this combination works so well. I have come up with some partial explanations, but they are admittedly purely layman style and not complete.
Prozac, in my opinion, is still the gold standard SSRI. My local doc has 200 patients on it, but only 50 patients on all other SSRIs combined. In a way, this is indirect evidence that in a real world office setting, my doc has greater success with Prozac than anything else. Prozac is not purely serotonin selective. It also has some affinity for norepinephrine, and it also has indirect effects on dopamine. It is less likely to cause numbing of emotions, and less likely to cause sexual dysfunction. But when it does, that's where the other meds in the combo come into play. They counteract any unwanted side effects. For many people with TRD, some physical and mental stimulation would be viewed as a good thing. Prozac is generally known for doing exactly that. The other SSRIs are more associated with sleepiness, sluggishness, and numbness.
Zyprexa at low doses feels like it stimulates dopamine, as well as serotonin and norepinephrine. It counteracts Prozac's insomnia, it counteracts any sexual dysfunction, and counteracts any anorexia. And it provides a good quality sleep, which is usually a welcome relief to someone suffering from TRD. According to clinical studies, there is some special synergy between Prozac and Zyprexa. Together they dramatically boost serotonin, NE, and dopamine, much more so that when Zyprexa is combined with any other antidepressant tested. The dramatic increase in neurochemicals from the combination is postulated by scientists as being one reason why the combination has a profound effect in treating TRD.
The final link in the chain is Adrafinil. It is known as a 'good arousal' drug, which provides stimulation, interest, motivation, creativity, memory enhancement, without the unwanted side effects common to stimulants. Though it is classified as a psychostimulant, in Europe it is more often viewed as an antidepressant. It does not generally come with the insomnia or anxiety of other stimulants. Its primary mechanism is as an alpha-1 agonist, though as with all meds the exact mechanism is unknown and debateable. From the way it feels, I would say it mimics norepinephrine. The end result is that you can enjoy all the benefits of increased NE function without the horrible side effects of increasing real NE amounts. If there is any malfunction in your NE chemistry, Adrafinil fixes it without increasing neurotransmitter levels. Many of the side effects are desireable, such as increased interest, motivations, memory, and creativity. If the SSRI in the combo causes any emotional numbness, Adrafinil fixes that. It also has been shown to have indirect effects on boosting dopamine D2 receptors.
With these three drugs, practically all the bases are covered. Whatever the cause of your symptoms, this combo is very likely to target the real underlying problem. And for those who think they need a mood stabilizer, Zyprexa is FDA approved for bipolar. No need to waste time on the mood stabilizers, which seem to disappoint more often than not, at least at this board anyway.
I admit I probably sound like a broken record in my posts, because I continually repeat my praise for these three drugs. But there is a reason for that. They work. It's that simple. I wish the explanation of why they work was simple, but regardless, the fact that it works is really all that matters. As a rough observation just at this board, 80% of people who have tried any two of the three drugs in combo have been very pleased with the results. To date I think I am the only one on all three. But I would humbly and confidently propose that 90% of people at this board who are having trouble would experience dramatic improvement with this combo. It covers all the chemistries, it works in different parts of the brain, and it results in near total recovery with a near absence of side effects. Why in the world someone would waste time on other things is a mystery and a frustration to me. Of course, I've been there and done that too. That's why it is frustrating to watch.
Forget all the other stuff. Narrow the universe down. Go straight to Prozac + Zyprexa + Adrafinil. You should know within two weeks, and often within 24 hours, if this combo will be promising for you. Then if it fails, go back to all the other stuff. If you have ever tried Prozac or Zyprexa or Adrafinil one at a time and were not happy with them, do not let that stand in your way. That's because they combination works totally different than any one of them alone.
Believe me, I understand mileage varies. That's why I tend to suggest something with the highest mileage potential. I have seen and observed much greater success with any combination of these three drugs than I have with MAOIs, mood stabilizers, or anything else. At this board as well as in my doc's office. It's purely anecdotal observation and purely subjective, backed up by clinical scientific evidence. For everyone having a difficult time, I honestly feel it is a waste of time, and begging for torture, to consider anything else until these three drugs have been tried first.
Many people will scoff at this post. That's ok. Those who do will probably continue to struggle and suffer. Those who take the leap of faith and actually try this combo will likely be glad they did. I just wish I was a salesman for these drugs so I could reap the commissions! :-)
John
Posted by adamie on August 19, 2001, at 11:43:10
In reply to Great Combo for TRD. Prozac + Zyprexa + Adrafinil, posted by JohnL on August 19, 2001, at 6:24:16
> For anyone having trouble with TRD, treatment resistant depression, a great combination to try is Prozac + Zyprexa + Adrafinil. Why exactly this combo works so well can be partially explained, but much of it is a mystery. Dosages that work for me are 20mg Prozac with breakfast, 300mg Adrafinil with breakfast, 5mg Zyprexa with dinner.
>
> I see so many people here suffering and struggling with things like plain jane SSRIs, Buspar, Pindolol, MAOIs, and mood stabilizers of all kinds. I wonder why they and their doctors just don't go straight to the meds with the strongest time-tested track records, such as the three in this combo.
>
> My observations and opinions on these three drugs are based on both anecdotal observations as well as clinical evidence and scientific studies. The scientific studies alone are so numerous it would be impossible to print them all here. Just keep in mind that whatever I say in this post, there is indeed ample scientific evidence to support it.
>
> I have often wondered why this combination works so well. I have come up with some partial explanations, but they are admittedly purely layman style and not complete.
>
> Prozac, in my opinion, is still the gold standard SSRI. My local doc has 200 patients on it, but only 50 patients on all other SSRIs combined. In a way, this is indirect evidence that in a real world office setting, my doc has greater success with Prozac than anything else. Prozac is not purely serotonin selective. It also has some affinity for norepinephrine, and it also has indirect effects on dopamine. It is less likely to cause numbing of emotions, and less likely to cause sexual dysfunction. But when it does, that's where the other meds in the combo come into play. They counteract any unwanted side effects. For many people with TRD, some physical and mental stimulation would be viewed as a good thing. Prozac is generally known for doing exactly that. The other SSRIs are more associated with sleepiness, sluggishness, and numbness.
>
> Zyprexa at low doses feels like it stimulates dopamine, as well as serotonin and norepinephrine. It counteracts Prozac's insomnia, it counteracts any sexual dysfunction, and counteracts any anorexia. And it provides a good quality sleep, which is usually a welcome relief to someone suffering from TRD. According to clinical studies, there is some special synergy between Prozac and Zyprexa. Together they dramatically boost serotonin, NE, and dopamine, much more so that when Zyprexa is combined with any other antidepressant tested. The dramatic increase in neurochemicals from the combination is postulated by scientists as being one reason why the combination has a profound effect in treating TRD.
>
> The final link in the chain is Adrafinil. It is known as a 'good arousal' drug, which provides stimulation, interest, motivation, creativity, memory enhancement, without the unwanted side effects common to stimulants. Though it is classified as a psychostimulant, in Europe it is more often viewed as an antidepressant. It does not generally come with the insomnia or anxiety of other stimulants. Its primary mechanism is as an alpha-1 agonist, though as with all meds the exact mechanism is unknown and debateable. From the way it feels, I would say it mimics norepinephrine. The end result is that you can enjoy all the benefits of increased NE function without the horrible side effects of increasing real NE amounts. If there is any malfunction in your NE chemistry, Adrafinil fixes it without increasing neurotransmitter levels. Many of the side effects are desireable, such as increased interest, motivations, memory, and creativity. If the SSRI in the combo causes any emotional numbness, Adrafinil fixes that. It also has been shown to have indirect effects on boosting dopamine D2 receptors.
>
> With these three drugs, practically all the bases are covered. Whatever the cause of your symptoms, this combo is very likely to target the real underlying problem. And for those who think they need a mood stabilizer, Zyprexa is FDA approved for bipolar. No need to waste time on the mood stabilizers, which seem to disappoint more often than not, at least at this board anyway.
>
> I admit I probably sound like a broken record in my posts, because I continually repeat my praise for these three drugs. But there is a reason for that. They work. It's that simple. I wish the explanation of why they work was simple, but regardless, the fact that it works is really all that matters. As a rough observation just at this board, 80% of people who have tried any two of the three drugs in combo have been very pleased with the results. To date I think I am the only one on all three. But I would humbly and confidently propose that 90% of people at this board who are having trouble would experience dramatic improvement with this combo. It covers all the chemistries, it works in different parts of the brain, and it results in near total recovery with a near absence of side effects. Why in the world someone would waste time on other things is a mystery and a frustration to me. Of course, I've been there and done that too. That's why it is frustrating to watch.
>
> Forget all the other stuff. Narrow the universe down. Go straight to Prozac + Zyprexa + Adrafinil. You should know within two weeks, and often within 24 hours, if this combo will be promising for you. Then if it fails, go back to all the other stuff. If you have ever tried Prozac or Zyprexa or Adrafinil one at a time and were not happy with them, do not let that stand in your way. That's because they combination works totally different than any one of them alone.
>
> Believe me, I understand mileage varies. That's why I tend to suggest something with the highest mileage potential. I have seen and observed much greater success with any combination of these three drugs than I have with MAOIs, mood stabilizers, or anything else. At this board as well as in my doc's office. It's purely anecdotal observation and purely subjective, backed up by clinical scientific evidence. For everyone having a difficult time, I honestly feel it is a waste of time, and begging for torture, to consider anything else until these three drugs have been tried first.
>
> Many people will scoff at this post. That's ok. Those who do will probably continue to struggle and suffer. Those who take the leap of faith and actually try this combo will likely be glad they did. I just wish I was a salesman for these drugs so I could reap the commissions! :-)
> Johnhi john. I just had an idea. To see if prozac doesn't effect me negatively like two seratonin meds have I will try to get a free sample tomorrow. Because tomorrow I will be seeing my pdoc. We were going to add something to the 5mg zyprexa I am taking. I will probably choose wellbutrin or reboxetine (supossed to be good for depression with extremely poor thinking ability). But as I pick one of these I will also ask the pdoc if I can get some prozac free samples first. With the effexor I felt during the second day how horribly it was affecting me. Therefor I should see how prozac will effect me within a few days also. if it doesn't make me worse then perhaps it could work very well for me. so I will see.
Posted by Cindylou on August 19, 2001, at 17:09:16
In reply to Great Combo for TRD. Prozac + Zyprexa + Adrafinil, posted by JohnL on August 19, 2001, at 6:24:16
John,
Thank you for this post! I just printed it out and faxed it to my pdoc.I have mentioned this combo to her in passing, but she hesitates giving me Zyprexa since most meds are very sedating to me. She thought Klonapin or Xanax would be more "benign."
I also sent information to her about Adrafinil. She said she had never heard of it before, so that's probably why she's a bit hesitant to add it to my "mix."
Last week, we added Adderall to my Prozac/ Wellbutrin/Klonapin combo (with the intention of dropping out the Wellbutrin eventually). I felt really good for about 5 days, but I "hit a wall" this weekend; very fatigued and agitated, a bit depressed as well.
I have some Adrafinil on hand -- ordered it online as a result of your great posts! So I am planning on trying it tomorrow.
Any suggestions, though, on if I should totally cut out the Wellbutrin and/or Adderall before trying the Adrafinil? I know the Adrafinil takes awhile to kick in ...
Anyway, I mostly wanted to thank you for all the help you've been to me on this board. I'll keep you posted on how the Adrafinil works, and if we decide to add Zyprexa to the combo as well.
Fondly and gratefully,
-cindyPS -- I asked you about Buspar last week -- well, after one night of taking only 5 mg. I felt so horrible that I stopped taking it! I felt extremely fatigued and heavy-headed. So, you were right about that one as well :)
> For anyone having trouble with TRD, treatment resistant depression, a great combination to try is Prozac + Zyprexa + Adrafinil. Why exactly this combo works so well can be partially explained, but much of it is a mystery. Dosages that work for me are 20mg Prozac with breakfast, 300mg Adrafinil with breakfast, 5mg Zyprexa with dinner.
>
> I see so many people here suffering and struggling with things like plain jane SSRIs, Buspar, Pindolol, MAOIs, and mood stabilizers of all kinds. I wonder why they and their doctors just don't go straight to the meds with the strongest time-tested track records, such as the three in this combo.
>
> My observations and opinions on these three drugs are based on both anecdotal observations as well as clinical evidence and scientific studies. The scientific studies alone are so numerous it would be impossible to print them all here. Just keep in mind that whatever I say in this post, there is indeed ample scientific evidence to support it.
>
> I have often wondered why this combination works so well. I have come up with some partial explanations, but they are admittedly purely layman style and not complete.
>
> Prozac, in my opinion, is still the gold standard SSRI. My local doc has 200 patients on it, but only 50 patients on all other SSRIs combined. In a way, this is indirect evidence that in a real world office setting, my doc has greater success with Prozac than anything else. Prozac is not purely serotonin selective. It also has some affinity for norepinephrine, and it also has indirect effects on dopamine. It is less likely to cause numbing of emotions, and less likely to cause sexual dysfunction. But when it does, that's where the other meds in the combo come into play. They counteract any unwanted side effects. For many people with TRD, some physical and mental stimulation would be viewed as a good thing. Prozac is generally known for doing exactly that. The other SSRIs are more associated with sleepiness, sluggishness, and numbness.
>
> Zyprexa at low doses feels like it stimulates dopamine, as well as serotonin and norepinephrine. It counteracts Prozac's insomnia, it counteracts any sexual dysfunction, and counteracts any anorexia. And it provides a good quality sleep, which is usually a welcome relief to someone suffering from TRD. According to clinical studies, there is some special synergy between Prozac and Zyprexa. Together they dramatically boost serotonin, NE, and dopamine, much more so that when Zyprexa is combined with any other antidepressant tested. The dramatic increase in neurochemicals from the combination is postulated by scientists as being one reason why the combination has a profound effect in treating TRD.
>
> The final link in the chain is Adrafinil. It is known as a 'good arousal' drug, which provides stimulation, interest, motivation, creativity, memory enhancement, without the unwanted side effects common to stimulants. Though it is classified as a psychostimulant, in Europe it is more often viewed as an antidepressant. It does not generally come with the insomnia or anxiety of other stimulants. Its primary mechanism is as an alpha-1 agonist, though as with all meds the exact mechanism is unknown and debateable. From the way it feels, I would say it mimics norepinephrine. The end result is that you can enjoy all the benefits of increased NE function without the horrible side effects of increasing real NE amounts. If there is any malfunction in your NE chemistry, Adrafinil fixes it without increasing neurotransmitter levels. Many of the side effects are desireable, such as increased interest, motivations, memory, and creativity. If the SSRI in the combo causes any emotional numbness, Adrafinil fixes that. It also has been shown to have indirect effects on boosting dopamine D2 receptors.
>
> With these three drugs, practically all the bases are covered. Whatever the cause of your symptoms, this combo is very likely to target the real underlying problem. And for those who think they need a mood stabilizer, Zyprexa is FDA approved for bipolar. No need to waste time on the mood stabilizers, which seem to disappoint more often than not, at least at this board anyway.
>
> I admit I probably sound like a broken record in my posts, because I continually repeat my praise for these three drugs. But there is a reason for that. They work. It's that simple. I wish the explanation of why they work was simple, but regardless, the fact that it works is really all that matters. As a rough observation just at this board, 80% of people who have tried any two of the three drugs in combo have been very pleased with the results. To date I think I am the only one on all three. But I would humbly and confidently propose that 90% of people at this board who are having trouble would experience dramatic improvement with this combo. It covers all the chemistries, it works in different parts of the brain, and it results in near total recovery with a near absence of side effects. Why in the world someone would waste time on other things is a mystery and a frustration to me. Of course, I've been there and done that too. That's why it is frustrating to watch.
>
> Forget all the other stuff. Narrow the universe down. Go straight to Prozac + Zyprexa + Adrafinil. You should know within two weeks, and often within 24 hours, if this combo will be promising for you. Then if it fails, go back to all the other stuff. If you have ever tried Prozac or Zyprexa or Adrafinil one at a time and were not happy with them, do not let that stand in your way. That's because they combination works totally different than any one of them alone.
>
> Believe me, I understand mileage varies. That's why I tend to suggest something with the highest mileage potential. I have seen and observed much greater success with any combination of these three drugs than I have with MAOIs, mood stabilizers, or anything else. At this board as well as in my doc's office. It's purely anecdotal observation and purely subjective, backed up by clinical scientific evidence. For everyone having a difficult time, I honestly feel it is a waste of time, and begging for torture, to consider anything else until these three drugs have been tried first.
>
> Many people will scoff at this post. That's ok. Those who do will probably continue to struggle and suffer. Those who take the leap of faith and actually try this combo will likely be glad they did. I just wish I was a salesman for these drugs so I could reap the commissions! :-)
> John
Posted by JohnL on August 19, 2001, at 17:36:32
In reply to Re: Great Combo for TRD. Prozac + Zyprexa + Adrafinil » JohnL, posted by adamie on August 19, 2001, at 11:43:10
>
> hi john. I just had an idea. To see if prozac doesn't effect me negatively like two seratonin meds have I will try to get a free sample tomorrow. Because tomorrow I will be seeing my pdoc. We were going to add something to the 5mg zyprexa I am taking. I will probably choose wellbutrin or reboxetine (supossed to be good for depression with extremely poor thinking ability). But as I pick one of these I will also ask the pdoc if I can get some prozac free samples first. With the effexor I felt during the second day how horribly it was affecting me. Therefor I should see how prozac will effect me within a few days also. if it doesn't make me worse then perhaps it could work very well for me. so I will see.Hi Adamie,
I like your idea. Here's the trick though. You will likely get either 10mg or 20mg capsules. It's just my opinion, but that is way too much to start with. You could indeed feel things you don't want to feel if you start right off with one of those doses. So here's what you can do. It worked great for me. I too was very sensitive to SSRIs, and like you many of them actually made me feel worse. Here's the trick...Take the capsule, open it, and dump the contents into a glass of orange juice. The Prozac will not dissolve, so stir it well to be sured it's mixed up well. Then drink a custom size dose, a SMALL custom size dose. For example, if it's a 20mg capsule, drink just 1/8th of the glass. Just a sip to start with. Save the rest in the fridge for the next time. Then the next day, stir it well again and drink another 1/8th. After a couple days, you can increase it to 1/4 glass. Eventually you could do 1/4 glass twice a day instead of just once. Just keep going at this pattern until you reach 20mg a day. For me that took about 3 weeks.
I say go for it! Just do the juice trick and keep it real low at first.
By the way, you mentioned Reboxetine. You know, I can't think of a single person yet who has tried it and liked it. For me it was horrible. Not to mention the total impotence it caused. But for the kind of symptoms you have described, you could well have a deficiency in the norepinephrine circuitry. I think Reboxetine is the wrong way to go about fixing that chemistry. A much better bet is Adrafinil. Adrafinil just so happens to work good on the symptoms you have. It's cheap and has hardly any, if any, side effects. And to top it off, it happens to go real well with Zyprexa and/or Prozac.
John
Posted by adamie on August 19, 2001, at 20:22:21
In reply to Re: Great Combo for TRD. Adamie, posted by JohnL on August 19, 2001, at 17:36:32
>
>
> >
> > hi john. I just had an idea. To see if prozac doesn't effect me negatively like two seratonin meds have I will try to get a free sample tomorrow. Because tomorrow I will be seeing my pdoc. We were going to add something to the 5mg zyprexa I am taking. I will probably choose wellbutrin or reboxetine (supossed to be good for depression with extremely poor thinking ability). But as I pick one of these I will also ask the pdoc if I can get some prozac free samples first. With the effexor I felt during the second day how horribly it was affecting me. Therefor I should see how prozac will effect me within a few days also. if it doesn't make me worse then perhaps it could work very well for me. so I will see.
>
> Hi Adamie,
> I like your idea. Here's the trick though. You will likely get either 10mg or 20mg capsules. It's just my opinion, but that is way too much to start with. You could indeed feel things you don't want to feel if you start right off with one of those doses. So here's what you can do. It worked great for me. I too was very sensitive to SSRIs, and like you many of them actually made me feel worse. Here's the trick...
>
> Take the capsule, open it, and dump the contents into a glass of orange juice. The Prozac will not dissolve, so stir it well to be sured it's mixed up well. Then drink a custom size dose, a SMALL custom size dose. For example, if it's a 20mg capsule, drink just 1/8th of the glass. Just a sip to start with. Save the rest in the fridge for the next time. Then the next day, stir it well again and drink another 1/8th. After a couple days, you can increase it to 1/4 glass. Eventually you could do 1/4 glass twice a day instead of just once. Just keep going at this pattern until you reach 20mg a day. For me that took about 3 weeks.
>
> I say go for it! Just do the juice trick and keep it real low at first.
>
> By the way, you mentioned Reboxetine. You know, I can't think of a single person yet who has tried it and liked it. For me it was horrible. Not to mention the total impotence it caused. But for the kind of symptoms you have described, you could well have a deficiency in the norepinephrine circuitry. I think Reboxetine is the wrong way to go about fixing that chemistry. A much better bet is Adrafinil. Adrafinil just so happens to work good on the symptoms you have. It's cheap and has hardly any, if any, side effects. And to top it off, it happens to go real well with Zyprexa and/or Prozac.
> Johnhi john. regarding the adrafinil I am probably going to order it in a week or so. my mom is unwilling to order it until 'she' sees how i am next week. so i'll be able to get it then. I really really want to try it. since it can work quite fast as in 1 week. is this the average time adrafinil takes to have a noticable effect or can it be shorter?
tomorrow I will ask the doc to prescribe small amounts of wellbutrin and prozac in order to try them out.
something i have noticed just today is that my skin from the accutane is less yellow and looks more normal. perhaps the milk thistle that I have been taking when I was taking effexor did some detoxification. also during this time i have felt suicidal. i feel it was mostly the effexor which caused that. deffinetly actually. since after the first dose i felt detached and horrible. but since my skin is better it makes me wonder how well i would be doing without being on any meds at all. since when i stopped the paxil in 4 days I was feeling actually quite good. gigantic improvement. but since it is very waitable now, since i am able to do things and enjoy them to a small extent I will keep on seeing how the zyprexa and other meds will affect me. thanks for replying. bye for now
Posted by ChrisK on August 20, 2001, at 3:31:27
In reply to Great Combo for TRD. Prozac + Zyprexa + Adrafinil, posted by JohnL on August 19, 2001, at 6:24:16
John,
I know that Zyprexa does wonderful things and highly reccommend it to anyone with TRD but my experience is that it also works well with TCA's. I never responded to one of the SSRI's and had to ask to try a TCA (mine happens to be Nortriptyline). My father had depression and ended up on amitriptyline for most of his life. The Zyprexa was a great augment for my Nortrip.
Also, for people who don't want to go overseas for Adrafanil I have had a great experience with Mirapex. It has lifted the anhedonia/apathy parts of my depression much like you have experienced with Adrafanil. Depression is an off label use but one that has been studied and found to be successful. I have decent insurance so it's not a terrible burden for me to get Mirapex. I would reccommend it for anyone having problems with anhedonia - I've had very good results.
Hope you continue to do well,
Chris
Posted by SallyR on August 20, 2001, at 9:09:47
In reply to Great Combo for TRD. Prozac + Zyprexa + Adrafinil, posted by JohnL on August 19, 2001, at 6:24:16
> John,
What about remeron? How is it different than Zyprexa? I was taking Prozac, Welbrutrin and then added Adrafinil. the adrafinil didn't do much for me. Then my pdoc suggested that I add remeron (15 mg). It really helped for a couple of days. Then seemed to "peter out". I will raise the dosage to 30mg tonight. So my question is how is remeron different than Zyprexa.
By the way, thanks for your input.
Posted by JohnL on August 21, 2001, at 4:40:35
In reply to Re: Great Combo for TRD. Prozac + Zyprexa + Adrafinil, posted by SallyR on August 20, 2001, at 9:09:47
Hi Sally,
I'm sorry Adrafinil didn't work out for you. For me it was just so-so until I combined it with Prozac. The two together work awesome, where either alone is nothing special. That's why I say that if someone has tried either Prozac or Adrafinil and weren't impressed, the combination should be tried. It is just so totally different than either alone.Though I think Remeron and Zyprexa share a few similarities, the biggest difference is that Zyprexa works on dopamine where Remeron does not. I was on Remeron for over a year and it didn't help me much. It's main benefit was that it knocked me out fast at bedtime, but unfortunately it also gave me a poor quality sleep even though I was konked out. Lots of nightmares, active dreams, and tossing and turning. A few people have done well with it though, but usually when it is combined with another antidepressant such as Effexor.
John> > John,
> What about remeron? How is it different than Zyprexa? I was taking Prozac, Welbrutrin and then added Adrafinil. the adrafinil didn't do much for me. Then my pdoc suggested that I add remeron (15 mg). It really helped for a couple of days. Then seemed to "peter out". I will raise the dosage to 30mg tonight. So my question is how is remeron different than Zyprexa.
> By the way, thanks for your input.
Posted by SallyR on August 21, 2001, at 10:01:35
In reply to Re: Great Combo for TRD. Sally, posted by JohnL on August 21, 2001, at 4:40:35
> John,
My current meds are:
Prozac
Wellbutrin
Adrafinil
Remeron
Does it make any sense to substitute the zyprexa for one of these (remeron or wellbutrin)
I thought that Wellbutrin also affected dopamine.
Also, can you or anyone suggest a good source for me to read so that I can better understand how all of this works. I want to understand what reuptake inhibitors, receptor blockers, agonists and antagonists work with the various neurotranmitters and sub groups. So far I have read all of the stuff on DR. Preskorn's site.
Thanks.
Posted by Zo on August 21, 2001, at 21:40:56
In reply to Great Combo for TRD. Prozac + Zyprexa + Adrafinil, posted by JohnL on August 19, 2001, at 6:24:16
John L. .. just being my usual party-pooper about Zyprexa and. . .FAT! (see other thread!)
love your posts,
Zo
Posted by JohnL on August 22, 2001, at 2:55:07
In reply to Re: Great Combo for TRD. Sally, posted by SallyR on August 21, 2001, at 10:01:35
Just my opinion, but I think changing Remeron to Zyprexa could be a good move. That's what I did, and I'm glad I did. Just that simple change could make all the difference in the world.
There are some good books out there. One is Dysthymia, The Spectrum of Chronic Depression by Hagop Akiskal. It does not have the detailed info you are looking for, but nonetheless is very good reading. Another is The Successful Treatment of Brain Chemical Imbalance by Dr Martin Jensen. This book also does not have the exact details you were looking for, but it does have details on how to go about trying different drugs, why and how, and how to read the clues that each one provides. Also, anything by the author Stahl is excellent.
John
> > John,
> My current meds are:
> Prozac
> Wellbutrin
> Adrafinil
> Remeron
> Does it make any sense to substitute the zyprexa for one of these (remeron or wellbutrin)
> I thought that Wellbutrin also affected dopamine.
> Also, can you or anyone suggest a good source for me to read so that I can better understand how all of this works. I want to understand what reuptake inhibitors, receptor blockers, agonists and antagonists work with the various neurotranmitters and sub groups. So far I have read all of the stuff on DR. Preskorn's site.
> Thanks.
This is the end of the thread.
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