Posted by AndrewB on April 29, 2000, at 10:30:06
In reply to Re: AndrewB, posted by JohnL on April 29, 2000, at 3:05:22
I have also noticed my depression worsens when serotonin is raised too much (like on 30+ mg Prozac, or any dose of a serotonin med slightly higher than the usual dose). Increasing serotonin levels does not work for me very well, and increasing NE levels generally causes worsening. With that in mind, I suspect a real MAOI would not be good for me.
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******Like you, serotonin enhancers don't seem to help me. Both serzone and 5-htp fail to improve my mood and they give me 'mummifying' side effects. (Have I tried enough serotonergic agents to make this generalization?) Unlike you though, NE enhancers are just fine with me. I really like reboxetine. I think the reason you had a bad expereince with reboxetine is because it stimulates beta adrenergic receptors. Stimulation of beta adrenergic receptors can cause anxiety and other side effects. Reboxtine stimulates both the alpha and beta andrenergic receptors while adrafinil stimulates only the alpha 1 adrenergic receptors. In general, adrafinil should have less side effects than reboxetine. So why take reboxetine? Stimulation of both the alpha and beta receptors have the potential to improve mood. Stimulation of the beta receptor probably explains why Bruce responded to reboxetine but not to adrafinil.
I've tried SJW with everything. Usually it seems rather neutral, like a vitamin. But with Adrafinil and Amisulpride, it kicked in nicely the very first day and continues still. But in theory, on paper, I do not suspect a MAOI would produce good results with me. May likely make me worse. I think the receptor stimulation effect of Adrafinil and Amisulpride is more important to my chemistry than is increasing neurotransmitter levels.
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******What effects specifically does SJW provide for you?
> I am not however completely free of side effects. I'm not sure who is at fault here, but my vital parts are rather limp, and having sex has been most frustrating. Either Adrafinil or Amisulpride could be guilty, though I suspect Adrafinil more. I noticed on the Amisulpride label that impotence is stated as a possible side effect. But I took it months ago with Prozac and didn't have any problem then. So I think it's the Adrafinil.
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*****You are right. It is the adrafinil. Adrafinil is an alpha 1 receptor agonist. Any med that stimulates the alphha receptors will increase the tone (contraction) of the vascular and non vascular smooth muscle. Therefore you can expect a rise in BP. Also, since there are a lot of alpha 1 receptors in the prostate, you can expect some tightening of the smooth muscle around the urogenital tract which may cause difficulty in urination. Alpha 1 stimulation also seems to cause reduction of the quality of erection and ejaculation due to tightening of smooth muscle in the groin area. Since reboxetine stimulates the alpha 1 receptors, I have also experienced poorer erections. Alas, I am no longer the rock of Gibralter. I have ordered some prazosin, a short acting alpha 1 antagonist to see if it will counteract this effect. It is inexpensive.
> Last night I tried my first 50mg dose of Viagra. I told my pdoc I would like to treat the side effect directly on an as-needed basis, and avoid adding or substracting from the psychiatric mix. I seem to have stumbled onto a delicate balance with my cocktail, and I don't want to rock the boat. Viagra works. :-)******I have also considered Viagra. I have read that most people don't need the larger doses. You can take a 50mg or 100mg pill, which are cheaper by the mg. than the smaller dosage viagra pills, and split them up. Some people even reduce them down to apporximately 5mg or 10mg. doses with good results, making the med quite affordable. Again, congrat.s on the mix you have. You may want to add mirapex at some time to the amisulpride to bolster amisulpride's effect.
AndrewB
poster:AndrewB
thread:31319
URL: http://www.dr-bob.org/babble/20000429/msgs/31665.html