Posted by SLS on August 31, 2001, at 19:26:57
In reply to Re: Foreign Medications » SLS, posted by Elizabeth on August 31, 2001, at 15:21:46
Hi Elizabeth.
> Scott,
>
> You've tried modafinil at some point, right? I vaguely recall hearing that its therapeutic efficacy is probably due at least in part to DA reuptake inhibition.Yes.
You might be right about the DA, although I believe it is thought that reuptake inhibition is negligible at therapeutic dosages. Who knows? I often wonder how it is determined the amount of anything that can be neglected.
I tried modafinil last year, having added it to Lamictal and sulpiride. Within the first hour of my first dose, I experienced a substantial improvement. I was sure I was on my way to Jamaica. Actually, my initial thoughts were that it "felt" like it would be a great drug to add to Parnate or Nardil, even if the positive effects were not to continue. The improvement faded by midday, but I remained encouraged that it would have a place in my regimen.
Gosh - it is so difficult to describe to someone how such a door is opened so rarely so as to be separated by years and experienced for only minutes. The movie "Awakenings" is so much a mirror of my life - as I'm sure it is of many others'. It is gut-wrenching to watch. Of the 25 years since the onset of a severe depressive state, I have spent only one 6 month period "awake". It was like Dorothy opening up the door of her black-and-white house to the rush of technicolor that was Oz. When I began to relapse, I felt as if I was being dragged away from everything and everyone, and no amount of effort could stop it from happening. I watched the world of the living, along with my new consciousness, grow more and more distant. Eventually, all of the color was gone, and I could do nothing to again unchain myself from the bottom of my mirky ocean. I desparately and recklessly self-medicated in a frantic effort to get it back, and ended up in the hospital from a Nardil overdose. It wasn't so bad, although I was a bit upset that they didn't serve me sorbé to clear my palette before regaling me with charcoal.
Sorry for the melodramatics.
"Flowers for Algernon" is another goodie.
Meanwhile, back at the ranch...
By day 3, I was in a total fog and was without any positive effect. I experienced a great deal of anxiety and a constant headache. After 5 days, I really felt weird and somehow worse. I decided to stop taking it. To my surprise, I felt terribly worse after discontinuing it - worse than I had before starting it. This really weird exacerbation went unabated for 9 days, whereafter things gradually returned to "normal". My experience was not unique. At least two other people on PB described similar scenarios. One of those silly little thoughts that sometimes plague me prodded me into pondering if there might be a conflict between modafinil and the lamotrigine I was taking. They are reported to exert opposite effects on the levels of intercellular glutamate. Lamotrigine provides me with some benefit. Perhaps the DA stuff helped and the glutamate stuff hurt. Of course, things are rarely that simple. I try not to be too smart, but it's hard work not to be. :-) I don't want to sabotage my treatment by pretending I can figure out what's going on in the black box and reject possibly effective strategies.
> > This week, I learned that brofaromine and befloxatone, both RIMA MAO-inhibitors, will never be available anywhere. All of these drugs seemed viable to me, and I feel demoralized that there should be fewer alternatives to hope for in the future.
> The RIMAs never had a good reputation for TRD.So far, this seems to be the case. I would like to have tried brofaromine or befloxatone nevertheless. I wish I could speak to some of the doctors who used brofaromine before it was yanked. It would be great to hear how they would compare it to moclobemide. Maybe I'll look into toloxatone at some point. I wonder if amiflamine is still floating around. I still like the idea of selectively inhibiting MAO-A. I really don't care if it's reversible or not. With respect to inhibition of MAO-A, if comparing moclobemide to clorgyline represents a comparison between reversiblity and irreversibility, reversibility would equate to reduced efficacy.
> Sal: Deracyn (adinazolam) is one drug you left off your list. That's all I can think of off the top of my head.
Elizabeth, do you know where adinazolam is being sold? I tried it in 1984 or thereabouts. It was extaordinarily clean. Unfortunately, I didn't respond to it. It was completely neutral, having none of the sedating or hypnotic effects of other benzodiazepines. My doctor at the time, Baron Shopsin, had agreed to investigate it for the drug company (Upjohn?) on an open-label basis. He really didn't think it had much of a chance of being effective. Ultimately, he was surprised to see how many of his patients responded to it. I think it is interesting that both adinazolam and alprazolam are triazolobenzodiazepines and that both have demonstrated antidepressant properties. However, where does that leave Halcion?
Thanks for the suggestions.
- Scott
poster:SLS
thread:76877
URL: http://www.dr-bob.org/babble/20010828/msgs/77153.html