Posted by Ritch on March 24, 2002, at 9:56:12
In reply to Re: Dexedrine Dysphoria - SAME-e to the rescue? HE, posted by Jerrympls on March 24, 2002, at 1:39:52
> Mitch-
>
> Thanks for your reply. Here's a order of events as far as my meds are concerned: Oh and my diagnosis is Major Depression with Generalized anxiety disorder.....
>
> Started Desipramine 50mg - had bad akathasia - added Ativan. After a couple weeks I got up to 150mg Desipramine - akathasia would rebound if I stopped ativan. NO antidepssant effect yet from Desipramine. Decided to add 100mg Seroquel as an augmentation strategy and also for sleep and anxiety. Seroquel worked very well. Still had some anxiety and restlessness so went up to 200mg Seroquel and finally after a month landed at 400mg Seroquel. Works very well for sleep and anxiety--perhaps mood too but I'm unsure. Akathasia calmed down a bit...still need ativan daily. Other than the restlessness, I'm not sure the Desipramine is ativating because I take it all at night. Desipramine totally wiped out my sex dive almost completely. Motivation and energy very low and still felt very apathetic--flat--a bit weepy - so decided to ad Provigil 200mg. Helped for a couple days....but not very helpful for mood. Next on to Dexedrine. Works well.
>
> So, the dysphoria I am describing is more of an intense sadness/dread than panic or ansiety. It's not as if my heart rate starts speeding up. It's like these brief waves of "everything is depressing and sad" kinda things.....am I making any sense? I don't feel anxiety is playing any part. There's no real pattern to it too. I did increase my SAM-e to 800mg today and I didn't have as many "dysphoria" moments. So...hmmm....
>
> I do try to take a day or two off of Dexedrine to help my brain recharge. It helps a bit. But without it during the week I wouldn't have the energy/will/motivation to get out of bed or to care about anything. So....damned if i do, damned if I dont.......
>
> I'm thinking of switching the Seroquel to Topamax - but the Seroquel is helping alot I think---except for making me so completey hungry. I'm not too fond of the Desipramine because it makes my hands shake alot and it's noticable to co-workers, etc....it also could be adding to the weight factor.
>
> Just a quick note about the meds I have been on: Over the past 10 years (I'm 30 now) I have been on every SSRI at least twice, imipramine, ascendin, Pamelor, Trazodone, Parnate, Serzone, Effexor, Wellbutrin, Remeron, Depakote, Lithium, Ritalin, Adderall, Cylert, Cytomel, a hand full of the benzos, Neurontin, Clonidine, Naltrexone (for SSRI augmentation)...and probably more I can't remember. I've also been through ECT (worst treatment mistake ever). And I currently have the VNS (Vegal Nerve Stimulator) implanted for almost 10 months (I can't comment yet on how well it is helping....I'm dyign to tell eveyone--but I must obey the study rules - have no fear--I will post everything here when they say I can....)
>
> So, I dunno....>I'm always appreciative of everyone comments, suggestions, questions...thanks alot........
>
> Jerry
Hi Jerry,Thanks for replying. There are a few things you mention above that are interesting:
1) The desipramine caused akathisia
2) The Ativan helps the akathisia
3) Seroquel helps it a lot more.
4) Dexedrine "Works well"Whenever I tried desipramine it was just 10mg and I took it at bedtime. It also caused an "inner restlessness", although I didn't have a lot of motor hyperactivity. So desipramine is the only TCA you "responded" to? Do you think most of your improvement is from the dexedrine add-on? I wonder what would happen if you could leave in the dexedrine/Ativan/Seroquel and flip or cross-taper the desipramine to something less agitating. That stuff made me too uptight. I would get "freezing" like reactions around other people. That also happened with Wellbutrin and Adderall, but *not* with dexedrine. Another weird thing about Seroquel that I noticed.. It has a short half-life. You said you take all of it at nite? I only took it at bedtime, too. But..the next day about mid-afternoon into the evening the stuff would start wearing off and I would get this weirdo rebound antidepressant effect with super focus and alertness. Do you notice the hand tremor in the evenings the most? Sorry, for all the questions, I hope you get better,
Mitch
poster:Ritch
thread:99601
URL: http://www.dr-bob.org/babble/20020322/msgs/99836.html