Posted by manowar on May 14, 2002, at 16:55:53
In reply to re: Provigil pooped out 2 months/ old guard ADs, posted by 3 Beer Effect on May 13, 2002, at 21:29:52
Hello 3 beers,
Unfortunately, it seems as if the Adrafinil is pooping out for me also. I take Wellbutrin IR-150 mg 2x a day, 72 mg Concerta in the morning and 10 mg Focalin in the late afternoon. This combo seems to work pretty well for ADD inattentive type, but doesn't do much at all for my depression. I never had any luck at all with the SSRIs or any of the new ADs, so I asked my doctor if I could try a TCA. He did an ECT on me and since that checked out he decided to start me on Nortriptyline.
I've taken it for a week at a very low dose (25 mg), and so far I haven't had any side effects. I did a little research on the drug at www.mentalhealth.com (Didn't you rave about this site?) and I thought this was interesting:
"The mechanism of mood elevation of tricyclic antidepressants is at present unknown. Nortriptyline is not an MAO inhibitor. It inhibits the activity of such diverse agents as histamine, 5-hydroxytryptamine, and acetylcholine. It increases the pressor effect of norepinephrine but blocks the pressor response of phenethylamine. Studies suggest that Nortriptyline interferes with the transport, release, and storage of catecholamines.
Indications
The relief of symptoms of depression. Endogenous depressions are more likely to be alleviated than are other depressive states. "Wow, it affects phenethylamine, dopamine, nor adrenalin, histamine, 5-hydroxytryptamine, and acetylcholine! Now that's what I call "shotgun effect"!
Since I definitely have "Endogenous" Depression, I'm hopeful that this drug might give me some relief.
BTW: Can someone tell me what this means:
"It increases the pressor effect of norepinephrine but blocks the pressor response of phenethylamine."?
What does pressor effect and pressor response mean?--Tim
> IsoM,
> The Provigil worked good for getting me out of bed in the morning at 200 mg/day. It didn't work that well for ADD/concentration, nowhere near as well as Ritalin & didn't help that much socially as it does some- It felt to me, exactly like extended release No-Doz (caffeine).
>
> At first it lasted a very long time (all day), but eventually it started losing efficacy after a little over 2 months & soon after that it only worked for 4 hours, then zero.
>
> So I switched to Dextrostat & am doing much better on that. Currently take 20 mg 2x per day. Dexedrine/Dextrostat is a wonderful anti-depressant, social disinhibitor, ADD medication but unfortunately it only lasts 4-5 hours. So during the 6 hours per day that i'm awake & its not working I feel severly depressed. In other words, the Dextrostat isn't enough of an anti-depressant on its own.
>
> None of the new ADs have worked for me (Celexa, Effexor, Remeron, Lamictal, Neurontin) except Zoloft 100 mg which worked wonderfully for both depression & social phobia but made me an insomniac & I think because of the sleep deprivation eventually manic- but the psychiatrist could have fixed that with a benzo or ambien or Remeron for sleep &/or by lowering the dose to 75 mg, but he didn't, suffice to say he is no longer my psychiatrist.
>
> I can't take Wellbutrin SR because I had a Soma muscle relaxer overdose a few years ago & had three small siezures- I don't think your supposed to take Wellbutrin if you've ever had a seizure.
>
> I've read sometimes AD non-responders/severe depressives have to turn to the "old guard" antidepressants like tricyclics or MAOIs to get relief. It seems like the MAOIs especially have a very high cure rate compared to SSRIs.
>
> So I'm thinking of asking the psychiatrist for Desipramine or Vivactil (protriptyline) or the MAOI Parnate. All three of these are supposed to be stimulating, & I seem to respond to stimulating ADs best (Remeron was a nightmare for me). The side effects of these old drugs though, sound pretty severe & I don't know much about them.
>
> Thanks,
> 3 Beers.........
poster:manowar
thread:106073
URL: http://www.dr-bob.org/babble/20020510/msgs/106387.html