Posted by not exactly on February 6, 2003, at 16:32:20
In reply to Re: Mirapex/Selegiline/Parnate » not exactly, posted by LAURA777 on February 6, 2003, at 7:33:39
Laura,
Yes, I saw your other post about anhedonia & dopamine [http://www.dr-bob.org/babble/20030204/msgs/139623.html] and I've been thinking about what you said - more on that topic later.
> did the stimulants like ritalin and dexadrine make you feel like you were coming down from cocaine , what i mean to say is was it similar to the uncomfortable feelings you get with cocaine ??
I have generally responded quite well to Ritalin and amphetamines. But I'm very sensitive to them, and the optimal dose for me is extremely small - 1 or 2 mg (far less than the smallest pill made), once or twice a day. At this effective level, they give me mild mood-boosting effects, and help dramatically with motivation, focus, and, yes, anhedonia (which, after thinking about your previous post, I'm coming to believe may well be the root cause of the mood, motivation, and focus problems). Side effects are virtually absent. Anxiety is not worsened, and sometimes it's reduced. The let-down is gradual & gentle, with no significant rebound effect. If I take my daily dose(s) early in the day, by bedtime I feel a bit drowsy (in a normal, healthy way) and sleep well. I set the alarm 1/2 hr. early and keep the morning dose ready by the bedside. When the alarm goes off, I'm a zombie (but getting up in the morning has always been like this, with or without stimulants), so I take my stim dose and go back to sleep. 30 minutes later I awake refreshed and ready to face the day. Used in this very conservative style, I find the benefits to be sustainable for months with no significant tolerance or "poop-out" effect. By themselves, stimulants are no substitute for an antidepressant, but they are a valuable adjunct.
However, if I take the kind of dose that most folks do - 5, 10, or more mg at a time - it makes me manic, anxious, and "hyper" (almost as unpleasant as cocaine, but discernably different), and afterwards I crash like a rock. Repetions of this roller-coaster ride cause tolerance to build rapidly.
Of course, YMMV, but I wonder if the reason many folks say they can't tolerate stimulants (including anhedonic low-dopamine folks who theoretically should benefit from them) is because they are actually taking far too much.
BTW, MAOIs are very different from stimulants in terms of benefits, side effects, duration, and underlying mechanism. My exposure to MAOIs is limited to selegiline, both at low oral doses, when it inhibits only MAO-B, and as a patch, when it acts like a general MAOI AD. Selegiline helped, but my subjective experience was not at all like with the stims.
Hope this helps. I'd be happy to discuss any aspect of these topics in more depth if you (or anyone else) is interested.
- Bob
poster:not exactly
thread:138954
URL: http://www.dr-bob.org/babble/20030204/msgs/139842.html