Posted by Ame Sans Vie on October 15, 2003, at 20:16:42
In reply to amineptine:HELP! New to this , posted by iris2 on October 15, 2003, at 14:10:11
> I am on Amineptine for the second time . The first time it worked very well and lifted my depression very much. This time it does not seem to be working. I have increased the dose the past few days to 300-400mg. I also take Ritlin, Klonopin and Perphenazine.Went off Topamax but am gaining wieght, bad for eating disorder.
The perphenazine, being a dopamine antagonist, is likely inhibiting the activity of the amineptine (which is a dopamine agonist).
> I will be out of the Amineptine within a couple of weeks and mine was from Argentina. Any suggestions to obtain it??Sorry -- I really wish I knew though. :-)
> I saw that amineptine was being augmented with amisulpride. Perhaps Reboxetine or Strattera? Again any suggestions?
What is the perphenazine being taken for? If not for a psychotic/disassociative type condition, I'd first talk to my doctor about discontinuing the antipsychotic, if I were you. Reboxetine and Strattera are noradrenergic in their effect, not dopaminergic, but a trial run surely couldn't hurt. Though I'd recommend Wellbutrin, Meridia, or Sanorex myself. Supplements to boost dopamine levels could be a great help as well -- DL-phenylalanine along with vitamins B6 and C is really wonderful. Phenylalanine is the starting point for dopamine, norepinephrine, and epinephrine in the body. The DL form also seems to increase the action of endorphins/enkephalins within the brain, decreasing pain, depression, and anxiety. L-theanine, NADH, L-tyrosine and many other OTC supplements are also conducive to increased dopamine activity.
> I really am at the end of my rope. I barely get out of bed anymore and have a constant death wish. I found this site wich gave me a little more hope but this has been going on and getting worse for 30 years. Can anyone make any suggestions? My pdoc will go along with anything that even remotely makes sense.
I totally understand how rough this must be for you... you mentioned being on Ritalin -- I'm assuming you've probably tried amphetamines as you seem to have tried plenty of dopaminergic/noradrenergic drugs. If you have, apparently they were not as helpful as the Ritalin. Desoxyn (methamphetamine) may be better than the usual amphetamines prescribed (Dexedrine, DextroStat, Adderall) if you haven't already tried it. Some even say phentermine is much more mood-elevating than amphetamines... I haven't tried it personally.
Have you given other dopamine agonists a try? Drugs usually prescribed for Parkinson's disease, I mean. Mirapex, Requip, Symmetrel, Parlodel, Dostinex... or even carbidopa/levodopa (direct precursor to dopamine) or the MAO inhibitor selegiline which decreases action of only one form of MAO which destroys dopamine -- no dietary restrictions required at normal doses.
You might also want to look down some of the roads less traveled. Rilutek and Emend are two drugs that appear quite promising for depression and anxiety; many, myself included, also find solace primarily in opioid therapy for treatment-resistant depression. Ultram can work great, as can methadone and the various forms of buprenorphine available. Of course morphine, hydromorphone, oxycodone, etc. can be just great for depression, but with those you have to take something in addition to delay development of tolerance (e.g. NMDA antagonists, DL-phenylalanine, low-dose naltrexone).
poster:Ame Sans Vie
thread:269694
URL: http://www.dr-bob.org/babble/20031015/msgs/269813.html