Posted by King Vultan on April 30, 2004, at 10:33:40
In reply to Dopamine Agonists and Drowsiness (Read This One), posted by Questionmark on April 30, 2004, at 4:13:09
> i have no experience with dopamine agonists, but i am extremely interested in trying one for some of my Nardil side effects (e.g., assumed cognitive difficulties, anorgasmia, afternoon fatigue).
> However, i have read-- on here and in a few research articles-- that after not-too-long-of-a-time, dopamine agonists (or at least Mirapex and Requip) can cause extreme drowsiness and i think also some other opposite effects as those desired and originally obtained. Does anyone know the mechanisms behind this, or reasons as to why this happens? And more importantly, does anyone know any possible means of preventing or counteracting this? Also, how commonly does this occur, and after how long typically?
> Much thanks.
>
>I'm on Nardil also and am likewise experiencing the afternoon fatigue--this is very common and referred to as the "Nardil Nod." Your sexual difficulties are likely the result of some of the same things that go on when people take SSRIs, as Nardil is very much skewed towards serotonin. The stimulation of serotonin 2A receptors in the spinal cord is thought to be at the root of these type of anorgasmia problems "Essential Psychopharmacology".
So what can be done about them? I would suggest avoiding the dopamine agonists, as these are notorious for increasing drowsiness. As I've mentioned in the past here, one thing that the stimulant Provigil is commonly used for is to help Parkinson's patients falling asleep in the middle of the day from their wretched dopamine agonists--this can really be a severe problem. The dopamine agonists are perhaps even more well known for causing nausea, particularly at higher dosages.
I suppose you could try adding Remeron, as this blockades serotonin 2A receptors, but as this drug is also sedating, I'm not sure it is really a very good choice. Again, Nardil is notorious for causing anorgasmia and like the SSRIs, is a good thing to try for men with premature ejaculation. For men without this problem and for women, it can be a real problem, and I'm not sure I can really offer much of a solution.
As for the drowsiness issue, I'm hoping that mine has something to do with the severe insomnia I am still experiencing, and that once I come up with something to get a more proper amount of sleep, the drowsiness will decrease. Honestly, all I can do right now is drink coffee throughout the day; although, I am trying to be careful, as I've heard that large amounts of caffeine can precipitate a hypertensive crisis. What exactly "large amounts" is I really don't know. Nardil is a safer drug to do this with than is Parnate, which is associated with a greater incidence of hypertensive crises, but I would imagine if someone were popping No-Doz all day they might get into trouble with either one. I would guess I am drinking perhaps 10 cups of coffee a day (the little cups such as are on coffee makers and the size one might get in a restaurant--not big mugs).
Todd
poster:King Vultan
thread:341645
URL: http://www.dr-bob.org/babble/20040429/msgs/341763.html