Posted by bleauberry on August 21, 2009, at 19:42:03
In reply to Brand new to group, posted by Tregonissey on August 21, 2009, at 7:39:48
Welcome! Sorry you're here, but very glad as well!
For elderly people, I think 65 qualifies as the lower end of that range, you know what some of the best antidepressants are? Stimulants.
Here are some suggestions:
1. Wean off prozac, endure a month with nothing, then start Parnate.
2. Add to prozac Ritalin (brand to start, not generic)
3. Add to prozac Adderall XR brand.
4. Try 200mg to 400mg per day of the supplement Tyrosine, divided into 3 doses (you will have to empty a capsule and make your own custom doses with empty gel caps, or split pills) Though you may feel hints of energy at first, or maybe nothing, it will take a full month to see changes happening.
5. Try 100mg to 200mg per day of the supplement DL-Phenylalanine. A month as will be needed to see changes.Internet hype suggests vastly higher doses of DLPA or Tyrosine, but clinical studies used the doses I quoted above. Those studies are several decades old, but the results were very good. Even accounting for perhaps poorer study control than these days, there is significant potential.
All of the above suggestions have one thing in mind...boosting the function of the other neurotransmitters (norepinephrine and dopamine)that Prozac is squashing. Prozac actually does increase both norepinephrine and dopamine, but its effects on increasing serotonin are so much stronger.
There is a common thing that happens when serotonin at the synapse is increased longterm by drugs. It somehow diminishes the function of norepineprhine and dopamine. Drowns them out. While all of the neurotransmitters are to mood, serotonin is primarily relaxing, calming (everything is ok, who cares), while norepinephrine and dopamine are tied to motivation, pleasure, and energy.
The apathetic syndrome you describe is rather common amongst longterm antidepressant users, primarily because most antidepressants work primarily only on serotonin.
Parnate works on all three equally.
Ritalin or Adderall or Tyrosine or DLPA work on the others, to add balance to what prozac is doing. A friend of mine was doing ok on prozac, but compained of being tired, uncaring, apathetic, unmotivated, couldn't get anything done. She was prescribed AdderallXR and was practically cured that very day. It worked perfectly with the Prozac.
All meds have downfalls. With Adderall and Ritalin the downfall is tolerance...needing a higher dose over time. But some people do stabilize at a certain dose for many years. There have been hints in clinical studies, and a couple anecdotal reports here, that the med Memantine prevented and reversed stimulant or opioid tolerance.
Someone might think that since Cymbalta works on both serotonin and norepinephrine, the apathy thing wouldn't happen. Until they learn that with Cymbalta the ratio of serotonin to norepinephrine is 9:1. Not anywhere close to equal. Mostly serotonin. Effexor is even worse at 30:1.
Just some ideas. Too much serotonin going on. That's where the apathy is coming from.
poster:bleauberry
thread:913299
URL: http://www.dr-bob.org/babble/20090818/msgs/913400.html