Posted by Conundrum on December 15, 2010, at 14:57:28
So I recently started taking Adderall along with SAM-e. It seems pretty good at speeding my heart up, but that is about it. I guess I just don't respond to stimulants. Currently taking 10mg twice a day. Maybe it will start working at 20mgs. I highly doubt it.
So I've tried a lot of meds and the only thing that has worked consistently, at all, is low dose prozac.
My pdoc wrote me a new script for that. So, like I have mentioned other times. I take 2.5 mg and it helps with motivation and interest. Good, just what I need to get through school. Not close to feeling normal, but at least I'm not a waste on it.
Other things that I have tried that have helped include remeron which started working after a week and half and pooped out and pristiq which worked the next day and then stopped after two weeks. Remeron really increased interest in doing things, and pristiq seemed to add color.
I don't know why Remeron stopped working. The crazymeds site said it is very quick to poop out. I think the reason pristiq worked well at first is because it increases norepinephrine after acute doses, it does not do this with serotonin, that takes a couple weeks, just around when it stopped working. This study with rats shows that pristiq increased norepinephrine right away, but not serotonin. My guess is that the norepinephrine was helping, but maybe I do have a problem with mood stability?
http://jpet.aspetjournals.org/content/318/2/657.full
"Effect of DVS on Hypothalamic Levels of Monoamines (5-HT, NE, and DA). Acute oral administration of DVS (30 mg/kg) did not significantly [F(2,19) = 0.74, P = 0.4898] alter concentrations of 5-HT in the hypothalamus (Fig. 4A). However, pretreatment with WAY-100635 (5-HT1A antagonist, 0.3 mg/kg s.c.), which did not alter 5-HT levels on its own, resulted in a significant 78% increase in extracellular 5-HT levels [F(1,9) = 36.09, P = 0.0001] in the rat hypothalamus. In contrast to the observations with 5-HT levels, acute administration of DVS, when given alone, produced a significant [F(2,16) = 6.11, P = 0.0107] increase in NE concentrations (Fig. 4B). Post hoc analysis revealed significant differences in maximal NE levels, comparing doses of 10 (data not shown) and 30 mg/kg to vehicle (96% above baseline; P = 0.0221 and 118% above baseline; P = 0.0034, respectively), although the effects of the two doses of DVS were not significantly different from each other (P = 0.4470). Pretreatment with WAY-100635 (0.3 mg/kg s.c.) did not significantly increase NE in this brain region when tested alone [F(2,15) = 1.986, P = 0.1768]. However, when combined with DVS, pretreatment with WAY-100635 did not alter the ability of DVS to significantly elevate extracellular NE levels [F(1,9) = 8.11, P = 0.0192]. The neurochemical effects of DVS were found to be specific for noradrenergic and serotonergic systems, because the acute administration of DVS (30 mg/kg p.o.) alone or in combination with WAY-100635 (0.3 mg/kg s.c.) did not significantly alter concentrations of DA in the hypothalamus [F(2,23) = 0.18, P = 0.8343; Fig. 4C]."
My pdoc thinks the reason they stopped working is I have some trouble with mood stability. I guess could anhedonia a symptom of BPII?
Anyway, I've been wondering if going on prozac again at that low dose makes sense, and then trying to add something to it. Tried lamictal and abilify without much luck. Abilify gave me drive to want to do things, but not much enjoyment. I'm wondering if I have a mood stability issue, if adding zyprexa or lithium would make sense? I'd like to try adding a TCA, but my pdoc thinks that would cause mood instability.
I'm also curious about Nardil, since it was life changing for my grandmom. The responses I've read about that med, make it sound like it really makes people come alive.
Also I had kind of written off dopamine as a target for drugs, since I've tried L tyrosine, NADH, ritalin, and wellbutrin with no luck, but now I just think I don't respond to short acting meds. Abilify did something for a couple days, and that works on dopamine in the prefrontal cortex. So perhaps adding selegiline to prozac is an option?
I'm also wondering if I could get a response from a low dose of another SSRI, or if its just that 5 HT2C antagonism that helps with prozac.
So what do you guys think? Go back on low dose prozac, and give it more than a 4 weeks? I always stopped it for some reason before, but I'm thinking of seeing what it does for 3 months, and maybe tweaking with add ons and if that is not enough try an MAOI?
Complaints: post-SSRI problems: anhedonia, memory and concentration problems, sexual dysfunction. )
Country:USA
Currently taking SAM-e 1200mgs
poster:Conundrum
thread:973640
URL: http://www.dr-bob.org/babble/20101203/msgs/973640.html