Posted by tensor on January 9, 2013, at 3:33:46
In reply to Re: An update » tensor, posted by SLS on January 9, 2013, at 2:27:19
> Hi Tensor.
Hi Scott!
> What kind of exercise do you do? There is such a thing as over-training, in which case you could experience a drop in energy and motivation. I don't know about anxiety, but I imagine it is possible that it gets worse if you are under physiological stress.
3x resistance-training and 3x cardio / week no more than 1h per session. I have been doing this for five and a half months.
> New drugs? I don't think there is anything new since your last visit...
>
> The most recent antidepressant is Viibryd (vilazodone). It is a serotonin reuptake inhibitor and serotonin 5-HT1a partial agonist.Yeah I know about this one, it's interesting but I don't think it's for me, never had any luck really with SRI and the like.
> Latuda (lurasidone), already available as an antipsychotic, will soon be approved for depression. It is a sister drug to Geodon (ziprasidone), and has 5-HT7 antagonism as an antidepressant property.
I was thinking of testing Geodon in the past but I had some success with Seroquel so I stuck with it. Its NE and 5HT reuptake properties are unique. Lurasidone is not available here yet, although it could be imported.
> Saphris (asenapine), and antipsychotic, has an interesting pharmacological profile, including NE alpha-2 antagonism (similar to Remeron). It can be energizing.
This is almost like Zyprexa and Remeron in one pill, it was considered before I started Seroquel.
> Minocycline seems to work well for depression in some people. It is an anti-inflammatory and is also anti-glutamatergic. There is a possibility that it might work particularly well with Lamictal. Minocycline can take months to exert its full effect, although the two people I know who take it (including me) experienced an improvement during week 1.
This one is new for me, never would have guessed and antibiotic as antidepressant! :-) Nice to hear you are having some luck with it, how long have you been taking it?
> I am having luck with prazosin. It might be particularly beneficial to people who have PTSD or a history of chronic childhood traumas (developmental PTSD). To me, it feels like an antidepressant.
Blocking effects of NE?
> NAC (N-acetylcysteine), a food supplement, is still being promoted by the NIMH and people at Harvard for treating depression. I had a bad reaction to it. It made my depression moderately worse. NAC can take 3 months or more to work. It is a precursor to a powerful antioxidant, glutathione, and has a suppressive effect on glutamate activity.
It seems to have a wide range of uses. Treating OCD and hangover(!)
> Have you tried adding a psychostimulant? I don't consider modafinil to be a psychostimulant, but rather, a promoter of wakefulness and vigilance. Amphetamine and methylphenidate are more robust stimulants and can help with energy, motivation, and anhedonia. I have read that methylphenidate is better for anhedonia. Focalin (dexmethylphenidate) would be my choice.
No I haven't and this is actually what I would like to try next instead of modafinil (which is rather useless nowadays). We do not have dexmethylphenidate here, only methylphenidate in forms of Ritalin and Concerta. So I guess Concerta would be the better candidate? I'm going to bring this up with my pdoc tomorrow morning.
Is stimulant and exercise going to be a problem? I'm thinking about cardiac issues.> I'm sorry to hear that you have taken a dip. Maybe it is just temporary. If you do intense resistance training 6 days a week, I recommend that you allow 2 weeks for recovery by not performing any anaerobic resistance exercises. You can do some light aerobic exercise, just to help maintain your calorie balance.
It may be a temporary thing, I don't know, but I feel more restless at work and I find it more difficult to concentrate and a workday feels much longer now than a month ago. As I wrote above, resistance-training three times a week, I don't really know the symptoms of overtraining but isn't elevated resting pulse one of them? I have normal resting pulse.
I do have chills and I sweat in the evenings, don't know what's up with that, have had it for months.
Thanks for your thorough update Scott, very appreciated!/tensor
poster:tensor
thread:1035051
URL: http://www.dr-bob.org/babble/20121231/msgs/1035057.html