Posted by Tom2228 on September 15, 2019, at 10:31:05
In reply to question about treatment resistant, posted by rjlockhart37 on September 12, 2019, at 21:45:51
> i've known a few people who ... there always depressed or in a melony mood, but let's think about this - the severe cases that are in psychiatric hospital were depression is severe they can't leave. This is jus the question, would extreme mood enhancer work....psychostimulant do think it would change - i know there's articles about it written but you can't access it, there old and put away. They do use dexedrine or dextroamphetamine. Im talking like the worst cases of depression in history, for treatment resistant, but let's say using methamphetamine with the severe cases, do you it would have benefit in anyway.....out of all the severe cases of depression over the centuries, it's like having to use extreme potent medications, like methamphetamine or ... because significant amount of dopamine and some serotonin is releaased. I do know that it's not a good long term treatment, because methamphetamine even at theraputic doses could level out. Plus when t wears off, that when severe depression would happen. That's only aspect i've thought, stimulants used i depression the downside is when they wear off you in bad mood. They used to use methadrine early on, but methamphetamine has gotten such a horrid reputation on drug lists, law enforcement, it's bad drug. But the prescribed Desoxn, they use lower doses. I don't know....but i 'm saying giving desoxyn to the most depressed person when nothing else worked....
>
> what ideas about using extreme medications for cases that are severe hospitalized?Hey RJ,
I wanted to share with you my Tx experiences with severely resistant bipolar depression. I am such a case who has greatly benefited from the therapeutic use of Desoxyn + MAOIs, for about 10yrs now. In 2010 I started the Desoxyn with Parnate, but both at probably too-low doses, though still the experience was a huge improvement over the prior years of struggles.
I switched MAOI to Marplan for many years which I loved, but arguably wasn't as globally effective as I required several AD adjuncts (+ bipolar meds), including TCAs (desipramine most effective while it lasted), DA agonists (mostly pramipexole, at times Neupro), even adjunctive sublingual ketamine. In 2015-2016 I was quite successful at work but lost control and never regained my clout. Then the Marplan shortage hit and I totally lost control on Nardil, only to start regaining stability with carbamazepine this summer -- which caused its own set of problems.
In August I switched back to Parnate, which has been worlds more efficacious. Recently, for first time in my life I am relatively stable on Parnate, Desoxyn, clonazepam, lithium, and Abilify -- and have begun to rebuild my life.
But the Desoxyn, I've been off and on it and on varying doses (been up to 80mg, now 50mg), and it is one of the very few meds that consistently keeps me afloat every time. I have to say it doesn't work as as well (except for ADHD) if depression isn't stable. It seems to greatly help the Parnate work better -- I am much more even, mood healthy, so much less anxious and socially present, as well as seem to need less with Parnate whereas on MAOIs I felt underdosed at 50mg.
I agree that the Rx methamphetamine is substantially different from other stimulants/ amphetamines, which I just don't seem to respond to. E.g., Adderall makes me sleep + agitation, dexmethylphendiate doesn't seem to clarify or help the executive function enough to help anxiety or function with ease, nor does Dexedrine, the latter I required 90-100mg while Desoxyn was on shortage and felt something was just missing, especially socially. The Desoxyn, for me, has qualitatively distinct antidepressant/ anxiolytic activity and just works seamlessly, with no side effects. It is in a class of its own.
Where I disagree, in my case at least (YMMV), is the wearing off. I take 10mg 5x/d and am covered for most of the day, with no sleep disruption. The crash with other stims was *far* worse, more abrupt, and dramatic, like moving backwards. With Desoxyn, when it wears off, the therapeutic benefits disappear, and it is only that functional decrease that makes me feel somewhat at a loss -- but it's easy to distinguish it's just the absence of the med. No "end of the world" phenomenon as with the others.
I also agree that it is a highly stigmatized Tx that many could benefit from if one can access an understanding, empathetic provider, or perhaps get over the stigma they hold themselves. I do not agree, however, that it is a bad long-term treatment, as it's consistently worked for me. There's new research that indicates lower therapeutic doses are qualitatively different in terms of brain health vs. the well-known neurotoxicity relevant to higher doses used in abuse. The data out there actually shows that therapeutic doses are profoundly neuro*trophic*/ neuro*protective* -- I see it as a matter of respecting this powerful medication and not crossing into neurodegenerative activity. Of course though, it is not a suitable treatment or one that will work for everyone, but in severe, recalcitrant cases, my personal opinion is that giving it a try is worth the possible gains vs. an ongoing loss of life due to severe illness.
Long-Term Treatment with Low Doses of Methamphetamine Promotes Neuronal Differentiation and Strengthens Long-Term Potentiation of Glutamatergic Synapses onto Dentate Granule Neurons
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939399/
The neuroprotective potential of low-dose methamphetamine in preclinical models of stroke and traumatic brain injury
https://www.sciencedirect.com/science/article/pii/S0278584615000469
Low dose methamphetamine mediates neuroprotection through a PI3K-AKT pathway
https://www.sciencedirect.com/science/article/pii/S0028390811001900
Treatment with low-dose methamphetamine improves behavioral and cognitive function after severe traumatic brain injury
https://journals.lww.com/jtrauma/Abstract/2012/08001/Treatment_with_low_dose_methamphetamine_improves.28.aspx
Administration of low dose methamphetamine 12 h after a severe traumatic brain injury prevents neurological dysfunction and cognitive impairment in rats
https://www.sciencedirect.com/science/article/pii/S0014488613003592
Acute, low-dose methamphetamine administration improves attention/information processing speed and working memory in methamphetamine-dependent individuals displaying poorer cognitive performance at baseline
https://www.sciencedirect.com/science/article/pii/S0278584610004653
poster:Tom2228
thread:1106104
URL: http://www.dr-bob.org/babble/20190728/msgs/1106124.html