![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by rogdog on November 14, 2000, at 11:51:17
I am just received a starter pack of zyprexa after a total let don with a trial of seroquel.. andrew, I read a previous post about your experience with zyprexa(i think it was you, or mabey it was John?)i cant remember. anyways, i was going to order some amisulpiride but my doctor wanted me to give zyprexa a "shot", I always here that it is augmented with something else, have you or anyone else out there had success with an antipsychotic alone? thanks for the input, rog
Posted by SLS on November 14, 2000, at 16:49:10
In reply to ZYPREXA OR AMISULPIRIDE? to johnl,andrew or anyon, posted by rogdog on November 14, 2000, at 11:51:17
> I am just received a starter pack of zyprexa after a total let don with a trial of seroquel.. andrew, I read a previous post about your experience with zyprexa(i think it was you, or mabey it was John?)i cant remember. anyways, i was going to order some amisulpiride but my doctor wanted me to give zyprexa a "shot", I always here that it is augmented with something else, have you or anyone else out there had success with an antipsychotic alone? thanks for the input, rog
Hey Rog.No. I haven't. But I met a girl for whom Zyprexa alone produced an antidepressant response.
I think Zyprexa is the best of the atypicals to treat depression. It makes an effective augmenting agent for SSRIs and MAOIs. I don't know how well it may work with other drugs.
Lilly has sponsored studies to assess the efficacy of combining Zyprexa with Prozac. They have been ongoing for over a year, but I don't know if any of the results have been published. Keep in mind that Lilly sells both drugs. However, I would look at any robustly positive results as being indicative of true efficacy.
I have been taking Parnate + desipramine + Lamictal. I added Zyprexa 2.5mg about a week ago and have increased it today to 5mg. It is helping.
The biggest drawback for me is that it can cause significant weight gain. I don't know exactly how universal this is at the reduced dosages used to treat depression.
If I gain too much weight, I will look to try to Zeldox (ziprasidone), a drug that acts very much like Zyprexa, but without the weight gain. The FDA has given Zeldox an "approvable" letter. I believe the only stumbling block at this point is the wording of the package insert with regards to possible changes in cardiac function. To my knowledge, there have been no cases of adverse events regarding this. The risk is considered more theoretical than phenomenological.
If you are in a position to make a choice as to whether to try amisulpride or sulpiride before going to Zyprexa, I would consider it if your symptoms are primarily anergic and anhedonic. With either of these drugs, if they are going to work, they usually demonstrate some sort of improvement within the first ten days. Neither of these drugs is usually associated with weight-gain, although they are both capable of producing increases in prolactin, and EPS. Zyprexa has a lower risk of EPS. However at the low dosages of amisulpride and sulpiride frequently used to treat depression and dysthymia, any risk is greatly reduced.
Zyprexa is worth a try. If weight-gain is not an issue with you, I would probably try it first, given its availability.
Good luck.
- Scott-------------------------------------------------------------
: Expert Opin Investig Drugs 2000 Apr;9(4):819-828
Ziprasidone: comprehensive overview and clinical use of a novel antipsychotic.
Daniel DG, Copeland LF
Clinical Studies Ltd., Falls Church, VA and Department of Psychiatry and
Behavioral Sciences, George Washington University, Washington DC 20037, USA.[Record supplied by publisher]
Ziprasidone (5-[2-(4-(1,2,-benzisothiazol-3-yl) piperazin-l-yl] ethyl]-6 -chloro indolin-2-one hydrochloride hydrate) is a novel antipsychotic with a pattern of receptor occupancy and preclinical attributes predictive of broad therapeutic efficacy and a favourable tolerability profile in the treatment of psychotic illness. Clinical trials indicate that ziprasidone is effective against positive, negative and affective symptoms in schizophrenia and schizoaffective disorder with minimal motor, cognitive, weight gain, prolactin related, or anticholinergic side effects. In addition, an im. formulation appears to be rapidly effective with significantly less motor side effect liability than haloperidol.
PMID: 11060712
Posted by Ant-Rock on November 14, 2000, at 19:03:24
In reply to Re: ZYPREXA OR AMISULPIRIDE? to johnl,andrew or anyon, posted by SLS on November 14, 2000, at 16:49:10
Hi Scott,
I was wondering, are you using the zyprexa for its dopamine enhancement at low doses, if this is indeed what it does, kind of like amisulpride. If this is true, do you find it helps with anhedonia?
The reason I ask is that I am currently augmenting parnate with lithium.(I'm not bipolar)It hasn't helped with the anhedonia. I have an appointment wednesday afternoon with psych-doc and need some strategies to go over with him before he asks me to consider ECT for the hundreth time. I remember you mentioned adding mirapex a while back, on the suggestion of a researcher you spoke of. What advantage, if any, would mirapex be over zyprexa?
Anyway, I've asked enough questions for now. As always, I appreciate any info you could provide me with.
Hope all is well.
Sincerely,
Anthony
Posted by SLS on November 14, 2000, at 22:12:13
In reply to Re: ZYPREXA OR AMISULPIRIDE? » SLS, posted by Ant-Rock on November 14, 2000, at 19:03:24
> Hi Scott,
> I was wondering, are you using the zyprexa for its dopamine enhancement at low doses, if this is indeed what it does, kind of like amisulpride. If this is true, do you find it helps with anhedonia?
> The reason I ask is that I am currently augmenting parnate with lithium.(I'm not bipolar)It hasn't helped with the anhedonia. I have an appointment wednesday afternoon with psych-doc and need some strategies to go over with him before he asks me to consider ECT for the hundreth time. I remember you mentioned adding mirapex a while back, on the suggestion of a researcher you spoke of. What advantage, if any, would mirapex be over zyprexa?
> Anyway, I've asked enough questions for now. As always, I appreciate any info you could provide me with.
> Hope all is well.
> Sincerely,
> Anthony
Hi Anthony.I have been taking Zyprexa (olanzapine) for only 9 days. It was added to a regimen of Parnate 80mg + desipramine 300mg + Lamictal 300mg. I just raised my dosage of Zyprexa from 2.5mg to 5.0mg. My doctor says that some people respond just fine at 2.5mg. I could "feel" after a week that 2.5mg was just a bit shy of what I think I need. The doctor gave me the latitude to make this dosage increase.
It has been helping. Although slightly perceptible at this point, I would say that it is helping with anhedonia. One of my biggest complaints about Parnate is that it doesn't seem to reduce the anhedonia, and actually produces some weird sort of apathy and a reduction of certain motivations. Zyprexa is definitely doing good things that are being missed by the Parnate.
ECT?
GO FOR THE ZYPREXA !!!!
I am not sure to what degree low-dose Zyprexa is analogous to low-dose sulpiride or amisulpride. There may be some overlap. The major difference between Zyprexa and the latter two drugs is that the latter are considered "preferential" for presynaptic autoreceptors - the blockade of which leads to increased dopaminergic tone. As I remember, dopaminergic presynaptic autoreceptors are inherently of higher affinity for DA and other receptor ligands (anything that attaches directly to the receptor). If this is true, I would guess that Zyprexa can produce a similar effect, possibly more effectively at lower dosages. Zyprexa has a relatively low affinity for DA receptors. My silly imagination can see how such a drug would effectively occupy presynaptic receptors before blocking enough postsynaptic receptors to exert an antipsychotic effect.
Zyprexa is a pretty cool drug that I believe exerts true antidepressant effects, particularly when used as an adjunct to SSRIs and MAO-inhibitors. Zyprexa potently blocks 5-HT2a receptors - the SAME receptors that are blocked by Serzone (nefazodone), Desyrel (trazodone), and Remeron (mirtazapine). This mechanism is thought to be of great importance in producing an antidepressant effect, and possibly adds to the ability of Zyprexa to treat the negative symptoms of schizophrenia. I have yet to gain an impression of the efficacy of Zyprexa as an adjunct to the tricyclics, Wellbutrin, Serzone, or Remeron.
As far as Mirapex (pramipexole) is concerned, on a simplistic level, it does the opposite of Zyprexa at the receptor level (although not necessarily at the clinical level). Mirapex stimulates, while Zyprexa and other neuroleptic antipsychotics block, dopamine D2 receptors. However, Mirapex also stimulates D3 receptors - the same receptors that are blocked by amisulpride and amisulpride. Don't be bashful about trying Mirapex before going on to ECT. It is perfectly safe and may possibly help more people with treatment-resistant depression than Parlodel (bromocryptine), an often used D2 agonist. Parlodel augmentation of Parnate is a recognized alternative. I felt better during the first 3 or 5 days after adding it to Parnate. It can work. If you decide to try Mirapex, please post how you do with it. I have it on my list of things-to-do.
I hope you find some of this helpful.
Good luck on your doctor's visit.
Sincerely,
Scott
Posted by JohnL on November 15, 2000, at 3:59:57
In reply to ZYPREXA OR AMISULPIRIDE? to johnl,andrew or anyon, posted by rogdog on November 14, 2000, at 11:51:17
> I am just received a starter pack of zyprexa after a total let don with a trial of seroquel.. andrew, I read a previous post about your experience with zyprexa(i think it was you, or mabey it was John?)i cant remember. anyways, i was going to order some amisulpiride but my doctor wanted me to give zyprexa a "shot", I always here that it is augmented with something else, have you or anyone else out there had success with an antipsychotic alone? thanks for the input, rog
I haven't heard of someone taking Zyprexa as monotherapy for depression. Actually there was someone here a couple months ago that commented how well Zyprexa was working for her, but I don't remember her name or whether she was taking something else with it.
In clinical trials Amisulpride was used as monotherapy. In one study it was tested head to head against Fluoxetine treated patients. Results were similar in both groups. It has been compared head to head with other antipsychotics, and was shown to equally or more effective, except it had a more robust effect on negative symptoms and was associated with a low risk of side effects commonly associated with antipsychotics. I don't think it has been tested head to head against Zyprexa.
My personal preference is Amisulpride, for the simple reason that it is nearly free of side effects. It is somewhat activating. Zyprexa on the other hand has a much harsher side effect profile, with me anyway. The sedation, tiredness, weak legs, weight gain, and morning hangover were just too much for me.
I think if someone's depression is linked primarily to a hypo-dopamine chemistry, then Amisulpride would be the better choice. But if serotonin and norepinephrine are also involved, then Zyprexa might be a better choice, since it acts on serotonin and norepinephrine in a way similar to Remeron. Even better would be to take Amisulpride+Remeron, because that way you could actually adjust each side of the equation as needed. More/less dopamine effect? Adjust Amisulpride. More/less 5HT or NE effect? Adjust Remeron.
For my anhedonia symptoms nothing has ever come close to being as effective as Amisulpride+Adrafinil. Each alone is rather mild, yet with good effects. But the two together is greater than the sum of the two added, if that makes any sense.
Another interesting thing about Amisulpride and/or Adrafinil... They seem to work better and faster with each re-trial. I've stopped and started them several times. For the first solid trial I experienced good effects within a week, even the first day, but didn't feel total improvement until about a month. But it's almost as if these drugs permanently modify something in the brain, because with each re-trial I have experienced a very rapid re-response. Usually the first day. I stopped taking both drugs a few weeks ago. No withdrawals. My good mood lingered on. I was surprised, but pleased. But a couple days ago I really crashed hard one afternoon. I could feel it coming on like a freight train. So the next morning I took one dose of Adrafinil and a mere 25mg Amisulpride. Bingo. By the afternoon I felt almost completely cured again. I didn't even feel the need to take anything the next day. So at least temporarily while I'm in a re-thinking mode, I'm dosing every other day and doing fine. It's weird. It's almost as if these drugs permanently fixed something that now only requires small erratic amounts for maintenance. I never experienced this same phenomenon with any other drug you can think of. But for that matter, no other drug ever worked as well as these in the first place either. I was never able to give Zyprexa a fair trial of at least a month because the side effects were too harsh for me.
John
Posted by ChrisK on November 15, 2000, at 6:35:44
In reply to ZYPREXA OR AMISULPIRIDE? to johnl,andrew or anyon, posted by rogdog on November 14, 2000, at 11:51:17
Rogdog,
I am a big fan of Zyprexa. When I first started it I had very strong ruminating thoughts of death and suicide. They had become obsessive even though I was taking Klonopin and Paxil at the time. Within days of adding Z I could feel a big difference in the way my mind was working.
Since then I have shifted my AD's to Wellbutrin and Nortriptyline. I still have some anhedonia but I am doing much better than I was two years ago. The one constant has been Zyprexa. On a couple of occasions I tried to phase it out but felt the differnce within a week.
When Zeldox finally comes out in the US I may try that but I have been satisfied with the way the Zyprexa has treated me. I started at 2.5 mg but ended up at 7.5 mg/day. It may be sedating at first but I found that the sedation went away after a couple of weeks.
Good Luck with whatever you try.
Chris
> I am just received a starter pack of zyprexa after a total let don with a trial of seroquel.. andrew, I read a previous post about your experience with zyprexa(i think it was you, or mabey it was John?)i cant remember. anyways, i was going to order some amisulpiride but my doctor wanted me to give zyprexa a "shot", I always here that it is augmented with something else, have you or anyone else out there had success with an antipsychotic alone? thanks for the input, rog
Posted by Ant-Rock on November 15, 2000, at 11:57:00
In reply to Re: ZYPREXA OR AMISULPIRIDE? » Ant-Rock, posted by SLS on November 14, 2000, at 22:12:13
> Hi Anthony.
>
> I have been taking Zyprexa (olanzapine) for only 9 days. It was added to a regimen of Parnate 80mg + desipramine 300mg + Lamictal 300mg. I just raised my dosage of Zyprexa from 2.5mg to 5.0mg. My doctor says that some people respond just fine at 2.5mg. I could "feel" after a week that 2.5mg was just a bit shy of what I think I need. The doctor gave me the latitude to make this dosage increase.
>
> It has been helping. Although slightly perceptible at this point, I would say that it is helping with anhedonia. One of my biggest complaints about Parnate is that it doesn't seem to reduce the anhedonia, and actually produces some weird sort of apathy and a reduction of certain motivations. Zyprexa is definitely doing good things that are being missed by the Parnate.
>
> ECT?
>
> GO FOR THE ZYPREXA !!!!
>
> I am not sure to what degree low-dose Zyprexa is analogous to low-dose sulpiride or amisulpride. There may be some overlap. The major difference between Zyprexa and the latter two drugs is that the latter are considered "preferential" for presynaptic autoreceptors - the blockade of which leads to increased dopaminergic tone. As I remember, dopaminergic presynaptic autoreceptors are inherently of higher affinity for DA and other receptor ligands (anything that attaches directly to the receptor). If this is true, I would guess that Zyprexa can produce a similar effect, possibly more effectively at lower dosages. Zyprexa has a relatively low affinity for DA receptors. My silly imagination can see how such a drug would effectively occupy presynaptic receptors before blocking enough postsynaptic receptors to exert an antipsychotic effect.
>
> Zyprexa is a pretty cool drug that I believe exerts true antidepressant effects, particularly when used as an adjunct to SSRIs and MAO-inhibitors. Zyprexa potently blocks 5-HT2a receptors - the SAME receptors that are blocked by Serzone (nefazodone), Desyrel (trazodone), and Remeron (mirtazapine). This mechanism is thought to be of great importance in producing an antidepressant effect, and possibly adds to the ability of Zyprexa to treat the negative symptoms of schizophrenia. I have yet to gain an impression of the efficacy of Zyprexa as an adjunct to the tricyclics, Wellbutrin, Serzone, or Remeron.
>
> As far as Mirapex (pramipexole) is concerned, on a simplistic level, it does the opposite of Zyprexa at the receptor level (although not necessarily at the clinical level). Mirapex stimulates, while Zyprexa and other neuroleptic antipsychotics block, dopamine D2 receptors. However, Mirapex also stimulates D3 receptors - the same receptors that are blocked by amisulpride and amisulpride. Don't be bashful about trying Mirapex before going on to ECT. It is perfectly safe and may possibly help more people with treatment-resistant depression than Parlodel (bromocryptine), an often used D2 agonist. Parlodel augmentation of Parnate is a recognized alternative. I felt better during the first 3 or 5 days after adding it to Parnate. It can work. If you decide to try Mirapex, please post how you do with it. I have it on my list of things-to-do.
>
> I hope you find some of this helpful.
>
> Good luck on your doctor's visit.
>
>
> Sincerely,
> ScottThank you once again Scott, for all your valuable information/advice. I definitely can relate to the parnate's lack of efficacy in the apathy dept. Actually, every time I've restarted this med it has lost potency, and now I feel no difference regarding depression whether I am on a high or low dose. It basically makes me get up in the AM, which is why I always go back to it.
Anyway, my p-doc has been suggesting ECT to me for years, but I made the decision to try every option available before even considering it. So on goes the battle...
Sincerely,
Anthony
Posted by SLS on November 15, 2000, at 19:46:36
In reply to Re: ZYPREXA OR AMISULPIRIDE? » SLS, posted by Ant-Rock on November 14, 2000, at 19:03:24
> Thank you once again Scott, for all your valuable information/advice. I definitely can relate to the parnate's lack of efficacy in the apathy dept. Actually, every time I've restarted this med it has lost potency, and now I feel no difference regarding depression whether I am on a high or low dose. It basically makes me get up in the AM, which is why I always go back to it.
> Anyway, my p-doc has been suggesting ECT to me for years, but I made the decision to try every option available before even considering it. So on goes the battle...
> Sincerely,
> AnthonyDear Anthony,
I do not believe that it is time for you to go to ECT, although I have no real aversion to using it if it is indicated given your position in your treatment algorithm or current mental status. I had 12 treatments in 1991. 6 unilateral left followed by 6 bilateral. Bilateral sucks for memory and cognitive side effects, but it was my experience that they were gone completely within a few weeks. The experience would have been worthwhile had it worked. In my recent correspondence with Max Fink, he was reluctant to divulge with certainty his position regarding unilateral right versus bilateral. His position in this issue is not in accord with many experts, including my own doctor at NYU. A while back, someone posted a study, the results of which indicated that *high-dosage* right unilateral was as effective as bilateral, but somewhat inferior to high-dosage bilateral. In addition, in my estimation, the difference in cognitive side effects between both high-dosage treatments was negligible. My suggestion would be to decide first whether you want to try low-dosage right unilateral or high-dosage bilateral. I don't see any advantage to high-dosage right unilateral.
I also have experienced diminishing returns with Parnate over the years. It was a combination of Parnate 60mg + desipramine 150mg that got me nearly 100% well in 1987 for over six months. I don't want to go into it here, but my doctor at the time discontinued this treatment in favor of Prozac, which had just come out. I have not responded to this combination ever again.
If I were you...
* Remain on lithium 300mg - 600mg (unipolar augmentation dosages)
* Keep praying
* Keep hoping - you haven't tried a whole bunch of stuff - I guarantee it.
* Keep smiling.
:-)
1. Add:
- sulpiride 50mg - 200mg or amisulpride 50mg - 100mg if you are not averse to procuring foreign drugs. You will get an answer witching 7 days.
- Zyprexa or Risperdal or Zeldox (when it come out - spring?)1. Add desipramine or nortriptyline to the above.
2. Do not add an SSRI, Effexor, or Serzone
3. Add a combination of stimulants along with the the above: one from group A and one from group B
Group A:
- Adderal
- Dexedrine
- Ritalin
- CylertGroup B:
- Mirapex
- Parlodel
- Permax4. Add thyroid hormone with the above:
- Cytomel T3
- Synthroid T4 (my preference)5. Switch to Nardil or, perhaps later, Marplan: all other medications remain in place.
7. Try other things your doctor suggests
8. Switch back to Parnate and combine it with what you have found most successful.
6. Ask JohnL about the usage of Remeron in this algorithm.
7. Ask AndrewB about the usage of Eldepryl (selegiline) in this algorithm.
8. Brainstorm some more
9. ECT - when you are ready to try it. Last or sooner.
* The band had a hard time keeping up with the Vice-President as he waltzed across the stage. They had no algorithm
Sorry.
- Scott
Posted by Ant-Rock on November 16, 2000, at 18:38:35
In reply to Re: ZYPREXA OR AMISULPIRIDE? » Ant-Rock, posted by SLS on November 15, 2000, at 19:46:36
>
> Dear Anthony,
>
> I do not believe that it is time for you to go to ECT, although I have no real aversion to using it if it is indicated given your position in your treatment algorithm or current mental status. I had 12 treatments in 1991. 6 unilateral left followed by 6 bilateral. Bilateral sucks for memory and cognitive side effects, but it was my experience that they were gone completely within a few weeks. The experience would have been worthwhile had it worked. In my recent correspondence with Max Fink, he was reluctant to divulge with certainty his position regarding unilateral right versus bilateral. His position in this issue is not in accord with many experts, including my own doctor at NYU. A while back, someone posted a study, the results of which indicated that *high-dosage* right unilateral was as effective as bilateral, but somewhat inferior to high-dosage bilateral. In addition, in my estimation, the difference in cognitive side effects between both high-dosage treatments was negligible. My suggestion would be to decide first whether you want to try low-dosage right unilateral or high-dosage bilateral. I don't see any advantage to high-dosage right unilateral.
>
> I also have experienced diminishing returns with Parnate over the years. It was a combination of Parnate 60mg + desipramine 150mg that got me nearly 100% well in 1987 for over six months. I don't want to go into it here, but my doctor at the time discontinued this treatment in favor of Prozac, which had just come out. I have not responded to this combination ever again.
>
> If I were you...
>
> * Remain on lithium 300mg - 600mg (unipolar augmentation dosages)
>
> * Keep praying
>
> * Keep hoping - you haven't tried a whole bunch of stuff - I guarantee it.
>
> * Keep smiling.
>
> :-)
>
>
>
> 1. Add:
> - sulpiride 50mg - 200mg or amisulpride 50mg - 100mg if you are not averse to procuring foreign drugs. You will get an answer witching 7 days.
> - Zyprexa or Risperdal or Zeldox (when it come out - spring?)
>
> 1. Add desipramine or nortriptyline to the above.
>
> 2. Do not add an SSRI, Effexor, or Serzone
>
> 3. Add a combination of stimulants along with the the above: one from group A and one from group B
>
> Group A:
> - Adderal
> - Dexedrine
> - Ritalin
> - Cylert
>
> Group B:
> - Mirapex
> - Parlodel
> - Permax
>
> 4. Add thyroid hormone with the above:
> - Cytomel T3
> - Synthroid T4 (my preference)
>
> 5. Switch to Nardil or, perhaps later, Marplan: all other medications remain in place.
>
> 7. Try other things your doctor suggests
>
> 8. Switch back to Parnate and combine it with what you have found most successful.
>
> 6. Ask JohnL about the usage of Remeron in this algorithm.
>
> 7. Ask AndrewB about the usage of Eldepryl (selegiline) in this algorithm.
>
> 8. Brainstorm some more
>
> 9. ECT - when you are ready to try it. Last or sooner.
>
>
>
>
* The band had a hard time keeping up with the Vice-President as he waltzed across the stage. They had no algorithm- Scott
Scott,
I too lost my algorithm.
Now it's on to Adderal monotherapy, which I find kind of strange, but the doc wants me to get off the parnate/lithium and give this a shot. I'm kind of pessimistic of any monotherapy, but I'll have to give it a try. Do you know if mirapex can be combined with adderal? They have mirapex for sale on the libertarian solutions web, and it's very cheap. Just a thought. Anyway, hope things continue to be well with you.Sincerely,
Anthony
* Would this be considered a treatment-resistant election ?
Posted by SLS on November 16, 2000, at 21:45:40
In reply to Re: ZYPREXA OR AMISULPIRIDE? » SLS, posted by Ant-Rock on November 16, 2000, at 18:38:35
Dear Aunt Rock,
> > * The band had a hard time keeping up with the Vice-President as he waltzed across the stage. They had no algorithm> > - Scott
> Scott,
> I too lost my algorithm.
> Now it's on to Adderal monotherapy, which I find kind of strange, but the doc wants me to get off the parnate/lithium and give this a shot. I'm kind of pessimistic of any monotherapy, but I'll have to give it a try. Do you know if mirapex can be combined with adderal? They have mirapex for sale on the libertarian solutions web, and it's very cheap. Just a thought. Anyway, hope things continue to be well with you.
>
> Sincerely,
> Anthony
> * Would this be considered a treatment-resistant election ?No LOL, but lots of SS (severe smile)
I think your doctor has made an excellent decision. Besides holding some hope that Adderal might be just the right key to your locked door, he is using it as a bridge between the time necessary to wean off Parnate and wait 10-14 days (depending on who you listen to) from your last dose before beginning an otherwise contraindicated combination. Although the current thoughts regarding Parnate are that it is not metabolized into amphetamine, Parnate itself may mimic phenylethylamine to produce amphetamine-like effects. If this is true, this could certainly explain the hypertensive reactions that some people experience. Regardless of the mechanism, I can tell you from personal experience that I experienced a "let-down" that lasted for weeks. If you were to discontinue Parnate without making any other changes in your regimen, you might experience a syndrome similar to withdrawal from amphetamine - great fatigue and possibly depression. What you are doing is using the temporary administration of amphetamine to prevent this, whereafter, you can either continue Adderal as an adjunct to subsequent treatment or wean from it at a rate you have better control of.Adderal will minimize your approach towards your otherwise unmedicated baseline depression while you wait.
Nardil?
6 months ago, I began to think about combining Nardil with Zyprexa. I bet it makes for an awesome combination. Prozac and Zyprexa should prove effective also. Adding Zyprexa to my current regimen of Parnate 80mg + desipramine 300mg + Lamictal 300mg has produced a very significant improvement. However, the first chance I get, I am going to switch to Nardil. Hopefully, the desipramine and Lamictal will provide me with a sufferable bridge.
What was your reaction to what I said about ECT?
Adderal + Mirapex should not produce any significant untoward reactions. Let me know what the doc has to say.
- Scott
Posted by shellie on November 18, 2000, at 16:53:33
In reply to Re: ZYPREXA OR AMISULPIRIDE? » SLS, posted by Ant-Rock on November 16, 2000, at 18:38:35
Hi Anthony. I'm sorry you have having such a hard time, but I was glad to see your name again on the board; I was wondering how you were doing.
If you start to get too down, keep reading Adam's post. It is very encouraging. Scott is right--there are lots of combinations still to try and ECT
may actually work miracles for you-- IF you decide to go down that path.Wishing you the best, Shellie
Posted by Ant-Rock on November 20, 2000, at 13:13:42
In reply to Re: ZYPREXA OR AMISULPIRIDE? » Ant-Rock, posted by shellie on November 18, 2000, at 16:53:33
> Hi Anthony. I'm sorry you have having such a hard time, but I was glad to see your name again on the board; I was wondering how you were doing.
>
> If you start to get too down, keep reading Adam's post. It is very encouraging. Scott is right--there are lots of combinations still to try and ECT
> may actually work miracles for you-- IF you decide to go down that path.
>
> Wishing you the best, ShellieThanks for your concern, Shellie. No, things aren't to good lately, but ECT is not an option for me personally. I've read to many horror stories, although I realize it has been a lifesaver for many as well. Trying to get some info on Mirapex. Sounds like it's worth a shot.
I start adderal monotherapy in about a week, so we'll see.
Sounds like you're doing better, hope that's the case.
Sincerely,
Anthony
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.