![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 53. Go back in thread:
Posted by MarkinBoston on January 25, 2001, at 14:08:45
In reply to Re: Reboxetine/Ritilin for Depression? MarkinBos, posted by Katz on January 24, 2001, at 19:21:36
> Hi Markin,
> How long have you been on ritilin? Has the dose remained constant throughout? What symptoms has it helped you with? Do you suffer from depression? Anhedonia? Social Phobia? ADD/ADHD?I have double depression, dysthimia/anhedonia with about 5 stress induced major unipolar melancholic episodes. SSRI's don't seem to work, Wellbutrin makes me unwell, and high dose Effexor works, though I dislike the side effects. Hence, NE and DO seem to be the major players for me. I rarely experience panic and am somewhat shy, though don't much limit activity due to it. I may have ADD/ADHD - I haven't looked into it.
About 5 months ago I tried Ritalin with Serzone. I liked the Ritalin. The Serzoone helped some, but left me tired and foggy despite a couple attempts at gradual increases in dose. I thought the Ritalin might be pooping out, and switched to the stronger Aderall. Serzone was the real problem and I gave up on it and started Effexor.
My pdoc initially started my Ritalin at 20mg ex/day, but I found one in the AM was enough. After a while I started taking the second dose. With Adderall, I take 20mg in the AM, and another in the afternoon about half the time. I have become more tolarant of side effects, but not compelled to increase each dosing.
I do like the extra energy, uplifted mood, greater sociablity, alertness, mental focus, appetite suppression, and weight loss.
Posted by Katz on January 25, 2001, at 14:17:55
In reply to Re: Reboxetine/Ritilin for Depression? » Katz, posted by MarkinBoston on January 25, 2001, at 14:08:45
>Hi Mark,
Thanks for the additional info. I've decided to quit the Rebox and try the andrafinil + amisulfide combo. If that doesn't work, I'm just going to have to be more aggressive in my search for a doc to prescribe ritiln.
Wishing you great happiness,
KathyinWorcester
> Hi Markin,
> > How long have you been on ritilin? Has the dose remained constant throughout? What symptoms has it helped you with? Do you suffer from depression? Anhedonia? Social Phobia? ADD/ADHD?
>
> I have double depression, dysthimia/anhedonia with about 5 stress induced major unipolar melancholic episodes. SSRI's don't seem to work, Wellbutrin makes me unwell, and high dose Effexor works, though I dislike the side effects. Hence, NE and DO seem to be the major players for me. I rarely experience panic and am somewhat shy, though don't much limit activity due to it. I may have ADD/ADHD - I haven't looked into it.
>
> About 5 months ago I tried Ritalin with Serzone. I liked the Ritalin. The Serzoone helped some, but left me tired and foggy despite a couple attempts at gradual increases in dose. I thought the Ritalin might be pooping out, and switched to the stronger Aderall. Serzone was the real problem and I gave up on it and started Effexor.
>
> My pdoc initially started my Ritalin at 20mg ex/day, but I found one in the AM was enough. After a while I started taking the second dose. With Adderall, I take 20mg in the AM, and another in the afternoon about half the time. I have become more tolarant of side effects, but not compelled to increase each dosing.
>
> I do like the extra energy, uplifted mood, greater sociablity, alertness, mental focus, appetite suppression, and weight loss.
Posted by Leonardo on January 26, 2001, at 5:12:16
In reply to Re: Reboxetine/Ritalin - what about ADHD?, posted by Katz on January 24, 2001, at 11:53:05
Hi Katz
I haven't had chance to try the amisulpride/adrafinil, but I will try to get some. I am in a 4 week washout period from deprenyl at the moment before my Pdoc will let me start Zoloft. I am willing to risk taking Ritalin at this time, it is quick acting and quick to clear, but it may not be worth starting the amisulpride/adrafinil as it takes a while to take effect, and would confuse things when I start the Zoloft.
I hope the stuff works for you! Keep us posted. I will keep working on my Pdoc for the ADHD and a trial of stims, but I think I need to trial at least Zoloft and Effexor before he will agree...
Best wishes
Leonardo> Hi Leonardo,
>
> Thank you for that quick response. Have you tried the combination of andrafinil & amisulpride that John recommends? Perhaps you should give it a try before going the Ritilin route. If it works, it sounds like it would be a kinder, gentler albeit very effective treatment. I know that you can't order from sources inside your own country but I'm sure you can find sources elsewhere, e.g. Mexico, Italy, etc. Perhaps someone with that information could post it here.
>
> As for the paxil. I don't feel I need it. At least not yet. I have not found the energizing effects of Rebox overwhelming. Now that I am beginning my dosing during the daytime, I doubt I will have a problem sleeping. In the event that I do, I will keep your Paxil suggestion in mind although I would really hate to increase my seratonin levels under any circumstances. Infact, now that I think about it, if sleep does become a problem, I think Melatonin might be a better choice for me.
>
> Leonardo, if you believe you have ADHD you should discuss it with your doctor immediately. He might be willing to introduce the stims more readily. I don't believe that I have either ADHD or ADD although I do believe there is some frontal lobe inactivity involved which is causing my anhedonia and possibly my social phobia. Who knows, unless one can actually look at the brain activity, it's just speculation as to what is really going on.
>
> Good luck,
>
> Kathy
Posted by HenryO on January 26, 2001, at 15:00:09
In reply to Reboxetine/Ritilin for Depression?, posted by Katz on January 23, 2001, at 19:02:07
I have tried so many anti-depressants over the last 12 years that I would be embarrassed to talk about it anywhere other than a forum like this one. The single most effective drug I have taken is RITAIN. I know that all these meds are idiosincratic and what works for some may not work, or even may exacerbate symtoms for others. I am a recovering alcholic. RITAIN has not been addictive for me. I can tell you if I had been able to get it as a teenager you might have thought I was addicted, as I would certainly have shown a great liking for it. Because it makes me feel better. It has powerful mood elavating properties. Now days it comes in smoother release formats as Concerta. Why is it that if a drug works really well for some people, it is suddenly under suspicion? Ritalin may be speed but it helps my depresion considerably. My doctor and I constantly dinker with other meds trying to find a combo that will move me to a better level of functioning. But the constant is Ritalin. I am currently undertaking a trial of Reboxetine/Edronax. I'm not so sure about it. I'm going to post a seperate message about that experience though. This web site is a wonderful service. Thank Dr.Bob whoever you are.
Posted by Katz on January 27, 2001, at 8:43:58
In reply to Re: Reboxetine/Ritalin - what about ADHD? » Katz, posted by Leonardo on January 26, 2001, at 5:12:16
>Hi Leonardo,
I agree with everything you have said about your treatment stratergy. I'll be thinking about you and wishing you well. Please keep us posted on your progrees. I'd love to hear your reactions to the Zoloft and Effexor. I will do the same with any new drugs that I try.
I'm off the Reboxetine know and hope to begin my trial of andrafinil and amisulpride by the end of next week. I let you know how it goes.
Blessings & best wishes,
Kathy
Hi Katz
>
> I haven't had chance to try the amisulpride/adrafinil, but I will try to get some. I am in a 4 week washout period from deprenyl at the moment before my Pdoc will let me start Zoloft. I am willing to risk taking Ritalin at this time, it is quick acting and quick to clear, but it may not be worth starting the amisulpride/adrafinil as it takes a while to take effect, and would confuse things when I start the Zoloft.
>
> I hope the stuff works for you! Keep us posted. I will keep working on my Pdoc for the ADHD and a trial of stims, but I think I need to trial at least Zoloft and Effexor before he will agree...
>
> Best wishes
> Leonardo
>
> > Hi Leonardo,
> >
> > Thank you for that quick response. Have you tried the combination of andrafinil & amisulpride that John recommends? Perhaps you should give it a try before going the Ritilin route. If it works, it sounds like it would be a kinder, gentler albeit very effective treatment. I know that you can't order from sources inside your own country but I'm sure you can find sources elsewhere, e.g. Mexico, Italy, etc. Perhaps someone with that information could post it here.
> >
> > As for the paxil. I don't feel I need it. At least not yet. I have not found the energizing effects of Rebox overwhelming. Now that I am beginning my dosing during the daytime, I doubt I will have a problem sleeping. In the event that I do, I will keep your Paxil suggestion in mind although I would really hate to increase my seratonin levels under any circumstances. Infact, now that I think about it, if sleep does become a problem, I think Melatonin might be a better choice for me.
> >
> > Leonardo, if you believe you have ADHD you should discuss it with your doctor immediately. He might be willing to introduce the stims more readily. I don't believe that I have either ADHD or ADD although I do believe there is some frontal lobe inactivity involved which is causing my anhedonia and possibly my social phobia. Who knows, unless one can actually look at the brain activity, it's just speculation as to what is really going on.
> >
> > Good luck,
> >
> > Kathy
Posted by Katz on January 27, 2001, at 8:50:39
In reply to Re: Reboxetine/Ritilin for Depression?, posted by HenryO on January 26, 2001, at 15:00:09
> Hi Henry,
"Right-on" about the Ritilin. It seems that it has helped many people on this board with depression whereas nothing else has. Your lucky to have a pdoc who prescribes it for you. How long have you been on the Ritilin and how much are you taking?
Yes, this is a wonderful website and I second your motion: "Thankyou Dr. Bob"!
I'm looking forward to reading your new post.
Best wishes,
Kathy
I have tried so many anti-depressants over the last 12 years that I would be embarrassed to talk about it anywhere other than a forum like this one. The single most effective drug I have taken is RITAIN. I know that all these meds are idiosincratic and what works for some may not work, or even may exacerbate symtoms for others. I am a recovering alcholic. RITAIN has not been addictive for me. I can tell you if I had been able to get it as a teenager you might have thought I was addicted, as I would certainly have shown a great liking for it. Because it makes me feel better. It has powerful mood elavating properties. Now days it comes in smoother release formats as Concerta. Why is it that if a drug works really well for some people, it is suddenly under suspicion? Ritalin may be speed but it helps my depresion considerably. My doctor and I constantly dinker with other meds trying to find a combo that will move me to a better level of functioning. But the constant is Ritalin. I am currently undertaking a trial of Reboxetine/Edronax. I'm not so sure about it. I'm going to post a seperate message about that experience though. This web site is a wonderful service. Thank Dr.Bob whoever you are.
Posted by HenryO on January 29, 2001, at 1:32:24
In reply to Re: Reboxetine/Ritilin for Depression? » HenryO, posted by Katz on January 27, 2001, at 8:50:39
Hey Kathy, I take Ritalin as I need it. I've been on it for maybe three years or more. Often 20mgs when I wake up. If I am up early enough in the day I just take Concerta 36mgs. I have found that I do experience its effectiveness diminishing over time, say 3-4 months. If I go off it for a time say again 3-4 months then when I return to it, its effectiveness is dramatic. That may be due to "poop out", it may also be the ebb and flow of my disease. I try not to go off and on it though, I pretty much take it daily. Somedays I need the crunch of the regular release but usually I preffer the sustained release. I NEVER get the genaric. I found early on that it was not the same at all.
Yes, I am lucky to have found a good doctor. He is a biological psychiatrist.
I must tell you that I have worked up bit of a cocktail. I take prozac 20mgs, the Ritalin (or Concerta) and Pindolol (a.k.a Visken) 5-10 mgs which is a tiny dose I think. The Pindolol is the catalist that seems to make the whole thing work, for me. Without it I am wiped-out with enervating depression. Pindolol doesn't work for most people but for me it stops the pain. I don't feel "happy" but when nothing else was working that is good enough, believe me.
I went off my "cocktail" for a month or so around November. I was experiencing some intermitant erectile interferance. It wasn't a prudent move. It almost seems to be a side affect of improved mood to want to get off meds. Anyway I was plowed under by my depression. No surprize. My doctor told me meds are 4 to 5 times better at preventing depression than they are at curing it. That made sense to me. I've heard many times before not to quit taking them abruptly but there is something that seems to make all of us want to think we don't need them when we are feeling good.
OK on to a new post Reboxetine/Edronax
Posted by Leonardo on January 29, 2001, at 10:15:21
In reply to Re: Reboxetine/Ritalin - what about ADHD? » Leonardo, posted by Katz on January 27, 2001, at 8:43:58
Thanks Kathy - I've been on no meds at all except for the occasional 'borrowed' Ritalin, and it is hell sometimes. I guess its not that much worse than with the meds I was on before, but then they weren't really working....
Lets hope I can last!
Leonardo
Posted by katz on January 30, 2001, at 11:24:28
In reply to Re: Reboxetine/Ritalin - what about ADHD? » Katz, posted by Leonardo on January 29, 2001, at 10:15:21
>Hi Lea!!! How's it going? Still hanging in there I hope! Thank God you have access to the Ritilin if things get too bad. Let me know when you start the Zoloft and how well you progress on it. In the meantime, keep your chin up! Things will get better. There's so much wonderful and helpful advice on this board that where bound to hit on the right med or cocktail! I think just having found this board puts us way ahead of the game!
As for me, I've had headaches since stopping the Rebox. The firt two days were the worst...a headache from hell! I added the andrafinil just as I stopped the Rebox. That could have contributed to my plight. Today, I am feeling better. I actually got out of bed this morning and did a few things around the house. I think the andrafinil must be beginning to have a mild effect. More antidpressant than stimulating at the moment. Again, I must repeat, its effect is very mild and not very significant. From what I understand that is to be expected. Andrafinil, unlike other stimulants comes on slow and has a cumulative effect building over days, weeks and even months. I'm expecting the amisulpride any day now. I wish I had the willpower to keep from trying it for at least another week so that I could determine exactly what effects I am getting from the andrafinil, but I doubt that I will be able to do that. I'm sure I'll pop that little sucker in my mouth as soon as I open the package. I am placing "high hopes" on that little pill...but then I place "high hopes" on every new med that I try. I guess we all do!
Best wishes,
Kathy
Thanks Kathy - I've been on no meds at all except for the occasional 'borrowed' Ritalin, and it is hell sometimes. I guess its not that much worse than with the meds I was on before, but then they weren't really working....
>
> Lets hope I can last!
>
> Leonardo
Posted by katz on January 30, 2001, at 11:49:06
In reply to Re: Ritalin, posted by HenryO on January 29, 2001, at 1:32:24
>Hi Henry,
Thanks for the info. I was a little disappointed to hear that the ritilin does infact lose its effectiveness over time. Since your building up a tolerance, how do you keep yourself from continuing to "up" the dose. That must take a lot of willpower. You mentioned that you did not like the generic. Any specific reasons? When I was on the ritilin for 6 months, I took the generic and never had I problem. I loved it! I never had a need to increase the dose (but of course I was on it only a short time). As a matter of fact, I felt as though I was getting better over time.
Thankyou for sharing your cocktail. You just never know who may benefit from it. I'm going to look up Pindolol. I've never heard of it. One can never have too many ideas held in reserve. I'm building my own little arsenal of drug info which I plan to use to combat this malady!
Best wishes,
Kathy
Hey Kathy, I take Ritalin as I need it. I've been on it for maybe three years or more. Often 20mgs when I wake up. If I am up early enough in the day I just take Concerta 36mgs. I have found that I do experience its effectiveness diminishing over time, say 3-4 months. If I go off it for a time say again 3-4 months then when I return to it, its effectiveness is dramatic. That may be due to "poop out", it may also be the ebb and flow of my disease. I try not to go off and on it though, I pretty much take it daily. Somedays I need the crunch of the regular release but usually I preffer the sustained release. I NEVER get the genaric. I found early on that it was not the same at all.
>
> Yes, I am lucky to have found a good doctor. He is a biological psychiatrist.
>
> I must tell you that I have worked up bit of a cocktail. I take prozac 20mgs, the Ritalin (or Concerta) and Pindolol (a.k.a Visken) 5-10 mgs which is a tiny dose I think. The Pindolol is the catalist that seems to make the whole thing work, for me. Without it I am wiped-out with enervating depression. Pindolol doesn't work for most people but for me it stops the pain. I don't feel "happy" but when nothing else was working that is good enough, believe me.
>
> I went off my "cocktail" for a month or so around November. I was experiencing some intermitant erectile interferance. It wasn't a prudent move. It almost seems to be a side affect of improved mood to want to get off meds. Anyway I was plowed under by my depression. No surprize. My doctor told me meds are 4 to 5 times better at preventing depression than they are at curing it. That made sense to me. I've heard many times before not to quit taking them abruptly but there is something that seems to make all of us want to think we don't need them when we are feeling good.
>
> OK on to a new post Reboxetine/Edronax
Posted by Katz on January 31, 2001, at 16:31:54
In reply to Reboxetine/Ritilin for Depression?, posted by Katz on January 23, 2001, at 19:02:07
Update: I just received my amisulpride in the mail and took my first 25mg dose about 20 minutes ago. I'M SO EXCITED!!! Please God, let this work!
I'm already starting to feel some effects. I feel, I don't know...like I've had a couple glasses of wine, I think. Of course it's too early to tell what the real effects of this drug will be. From what I understand from reading John L's posts, I should know that in about four days. Let's hope I'm not reporting back to you all from the depths of hell! Quite frankly, I do think I will be devasted if this drug does not work as anticipated.Some of you may be interested to know that I placed my order from: xxx
I ordered late Thursday afternoon. They shipped it Friday morning and it arrived today (Weds)! Now, that's pretty impressive. Their prices are impressive also.
Keep your fingers crossed for me. I'll keep you posted.
Thankyou all for all your support, imput and great suggestions,
Kathy
Posted by Lynne on January 31, 2001, at 17:34:04
In reply to Re:Amisulpride Everyone, posted by Katz on January 31, 2001, at 16:31:54
> Update: I just received my amisulpride in the mail and took my first 25mg dose about 20 minutes ago. I'M SO EXCITED!!! Please God, let this work!
> I'm already starting to feel some effects. I feel, I don't know...like I've had a couple glasses of wine, I think. Of course it's too early to tell what the real effects of this drug will be. From what I understand from reading John L's posts, I should know that in about four days. Let's hope I'm not reporting back to you all from the depths of hell! Quite frankly, I do think I will be devasted if this drug does not work as anticipated.
>
> Some of you may be interested to know that I placed my order from: xxx
>
> I ordered late Thursday afternoon. They shipped it Friday morning and it arrived today (Weds)! Now, that's pretty impressive. Their prices are impressive also.
>
> Keep your fingers crossed for me. I'll keep you posted.
>
> Thankyou all for all your support, imput and great suggestions,
>
> KathyGood For You!!!! I hope it works. Please let us know.
Posted by natg on January 31, 2001, at 19:18:10
In reply to Re:Amisulpride Everyone, posted by Lynne on January 31, 2001, at 17:34:04
> > Update: I just received my amisulpride in the mail and took my first 25mg dose about 20 minutes ago. I'M SO EXCITED!!! Please God, let this work!
> > I'm already starting to feel some effects. I feel, I don't know...like I've had a couple glasses of wine, I think. Of course it's too early to tell what the real effects of this drug will be. From what I understand from reading John L's posts, I should know that in about four days. Let's hope I'm not reporting back to you all from the depths of hell! Quite frankly, I do think I will be devasted if this drug does not work as anticipated.
> >
> > Some of you may be interested to know that I placed my order from: xxx
> >
> > I ordered late Thursday afternoon. They shipped it Friday morning and it arrived today (Weds)! Now, that's pretty impressive. Their prices are impressive also.
> >
> > Keep your fingers crossed for me. I'll keep you posted.
> >
> > Thankyou all for all your support, imput and great suggestions,
> >
> > Kathy
>
> Hi Kathy:
Keep us posted, I pray this helps you!Good Luck,
Nat
Posted by Leonardo on February 1, 2001, at 8:56:35
In reply to Re: Reboxetine/Ritalin - what about ADHD? » Leonardo, posted by katz on January 30, 2001, at 11:24:28
Hi Kathy
> As for me, I've had headaches since stopping the Rebox. The firt two days were the worst...a headache from hell! I added the andrafinil just as I stopped the Rebox. That could have contributed to my plight.
I too have had headaches a lot when mixing/changing meds. Like you say, you can't tell if its withdrawal from one, starting the other, or the combination. A good reason to take things slowly, but...
I am placing "high hopes" on that little pill...but then I place "high hopes" on every new med that I try. I guess we all do!It is hard to be patient and give all the meds a fair chance on their own when you've been feeling rotten for years.
Re. the reboxetine, I didn't get headaches just coming off it, but I did when I was switching to wellbutrin or selegeline I think. I also got headaches just coming off Paxil.
I am presently using valerian for anxiety and a brain boost mixure containg ginseng, phelalaline etc, and guess what I'm getting headaches! The ritalin was much less hassle, but I daren't use any more of my son's stuff..
Good luck!
Posted by Leonardo on February 1, 2001, at 9:01:44
In reply to Re: Ritalin » HenryO, posted by katz on January 30, 2001, at 11:49:06
> >Hi Henry,
>
> Thanks for the info. I was a little disappointed to hear that the ritilin does infact lose its effectiveness over time.I have read that ADHD people can usualy take ritalin for very long periods (many years) and not have it wear off. If your problem was not just ADHD but depression from some other cause, then it is understandable if the stimulating effect would wear off fairly quickly. This is why they won't prescribe ritalin for depression generally, it is not an effective treatment long term unless you have ADHD.
Leonardo
Posted by Katz on February 1, 2001, at 16:09:41
In reply to Headaches on switching meds.. » katz, posted by Leonardo on February 1, 2001, at 8:56:35
> I am presently using valerian for anxiety and a brain boost mixure containg ginseng, phelalaline etc, and guess what I'm getting headaches!It's probably the phenalanaline that is causing the headaches.
>The ritalin was much less hassle, but I daren't use any more of my son's stuff..
Kind of like keeping your "hand out of the cookie jar", no doubt! When do you start on your Zoloft trial? Please keep us posted.Best of luck,
Kathy
Posted by Katz on February 1, 2001, at 16:33:35
In reply to Re:Amisulpride Everyone, posted by Katz on January 31, 2001, at 16:31:54
> Update: I just received my amisulpride in the mail and took my first 25mg dose about 20 minutes ago. I'M SO EXCITED!!! Please God, let this work!
> I'm already starting to feel some effects. I feel, I don't know...like I've had a couple glasses of wine, I think. Of course it's too early to tell what the real effects of this drug will be. From what I understand from reading John L's posts, I should know that in about four days. Let's hope I'm not reporting back to you all from the depths of hell! Quite frankly, I do think I will be devasted if this drug does not work as anticipated.
>
> Some of you may be interested to know that I placed my order from: xxx
>
> I ordered late Thursday afternoon. They shipped it Friday morning and it arrived today (Weds)! Now, that's pretty impressive. Their prices are impressive also.
>
> Keep your fingers crossed for me. I'll keep you posted.
>
> Thankyou all for all your support, imput and great suggestions,
>
> KathyUpdate # 2: It has now been 24 hours since my first 25mg dose of amisulpride. I took my second dose this morning at 8:00 AM. The feelings of intoxication and dizziness have now dissapated giving way to a feeling of sedation. I feel "over-tired"! It is that uncomfortable feeling when your tired and you want to sleep but you cannot! Totally different from the kind of knock out sleepiness that I have experienced from most AD's where I wouldn't be able to stay awake to save my soul. Other than that, I see no other changes. Mood and motivation remain unchanged. I hope this tired yet wired feeling will soon fade. I am tired despite the fact that in addition to the amisulpride, I have been taking adrafinil 300mg/bid for the past week. I think I may need a stronger stimulant. Who knows????? I'll keep you posted.
Any information on the sedating effect on amisulpride would be appreciated. Does it fade with time?
To Lynne, Nat and Leonardo and to all my fellow Babblers, thankyou for your continued encouragement and good wishes.
Posted by Lynne on February 1, 2001, at 18:13:10
In reply to Re: Headaches on switching meds.., posted by Katz on February 1, 2001, at 16:09:41
>
> > I am presently using valerian for anxiety and a brain boost mixure containg ginseng, phelalaline etc, and guess what I'm getting headaches!
>
> It's probably the phenalanaline that is causing the headaches.
>
> >The ritalin was much less hassle, but I daren't use any more of my son's stuff..
>
> Kind of like keeping your "hand out of the cookie jar", no doubt! When do you start on your Zoloft trial? Please keep us posted.
>
> Best of luck,
>
> KathyKathy,
I could not wait to read your post today. I am disappointed that Amisulpride is making you drowsy.Hopefully it will go away. How did the Andrafinil make you feel when you were just taking it? It made me drowsy and feel like I was on drugs.I hope this drug will work out for you. My thoughts are with you.Lynne
Posted by AndrewB on February 2, 2001, at 0:08:45
In reply to Re:Amisulpride Update #2, posted by Katz on February 1, 2001, at 16:33:35
Katz,
First of all I would like to suggest that you not get your expectations up too high about any one med. You never know what is going to work. The best avenue to success is patience and willingness to try various med. (combo.s). But chances are, with time, you will find the right med.
Sedation is one the most common sided effects among non-responders to amisulpride. Usually, but not always, it does not go away.
I suggest you try amisulpride at your current dosage for a total of 5 days.
Since we know too high doses of amisulpride cause sedation, if the sedation persists, after five days switch to taking 12.5mg.s of amisulpride at night. Give this trial 5 days. If you are still sedated or unresponsive it is time to try something else.
It is possible that the sedation in this case is caused by supersensitive and very responsive postsynaptic dopamine D2/D3 receptors. The receptors may be so sensitive they are attracting amisulpride, even at low doses to attach to them. When this happens the amisulpride will block these receptors and can cause sedation and tension.
This scenario, if applicable, gives us a clue as to what may work for you. Specifically you may benefit from stimulation of those D2/D3 receptors. Mirapex is very effective at doing this, so I would make it my first choice for a trial if amisulpride doesn’t work.
Mirapex is available in the US or without an Rx abroad.
Please keep us informed on how it is going and try to keep the faith that a med. that will help you is out there.
AndrewB
Posted by Katz on February 2, 2001, at 11:29:39
In reply to Re: Headaches on switching meds.., posted by Lynne on February 1, 2001, at 18:13:10
> > Hi Lynne,
Andrafinil is a drug that I was introduced to about 3 years ago. My past experience is thus: Week 1 - It had a dramatic speed like feel to it.
Week 2 - Amphetamine like feeling stopped. The drug no longer appeared to be working.Not understanding the mechanism of how this drug worked. I became frustrated and gave up on it too soon. Andrafinil takes weeks and sometimes months for its full effect to be realized. Please note: I never felt drugged or sedated. To me, this would be an indication that this is not the right drug for you.
Presently, I am not feeling any effects from the andrafinil (at least not that I'm not aware of). I am only into my second week of andrafinil. If its going to work, it will need more time to do its job. Since I am combining it with the amisulpride, determining exactly what effects the andrafinil is having may be difficult.
I hope this has been helpful. What is your history and what meds are you currently using?
I hope to post everyday around 4 PM to keep everyone aprised of my day to day trial with amisulpride.
Kathy
The first week that I took andrafinil, It felt like speed. It had that nervous edge to it that usually occurs with amphetamines. That feeling soon waned and into the second week, no effect was felt.
> > > I am presently using valerian for anxiety and a brain boost mixure containg ginseng, phelalaline etc, and guess what I'm getting headaches!
> >
> > It's probably the phenalanaline that is causing the headaches.
> >
> > >The ritalin was much less hassle, but I daren't use any more of my son's stuff..
> >
> > Kind of like keeping your "hand out of the cookie jar", no doubt! When do you start on your Zoloft trial? Please keep us posted.
> >
> > Best of luck,
> >
> > Kathy
>
> Kathy,
> I could not wait to read your post today. I am disappointed that Amisulpride is making you drowsy.Hopefully it will go away. How did the Andrafinil make you feel when you were just taking it? It made me drowsy and feel like I was on drugs.I hope this drug will work out for you. My thoughts are with you.
>
> Lynne
Posted by Katz on February 2, 2001, at 13:12:54
In reply to Re:Amisulpride Update #2, posted by AndrewB on February 2, 2001, at 0:08:45
Hi AndrewB!!!
Thankyou! I value your suggestions. Being that you are, our resident pharmacologist/chemist, I was about to seek you out, but alas, you have found me.
I was somewhat disillusioned to hear about the amisulpride/sedation situation. I'm hanging in there though and hoping for the best. I will keep in mind your dosage suggestions and titrate down instead of up as I had intended to do. For the next few days I will stay at 25mg as you also suggested. In the meantime, I will begin to research Merapex. It's comforting to know what my next step will be should the amisulpride not work out. There is something about the "feel" of the amisulpride that gives me an innate sense that I'm on the right track. I think if anything (aside from methylphenidate) is going to work for me, it will be one of the antipsychotics. I have no idea why I am saying that, it is based on nothing more than a "feeling". It is certainly not based on any educated guess or even anicdotal evidence.
Now, getting back to what's happening with my amisulpride trial: tired and exhausted last night I could not get to sleep. Refusing to put up with the insommnia, I decided to take something for it. My choices of meds where: valium, melatonin or bromocriptine. I decided against the bromocriptine because of its dopamine action. I didn't want to complicate the amisulpride issue and besides, I had taken the bromocripine before for anti-aging, growth hormone releasing action and although at 2.5 mg, it put be quickly to sleep, it also caused a rapid onset of depression. I quit the bromocriptine within a week of the initial trial. (I wonder, Andrew, if this might provide a further clue to what is going on inside my head?) I decided against the melatonin. It knocks me out cold but leaves me feeling drugged and zombie-like when I awake. I went with the valium (generic) and took 5 mg. I was asleep within 20 min. It put me into a dead sleep that I did not awake from until 10 AM (I'm usually up at 8). Had I not been awaken by the phone, I would have been sleeping several more hours. I awoke feeling drugged and sleepy. I quickly took 25 mg amisulpride + 300 mg andrafinil. The drugged and sleepy feeling quickly disappeared. I am now feeling awake and alert. Not motivated and not energized, just awake and alert. There is another issue that might give you another clue into what is going on. My sleep is very deep. I don't seem to experience very much REM. I very rarely dream! When I was on the reboxetine, sleep became a "night out at the movies". The reboxetine was discontinued after a month because it lost it's initial energizing effects and I was beginning to experience periods of fleeting depression which would last anywhere from 30 min. to an hour. Any postive effects from the reboxetine had disappeared and I was left with only the negative ones. I may have given up on this trial too soon.
So, that's the situation as it now stands. I am trying to do a daily update on my day to day amisulpride trial in hopes that it may be of benefit to someone else. I hope you will keep a check on these posts and keep me advised as to what you believe my next steps should be.
Thanks again,
Kathy
>Katz,
>
> First of all I would like to suggest that you not get your expectations up too high about any one med. You never know what is going to work. The best avenue to success is patience and willingness to try various med. (combo.s). But chances are, with time, you will find the right med.
>
> Sedation is one the most common sided effects among non-responders to amisulpride. Usually, but not always, it does not go away.
>
> I suggest you try amisulpride at your current dosage for a total of 5 days.
>
> Since we know too high doses of amisulpride cause sedation, if the sedation persists, after five days switch to taking 12.5mg.s of amisulpride at night. Give this trial 5 days. If you are still sedated or unresponsive it is time to try something else.
>
> It is possible that the sedation in this case is caused by supersensitive and very responsive postsynaptic dopamine D2/D3 receptors. The receptors may be so sensitive they are attracting amisulpride, even at low doses to attach to them. When this happens the amisulpride will block these receptors and can cause sedation and tension.
>
> This scenario, if applicable, gives us a clue as to what may work for you. Specifically you may benefit from stimulation of those D2/D3 receptors. Mirapex is very effective at doing this, so I would make it my first choice for a trial if amisulpride doesn’t work.
>
> Mirapex is available in the US or without an Rx abroad.
>
> Please keep us informed on how it is going and try to keep the faith that a med. that will help you is out there.
>
> AndrewB
Posted by Katz on February 2, 2001, at 15:33:29
In reply to Re:Amisulpride Update #2, posted by Katz on February 1, 2001, at 16:33:35
Update #3: Nothing significant to add. The good news is that the sedative effect has worn off. I am feeling awake and alert. There is no improvement in motivation, energy or socialization. I spent the day (as usual) in bed watching the soaps. Thank God for the soaps! I live my life vicariously through them. If I start getting out of bed, doing things around the house and going to the mailbox, it will be a sure sign that things are beginning to happen. I don't know what it is but I am still hopeful that this drug is going to work. It just "feels" right! Oh, one more thing...my appetite is ravenous! It seems to be an effect of the amisulpride. I can't afford to gain weight. I already have a sluggish metabolism which the AD's made even worse. Even though I ate a lot more than usual. I haven't gained any weight (at least not yet). Maybe it is stimulating my metabolisim as well as my appetite.
Anyway, that's the latest. Look for my post again tomorrow. It will be DAY 4! Will the groundhog see his shadow?????
>
> Update # 2: It has now been 24 hours since my first 25mg dose of amisulpride. I took my second dose this morning at 8:00 AM. The feelings of intoxication and dizziness have now dissapated giving way to a feeling of sedation. I feel "over-tired"! It is that uncomfortable feeling when your tired and you want to sleep but you cannot! Totally different from the kind of knock out sleepiness that I have experienced from most AD's where I wouldn't be able to stay awake to save my soul. Other than that, I see no other changes. Mood and motivation remain unchanged. I hope this tired yet wired feeling will soon fade. I am tired despite the fact that in addition to the amisulpride, I have been taking adrafinil 300mg/bid for the past week. I think I may need a stronger stimulant. Who knows????? I'll keep you posted.
>
> Any information on the sedating effect on amisulpride would be appreciated. Does it fade with time?
>
> To Lynne, Nat and Leonardo and to all my fellow Babblers, thankyou for your continued encouragement and good wishes.
> > Update: I just received my amisulpride in the mail and took my first 25mg dose about 20 minutes ago. I'M SO EXCITED!!! Please God, let this work!
> > I'm already starting to feel some effects. I feel, I don't know...like I've had a couple glasses of wine, I think. Of course it's too early to tell what the real effects of this drug will be. From what I understand from reading John L's posts, I should know that in about four days. Let's hope I'm not reporting back to you all from the depths of hell! Quite frankly, I do think I will be devasted if this drug does not work as anticipated.
> >
> > Some of you may be interested to know that I placed my order from: xxx
> >
> > I ordered late Thursday afternoon. They shipped it Friday morning and it arrived today (Weds)! Now, that's pretty impressive. Their prices are impressive also.
> >
> > Keep your fingers crossed for me. I'll keep you posted.
> >
> > Thankyou all for all your support, imput and great suggestions,
> >
> > Kathy
Posted by Katz on February 2, 2001, at 18:07:03
In reply to Re:Amisulpride Update #2, posted by AndrewB on February 2, 2001, at 0:08:45
>Andrew, a couple more questions: Where can I purchase the Mirapex overseas w/o prescription? Is it expensive? Is there a generic?
Thanks,
Kathy
Katz,
>
> First of all I would like to suggest that you not get your expectations up too high about any one med. You never know what is going to work. The best avenue to success is patience and willingness to try various med. (combo.s). But chances are, with time, you will find the right med.
>
> Sedation is one the most common sided effects among non-responders to amisulpride. Usually, but not always, it does not go away.
>
> I suggest you try amisulpride at your current dosage for a total of 5 days.
>
> Since we know too high doses of amisulpride cause sedation, if the sedation persists, after five days switch to taking 12.5mg.s of amisulpride at night. Give this trial 5 days. If you are still sedated or unresponsive it is time to try something else.
>
> It is possible that the sedation in this case is caused by supersensitive and very responsive postsynaptic dopamine D2/D3 receptors. The receptors may be so sensitive they are attracting amisulpride, even at low doses to attach to them. When this happens the amisulpride will block these receptors and can cause sedation and tension.
>
> This scenario, if applicable, gives us a clue as to what may work for you. Specifically you may benefit from stimulation of those D2/D3 receptors. Mirapex is very effective at doing this, so I would make it my first choice for a trial if amisulpride doesn’t work.
>
> Mirapex is available in the US or without an Rx abroad.
>
> Please keep us informed on how it is going and try to keep the faith that a med. that will help you is out there.
>
> AndrewB
Posted by JohnL on February 3, 2001, at 5:38:10
In reply to Re:Amisulpride Update #2 » AndrewB, posted by Katz on February 2, 2001, at 18:07:03
Kathy,
I'm sorry to hear you got off to a rough start with your new drugs. I've had that happen so many times, when I had my hopes on a new drug and it turned out lousy. I definitely empathize with you.
I think Andrew offered excellent advice. I would simply add that both of your drugs do take time to do their thing, so try as best you can to hang in there. I once experienced that same tired feeling you described. At the time I was taking 600mg Adrafinil and 100mg Amisulpride. A reduction to 300mg Adrafinil and 33mg Amisulpride worked much better. These drugs are weird in that more is not better. Sometimes less is better. In any case, benefits build up over time.
I felt some benefits in the first week, which then continued to improve slowly but steadily week after week. My situation is not directly comparable to yours though, because I do take a little bit of Prozac in the background because it seems to act kind of like a turbocharger, and I take a little bit of Zyprexa for sleep.
In the future if you need other drugs, www.farmaciacerati.it/drug/html is by far the best source. They have so many drugs...all the SSRIs, all the antipsychotics, all the mood stabilizers, all the dopamine agonists (Mirapex for example). Except for stimulants or benzos, they have just about everything. Cheap, easy, and fast.
In the meantime though I'm cheering for your current meds to work!
Johnps...my favorite psychiatrist's name (now retired) was Dr Katz! :-)
Posted by Katz on February 3, 2001, at 10:41:16
In reply to Re:Amisulpride Update #2 - Katz, posted by JohnL on February 3, 2001, at 5:38:10
Hi John,
Thankyou for your comforting comments. I'm finding myself becomming more discouraged but I do plan to stick it out. I don't have anything else handy to try at the moment anyway. I will have to place an order for the Mirapex (or the Rohip which is probably much cheaper). I must tell you, the Mirapex does not look as good on paper as either the Reboxetine, amisulpride or andrafinil. On top of that, it seems to have a "poop out" effect to it. That is assumming that it actually works in the first place. The idea of the Mirapex does not thrill me! Can messing with all this dopamine stuff actually cause Parkinson's? If bromocriptine causes depression, would mirapex cause depression also. Do they have the same mode of action?
Anyway, these are just a few of the many questions going through my mind right now. I'm trying to remain positive. Your last sentence (Dr. Katz) definitely put a smile on this somewhat disturbed and increasingly depressed face.
Thanks John! Your warm wishes have transcended the page and leaped into my heart.
All the best to you,
Kathy
Kathy,
>
> I'm sorry to hear you got off to a rough start with your new drugs. I've had that happen so many times, when I had my hopes on a new drug and it turned out lousy. I definitely empathize with you.
>
> I think Andrew offered excellent advice. I would simply add that both of your drugs do take time to do their thing, so try as best you can to hang in there. I once experienced that same tired feeling you described. At the time I was taking 600mg Adrafinil and 100mg Amisulpride. A reduction to 300mg Adrafinil and 33mg Amisulpride worked much better. These drugs are weird in that more is not better. Sometimes less is better. In any case, benefits build up over time.
>
> I felt some benefits in the first week, which then continued to improve slowly but steadily week after week. My situation is not directly comparable to yours though, because I do take a little bit of Prozac in the background because it seems to act kind of like a turbocharger, and I take a little bit of Zyprexa for sleep.
>
> In the future if you need other drugs, www.farmaciacerati.it/drug/html is by far the best source. They have so many drugs...all the SSRIs, all the antipsychotics, all the mood stabilizers, all the dopamine agonists (Mirapex for example). Except for stimulants or benzos, they have just about everything. Cheap, easy, and fast.
>
> In the meantime though I'm cheering for your current meds to work!
> John
>
> ps...my favorite psychiatrist's name (now retired) was Dr Katz! :-)
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