![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by dennison on March 28, 2002, at 14:23:38
Hi- Hello fello psychobabbler's!!!!! My pdoc has offerred to change my meds to any psychostimulant ex. ritalin,dexedrine,concerta and adderall-sustained release version of or normal------In combination with any antidepressant ssri,tricyclic etc. "all but an maoi"....... I would appreciate any input, opinions ,experiences anyone has had such as (zoloft+dexedrine) or (desimpramine + ritalin) or (prozac + adderall) !!!! These are just 3 examples obviously, but you get the concept!!!!! :) ....... Not looking for studies here or pubmed abstracts familiar with all those and more,actually more interested in personal experiences or your gut feelings or just your personal recommendations. Taking maoi presently,but it has seen it's better days-- aware of washout period --hmm -that should be fun :(:( ........ I'll add more information, in near future as I perceive relevant matters......... Thank You :):)
Posted by dennison on March 28, 2002, at 14:52:15
In reply to Any psychostimulant and antidepressant combination, posted by dennison on March 28, 2002, at 14:23:38
Back again lol!!! -- <br> <br> In past have taken ritalin and dexedrine small doses, personally found dexedrine superior,effect was more smooth and the balance between central and peripheral effects was more favorable. Ritalin seemed to cause some sedation and lethargy , while dexedrine definitely didn't. Kinda along the line of difference between just having brain stimulated with a dead body versus having brain stimulated with enough bodily energy to actually do something. These were low doses though perhaps 5mg dexedrine versus 10>15mg ritalin. The ritalin also had a rather annoying anxious aspect to it while the dexedrine was definitely calming yet energizing and mood elevating. <br> <br> In past tried effexor as a monotherapy, had slight response for a week then absolutely nothing,but straight downhill and very sedated and sleeping and eating were all that I was good at!!!! No functionality whatsoever. Hmmm How do you get paragraph indentations in this html--They keep disappearing ............ Thank You :):)
Posted by Hawkeye on March 28, 2002, at 15:45:31
In reply to Any psychostimulant and antidepressant combination, posted by dennison on March 28, 2002, at 14:23:38
I Recommend Fudge Layer Cake with a Coca-Cola.
Posted by Ritch on March 28, 2002, at 22:12:14
In reply to Any psychostimulant and antidepressant combination, posted by dennison on March 28, 2002, at 14:23:38
> Hi- Hello fello psychobabbler's!!!!! My pdoc has offerred to change my meds to any psychostimulant ex. ritalin,dexedrine,concerta and adderall-sustained release version of or normal------In combination with any antidepressant ssri,tricyclic etc. "all but an maoi"....... I would appreciate any input, opinions ,experiences anyone has had such as (zoloft+dexedrine) or (desimpramine + ritalin) or (prozac + adderall) !!!! These are just 3 examples obviously, but you get the concept!!!!! :) ....... Not looking for studies here or pubmed abstracts familiar with all those and more,actually more interested in personal experiences or your gut feelings or just your personal recommendations. Taking maoi presently,but it has seen it's better days-- aware of washout period --hmm -that should be fun :(:( ........ I'll add more information, in near future as I perceive relevant matters......... Thank You :):)
Howdy,The only combination I tried was Celexa + Dexedrine. It actually made me too anxious. If I take either one by itself I feel OK. For somebody with treatment resistant depression it might work nicely at higher doses. However, there was a report here about a Luvox, Wellbutrin, Ritalin combo that went total haywire when the Luvox got added. Watch it.
Posted by Bekka H. on March 28, 2002, at 22:30:30
In reply to Re: Any psychostimulant and antidepressant combination » dennison, posted by Ritch on March 28, 2002, at 22:12:14
Hi Ritch,
Can you tell me how long you were on the Celexa plus Dex combination? I had a lot of trouble with that one, too; however, my problem was just the opposite. I got too tired and wimpy from the Celexa. I'm interested to know what doses of the two meds you were taking and for how long.
thanks
Bekka
Posted by Ritch on March 28, 2002, at 23:56:55
In reply to stimulant and antidepressant combination-Ritch, posted by Bekka H. on March 28, 2002, at 22:30:30
> Hi Ritch,
>
> Can you tell me how long you were on the Celexa plus Dex combination? I had a lot of trouble with that one, too; however, my problem was just the opposite. I got too tired and wimpy from the Celexa. I'm interested to know what doses of the two meds you were taking and for how long.
>
> thanks
> BekkaBekka,
This was just the reaction from chronic long-term low-dose Celexa dosing (approx. 2mg day or less) in conjunction with several mood stabilizers. I just added on a little dexedrine and happened to notice that when I was taking both at the same time I got a real anxiety boost. I could feel wired on the Celexa, but "tired" at the same time. Added in the dexedrine and I was just wired! I quit the Celexa last week. I have been seeing how taking low-dose dex with my mood stabilizers and supplements on their own would do (how that would affect my mood cycling, attention, anxiety, etc.). Psychostims-only have tried Adderall and now the dexedrine. It seems that 5mg is a min. dose but I think I could go to 10mg of dexedrine/day without any problems. No panic thus far, no "freezing" like with Wellbutrin and somewhat less with Adderall.
Mitch
Posted by Bekka H. on March 29, 2002, at 0:49:11
In reply to Re: stimulant and antidepressant combination-Ritch » Bekka H., posted by Ritch on March 28, 2002, at 23:56:55
Hi Mitch,
So, you cut the Celexa into eight tiny pieces or does it come in a liquid form? I tried cutting it with a pill cutter, but I usually ended up with crumbs.
You've probably told me this already, but could you remind me what other meds you're on?
The anxiety reaction you described from Celexa plus Dex is similar to the rxn. I got from every other SSRI plus stimulant combo. Celexa + Dex was the only such combo that didn't give me a terrible reaction. I didn't do well on Celexa + Dex, but at least I didn't end up in the ER. I'm convinced I've had mild serotonin syndrome on a number of occasions from the other ssri+stim combos. For me, Celexa + Dex seemed to negate eachtother. Whatever is good about each one individually seems to be counteracted by the other. Celexa and other ssris are supposed to lower dopamine levels, and amphetamines can deplete serotonin and dopamine, so over the long haul, it just doesn't work for me -- unfortunately. Whenever I've been off of Celexa for a long time (at least 4-5 months or so) and then I resume it at very low dose plus Dex, I feel excellent for about 10 days to two weeks, and then I poop out. I've also found that Celexa makes me have to increase the Dex dose just to counteract the Celexa-induced fatigue, etc., so I end up developing tolerance to Dex much faster. Then I end up having to stop Dex for several months just to lose the tolerance. As you can see, this is a most unsatisfactory combination for me, but someone else might do very well on it. I have a tough time on nearly all med combinations.
Bekka
Posted by Ritch on March 30, 2002, at 10:08:59
In reply to Re: stimulant and antidepressant combination-Ritch, posted by Bekka H. on March 29, 2002, at 0:49:11
> Hi Mitch,
>
> So, you cut the Celexa into eight tiny pieces or does it come in a liquid form? I tried cutting it with a pill cutter, but I usually ended up with crumbs.
>
> You've probably told me this already, but could you remind me what other meds you're on?
>
Well, crumbs just about sums up what I take! I use a carpet razor blade to chop pills not pill cutters (they are very thin, large, and flexible-you use both hands). Chopping the 10mg half-tabs into 5mg chunks isn't too tough-it is the 2nd operation which is a little tricky due to the shape of the tabs. There is a Celexa liquid available, but I have a big handful of free samples which will last months. You can also crush the tabs and mix them with a small, carefully measured amount of juice+ethanol (citalopram is freely soluble in ethanol). Pdoc told me how to do that one!Oh, I stopped taking Celexa about 10 days ago. My current meds are:
Neurontin 100mg 3x daily
Depakote 125mg bedtime
Klonopin .5mg bedtime
Dexedrine 2.5-5.0mg early-afternoon..early evening
Supplements: SAMe 200mg AM,FlaxOil 1G midday + vitamins.
> The anxiety reaction you described from Celexa plus Dex is similar to the rxn. I got from every other SSRI plus stimulant combo. Celexa + Dex was the only such combo that didn't give me a terrible reaction. I didn't do well on Celexa + Dex, but at least I didn't end up in the ER. I'm convinced I've had mild serotonin syndrome on a number of occasions from the other ssri+stim combos. For me, Celexa + Dex seemed to negate eachtother. Whatever is good about each one individually seems to be counteracted by the other. Celexa and other ssris are supposed to lower dopamine levels, and amphetamines can deplete serotonin and dopamine, so over the long haul, it just doesn't work for me -- unfortunately. Whenever I've been off of Celexa for a long time (at least 4-5 months or so) and then I resume it at very low dose plus Dex, I feel excellent for about 10 days to two weeks, and then I poop out. I've also found that Celexa makes me have to increase the Dex dose just to counteract the Celexa-induced fatigue, etc., so I end up developing tolerance to Dex much faster. Then I end up having to stop Dex for several months just to lose the tolerance. As you can see, this is a most unsatisfactory combination for me, but someone else might do very well on it. I have a tough time on nearly all med combinations.
>
> Bekka
I tried my small dose of Dex+Celexa just for a few days. All SSRI's make me buzzy and I feel like I just smoked grass. I am tempted to restart the Celexa again, not because I am depressed, I just miss the mild hypomania it caused. Also, the reduction of SP symptoms was kinda nice. It was just like a warm and fuzzy blanket I hauled around with me. But, I don't miss all of the side effects that's for sure! I mood chart very vigorously and I have noticed a trend of improved sleep patterns since I have quit the SSRI. I am still taking a stimulant at the same dosages though, nothing else has changed and my sleep is improving. I know the stuff triggers cycling, but I miss that "buzz".Mitch
Posted by BLPBart on March 30, 2002, at 20:08:20
In reply to Any psychostimulant and antidepressant combination, posted by dennison on March 28, 2002, at 14:23:38
> Hi- Hello fello psychobabbler's!!!!! My pdoc has offerred to change my meds to any psychostimulant ex. ritalin,dexedrine,concerta and adderall-sustained release version of or normal------In combination with any antidepressant ssri,tricyclic etc. "all but an maoi"....... I would appreciate any input, opinions ,experiences anyone has had such as (zoloft+dexedrine) or (desimpramine + ritalin) or (prozac + adderall) !!!! These are just 3 examples obviously, but you get the concept!!!!! :) ....... Not looking for studies here or pubmed abstracts familiar with all those and more,actually more interested in personal experiences or your gut feelings or just your personal recommendations. Taking maoi presently,but it has seen it's better days-- aware of washout period --hmm -that should be fun :(:( ........ I'll add more information, in near future as I perceive relevant matters......... Thank You :):)
I have depression which is being treated with Wellbutrin SR 300 mg/day. I couldn't deal with prozac because it made me so tired I would sleep through entire days and I was already lethargic before I started the prozac. I recently added dexedrine to the mix which helps with recently diagnosed ADD (definitely inattentive or hypo-active like Fachad's description). I titrated from 10 mg/day of the spansules up to 40 which is what I'm on now. I know that combo would send some people through the roof, but I could still take an afternoon nap on it and have no problems sleeping at night.
Posted by Bekka H. on April 1, 2002, at 20:05:44
In reply to Re: stimulant and antidepressant combination-Ritch » Bekka H., posted by Ritch on March 30, 2002, at 10:08:59
> Well, crumbs just about sums up what I take! I use a carpet razor blade to chop pills not pill cutters (they are very thin, large, and flexible-you use both hands).
************************************************
Hi Mitch/Ritch,
A carpet razor??!! YIKES! Be careful with your fingers!!
Bekka
Posted by Ritch on April 1, 2002, at 23:19:57
In reply to Re: stimulant and antidepressant combination-Ritch, posted by Bekka H. on April 1, 2002, at 20:05:44
> > Well, crumbs just about sums up what I take! I use a carpet razor blade to chop pills not pill cutters (they are very thin, large, and flexible-you use both hands).
>
> ************************************************
>
> Hi Mitch/Ritch,
>
> A carpet razor??!! YIKES! Be careful with your fingers!!
>
> BekkaYes, you need to hold it by the *sides*. I have had to use all sorts of knives/hammers/chisels when I did commercial construction finish work. I probably shouldn't have mentioned that. I cut myself up several times pretty bad by accident until I got used to how to handle it properly in an intuitive manner. Smash your thumb with a hammer that's worse, I think. I have thought about *inventing* a pill cutter that uses very fine, but sharp *wires*. Maybe I could sneak around at work and come up with it.
Mitch
Posted by Bekka H. on April 2, 2002, at 0:09:34
In reply to Re: stimulant and antidepressant combination-Ritch » Bekka H., posted by Ritch on April 1, 2002, at 23:19:57
I have thought about *inventing* a pill cutter that uses very fine, but sharp *wires*. Maybe I could sneak around at work and come up with it.
>
> Mitch
************************************************That sounds like a great idea! Well, one thing is clear. . . these meds have NOT stifled your resourcefulness and creativity.
Bekka
Posted by Ritch on April 2, 2002, at 8:59:39
In reply to Re: stimulant and antidepressant combination-Ritch, posted by Bekka H. on April 2, 2002, at 0:09:34
> I have thought about *inventing* a pill cutter that uses very fine, but sharp *wires*. Maybe I could sneak around at work and come up with it.
> >
> > Mitch
> ************************************************
>
> That sounds like a great idea! Well, one thing is clear. . . these meds have NOT stifled your resourcefulness and creativity.
>
> Bekka
Well... that is primarily because I am between seasonal major depressions right now. I even checked my DSM code from my pdoc and it has changed again! It probably is because of the various meds that I get prescribed-who knows? Anyhow, now I am just a major depressive disorder, recurrent, moderate. Go figure. Before it was social phobia, ADD, before that was bipolarII, then bipolar-NOS,. Maybe it is some sneaky form of therapy? i.e.-it's just a label, we are treating symptoms..don't let labels or statements by others completley change your thinking..? I am not even going to ask! Try this med feel like crap-don't take it-try this one-feel better, take that one. Whatever.Mitch
Posted by JohnX2 on April 2, 2002, at 9:15:32
In reply to Re: stimulant and antidepressant combination-Ritch » Bekka H., posted by Ritch on April 2, 2002, at 8:59:39
> > I have thought about *inventing* a pill cutter that uses very fine, but sharp *wires*. Maybe I could sneak around at work and come up with it.
> > >
> > > Mitch
> > ************************************************
> >
> > That sounds like a great idea! Well, one thing is clear. . . these meds have NOT stifled your resourcefulness and creativity.
> >
> > Bekka
>
>
> Well... that is primarily because I am between seasonal major depressions right now. I even checked my DSM code from my pdoc and it has changed again! It probably is because of the various meds that I get prescribed-who knows? Anyhow, now I am just a major depressive disorder, recurrent, moderate. Go figure. Before it was social phobia, ADD, before that was bipolarII, then bipolar-NOS,. Maybe it is some sneaky form of therapy? i.e.-it's just a label, we are treating symptoms..don't let labels or statements by others completley change your thinking..? I am not even going to ask! Try this med feel like crap-don't take it-try this one-feel better, take that one. Whatever.
>
> MitchHi Mitch,
What is bipolar-NOS?
Have you ever had clear cut non med induced euphoric like manic episodes (feelings of utopia, grandiouse ideas, mega-self esteem, insane business plans/ideas, pressured speech, spending sprees, bad investments) ?
John
Posted by Ritch on April 2, 2002, at 21:41:22
In reply to Re: bipolar NOS? » Ritch, posted by JohnX2 on April 2, 2002, at 9:15:32
>
> Hi Mitch,
>
> What is bipolar-NOS?
>
> Have you ever had clear cut non med induced euphoric like manic episodes (feelings of utopia, grandiouse ideas, mega-self esteem, insane business plans/ideas, pressured speech, spending sprees, bad investments) ?
>
> JohnHi John,
"NOS" Not otherwise specified. A neuro called me an "atypical" bipolar. He also thought I was having frontal lobe seizures based on my response to SSRI's and my family history of nocturnal epilepsy (and some type of temporal lobe probs, too). I also have a couple of "flat spots" on my EEG "map" that got done-that were considered possible head injuries. The bottomline is that all the pdocs I have seen over the last several years have been wondering some about the dx I got pinned with in 1978. The only thing that really stands out like a sore thumb is the seasonal recurrent depressions I have had consistently as far back as I can remember(even as a kid). I burn about 25% of the year being clinically depressed, and about another 25% being dysthymic (the grey areas on either "side" of my depressions). They are predictable down to a week or two give or take year after year after year. Thus far the only thing that has clearly "worked" to knock them out is a psychostimulant. *I* still consider my dx to include bipolarII amongst others things, but if "296.2" is what my pdoc thinks it is-then that is it I guess. Yes, I do get med-induced hypomania-no doubt about it. But, I have had one comment by one pdoc in about five years like "I see you are a little hypo today". SSRI's(*any* dose-*any* SSRI) and high-dose TCA set off the hypomanias the worst. SSRi's setoff what I call "laugh attacks". I took just 25mg of Luvox one time and after a few hours I was thinking of something funny and couldn't stop laughing-all my facial muscles "froze up" and I turned bright red, and then my heart started racing and I felt like I was having a panic attack. I quit my Celexa about two weeks ago and my mood flattened out considerably. But, I felt humorless, I wanted to get *high*. So, I took a couple of milligrams Sunday and BANG! back to my "old" silly self again. It shortened my sleep by two hours that night, one hour last night, and I can still feel the Celexa right now. I am going to wait 7 days exactly before I take any more (and chart everything closely), and then I am going to cut it down to about 1.25 mg (once a week?). The stuff acts almost like pot to me, I swear! I used to smoke grass as a teen and that is when the hypomanias started. I know some docs consider med-induced hypomania indicative of bipolar and that's OK. It's just a label. Probably, if you pull me off all antidepressants I wouldn't get hypomania. Interestingly, pstims don't trigger cycling. When I tried Adderall+Neurontin before and stopped all AD's my cycling dissapeared. Interestingly, there is a form of epilepsy called gelastic epilepsy that can involve conscious spells of laughter, and they treat it with .. dexedrine.
Mitch
Posted by Ritch on April 3, 2002, at 0:45:51
In reply to Re: bipolar NOS? » JohnX2, posted by Ritch on April 2, 2002, at 21:41:22
John,
I just casually mentioned the gelastic epilepsy thing and the dexedrine. I saw something somewhere in my memory that made me think of it. But I just did some searching about and drug up a lot of creepy crap that sounds a lot like some of my symptoms. Most especially, some of the things relating to autonomic instability (blood pressure, basal temperature, heartrate, and GI symptoms) and the "flushing" and laughing response to Luvox. When the neuro I saw once mentioned something about frontal lobe problems-it was related to some gastrointestinal problems I was having with Prozac at the time. It felt like my esophagus (just below my ribcage) was "pushing out"-like I had a rod shoved through there to my spine-like my guts were all going to fly out if I didn't hold them in. I was also having some nightime "sub-hallucinations" on the Prozac. Here is some of the links I found that are freaking me out (what do you think?):
http://mentalhealth.com/fr30.html
http://www.epub.org.br/cm/n13/mente/laughter/page5.html
http://www.john-libbey-eurotext.fr/articles/epd/1/4/221-8/
http://www.geocities.com/hhugs2001/infoabouthh.htm
http://www.epilepsy.org/ctf/gelastic.html
http://murdoch.rch.unimelb.edu.au/pages/clinical/neurosciences/projects.html
http://archinte.ama-assn.org/issues/v159n17/ffull/ilt0999-5.html
Posted by JohnX2 on April 4, 2002, at 16:58:26
In reply to This is starting to scare me.., posted by Ritch on April 3, 2002, at 0:45:51
Mitch,I don't know what to say.
I came across the concept of pathological laughing and crying in the context of the "pseudobulbar affect" in ALS and MS.
Supposedly this is also related to some interactions in the frontal lobe, although I don't know all the nitty gritty details.I did find one medicine that was in clinical trials to treat this phenomina, but I don't know if it would help "gelastic epilepsy". This is a new one for me.
The medicine i was looking at was Neurodex. (Maybe you've seen some posts I've made on it).
http://www.avanir.com/product/product.php?ID=3
I read through some of your links swiftly, where did you find information that dexedrine helps with "gelastic epilepsy" (or was this just your own observation). ?
PS, I once did an EEG and it turned up nada.
I wonder if Lamictal would help you (given its activity at the nmda receptor)? (SWAG)
John
> John,
>
> I just casually mentioned the gelastic epilepsy thing and the dexedrine. I saw something somewhere in my memory that made me think of it. But I just did some searching about and drug up a lot of creepy crap that sounds a lot like some of my symptoms. Most especially, some of the things relating to autonomic instability (blood pressure, basal temperature, heartrate, and GI symptoms) and the "flushing" and laughing response to Luvox. When the neuro I saw once mentioned something about frontal lobe problems-it was related to some gastrointestinal problems I was having with Prozac at the time. It felt like my esophagus (just below my ribcage) was "pushing out"-like I had a rod shoved through there to my spine-like my guts were all going to fly out if I didn't hold them in. I was also having some nightime "sub-hallucinations" on the Prozac. Here is some of the links I found that are freaking me out (what do you think?):
>
> http://mentalhealth.com/fr30.html
> http://www.epub.org.br/cm/n13/mente/laughter/page5.html
> http://www.john-libbey-eurotext.fr/articles/epd/1/4/221-8/
> http://www.geocities.com/hhugs2001/infoabouthh.htm
> http://www.epilepsy.org/ctf/gelastic.html
> http://murdoch.rch.unimelb.edu.au/pages/clinical/neurosciences/projects.html
> http://archinte.ama-assn.org/issues/v159n17/ffull/ilt0999-5.html
Posted by JohnX2 on April 4, 2002, at 17:16:20
In reply to Re: This is starting to scare me.. » Ritch, posted by JohnX2 on April 4, 2002, at 16:58:26
This is somewhat amusing:John
>
> Mitch,
>
> I don't know what to say.
>
> I came across the concept of pathological laughing and crying in the context of the "pseudobulbar affect" in ALS and MS.
> Supposedly this is also related to some interactions in the frontal lobe, although I don't know all the nitty gritty details.
>
> I did find one medicine that was in clinical trials to treat this phenomina, but I don't know if it would help "gelastic epilepsy". This is a new one for me.
>
> The medicine i was looking at was Neurodex. (Maybe you've seen some posts I've made on it).
>
> http://www.avanir.com/product/product.php?ID=3
>
> I read through some of your links swiftly, where did you find information that dexedrine helps with "gelastic epilepsy" (or was this just your own observation). ?
>
> PS, I once did an EEG and it turned up nada.
>
> I wonder if Lamictal would help you (given its activity at the nmda receptor)? (SWAG)
>
> John
>
>
> > John,
> >
> > I just casually mentioned the gelastic epilepsy thing and the dexedrine. I saw something somewhere in my memory that made me think of it. But I just did some searching about and drug up a lot of creepy crap that sounds a lot like some of my symptoms. Most especially, some of the things relating to autonomic instability (blood pressure, basal temperature, heartrate, and GI symptoms) and the "flushing" and laughing response to Luvox. When the neuro I saw once mentioned something about frontal lobe problems-it was related to some gastrointestinal problems I was having with Prozac at the time. It felt like my esophagus (just below my ribcage) was "pushing out"-like I had a rod shoved through there to my spine-like my guts were all going to fly out if I didn't hold them in. I was also having some nightime "sub-hallucinations" on the Prozac. Here is some of the links I found that are freaking me out (what do you think?):
> >
> > http://mentalhealth.com/fr30.html
> > http://www.epub.org.br/cm/n13/mente/laughter/page5.html
> > http://www.john-libbey-eurotext.fr/articles/epd/1/4/221-8/
> > http://www.geocities.com/hhugs2001/infoabouthh.htm
> > http://www.epilepsy.org/ctf/gelastic.html
> > http://murdoch.rch.unimelb.edu.au/pages/clinical/neurosciences/projects.html
> > http://archinte.ama-assn.org/issues/v159n17/ffull/ilt0999-5.html
Posted by Zo on April 5, 2002, at 0:13:12
In reply to Re: This is starting to scare me.., posted by JohnX2 on April 4, 2002, at 17:16:20
Is this possible? Do they still sell that stuff in cough syrup?
Zo
Posted by Ritch on April 5, 2002, at 0:17:45
In reply to Re: This is starting to scare me.., posted by JohnX2 on April 4, 2002, at 17:16:20
> > I came across the concept of pathological laughing and crying in the context of the "pseudobulbar affect" in ALS and MS.
> > Supposedly this is also related to some interactions in the frontal lobe, although I don't know all the nitty gritty details.
Gee thanks John, for replying. I *really* don't think (and hope not) that I am an ALS or MS candidate. Although I *do* wonder about the Parkinson's stuff some. When I dug up all of those links it was rather hurried and the one about the hypothalamic tumors was neato because it got into the endocrine system and all of its hormones. It plays into my seasonal depressions big time. I never get the laugh..until ya..cry type *episodes* without medication help for the most part. I am just wondering: Why is it that teensy-tinsy doses of SSRI's have such a powerful effect and turn me into a total gigglebox standup comedian (depending on what time of year it is-neuroendocrine setting?), and then when I stop them I am all fatigued and humourless? Well.. that "sense of humor" link gave me a good clue. It says that our sense of humor is in the right frontal lobe. I conclude that SSRI's are triggering something in my right hemisphere somehow (or "switching" control or dominance of the left hemisphere to the right). Maybe that is why they are so effective for OCD-because they tend to diminish ruminative thinking (from the left). One interesting thing as well is the rap about frontal versus temporal lobe involvement in "pathological" laughter. Frontal lobe involvement tends to be mechanical, whereas temporal (right temporal) lobe involvement tends to contain mirth or an uncontrollable sense of funniness. Well, that is what happens with me. And..most hypomanic symptoms (elation) tends to arise from that area. In the link from France they found that the gelastic epileptiform activity of that teen was abolished with sodium valproate. Hmmm..
> >
> > I did find one medicine that was in clinical trials to treat this phenomina, but I don't know if it would help "gelastic epilepsy". This is a new one for me.
> >
> > The medicine i was looking at was Neurodex. (Maybe you've seen some posts I've made on it).
> >
> > http://www.avanir.com/product/product.php?ID=3
> >
> > I read through some of your links swiftly, where did you find information that dexedrine helps with "gelastic epilepsy" (or was this just your own observation). ?
> >
> > PS, I once did an EEG and it turned up nada.
> >
> > I wonder if Lamictal would help you (given its activity at the nmda receptor)? (SWAG)
> >
> > John
> >
> >
Thanks for the dextromethorphan links. That is very interesting. I used to have a chronic cough working in this factory a long time ago and took DXM tabs every so often-I don't remember anything *unpleasant* from taking them. I may retry that-my pharmacist is already starting to question me a bit lately-despite their pill-raking frenzied distraction.Lamictal... Well, I think it would be a great compliment to Neurontin and Klonopin (without the Depakote). I have to say that the last few days one of my coworkers has been starting to pick loose hairs off my shirt. I asked her what it was-and she said "Oh, just a hair". Well, here comes the Selenium and Zinc it looks like, or just run out of Depakote... and try some DXM? The only thing that doesn't keep me from bringing that one (Lamictal) up is the skin trips. I get an itchy reaction from about 1 out of 4 or 5 meds that I take. Plus I take allergy shots already for molds/dust, and see an immunologist every six months.
Dexedrine: There is an Ontario Epilepsy.org thing that mentioned that (I just remembered it at last!), also, the mentalhealth.com link didn't take you to the (old) dexedrine monograph on that site. If you click on the medications...dexedrine link you will see the indications include Parkinsonism, Epilepsy, and the ADHD stuff (minimal brain dysfunction I think). SSRi's make me laugh, Dexedrine and other pstims (Adderall), make me focused, serious, and relatively humorless. I think the dexedrine *turns on* the *left* frontal lobe and facilitates language processing. I notice when I go in a grocery store in the afternoon after I take a 2.5mg dose (and SAMe seems to do this some, too), my eyes are "clicking" or "snapping" across all of the *lexical* information (the letters, words, etc.) of the products on the shelves which are the topics of my attention. Otherwise, (taking an SSRI, i.e., with no stimulant), I walk in there and see a big panoramic rectangle of mosaic(ed) colors like a Joan Mirro thingie, and I have a hell of a time picking *anything* out of it. I have to hold a couple of fingers out in front of me and force my eyes to track the names that go flitting by as I move my fingers horizontally and scan the shelves to find someting -whew what a hassle!
ALso: I have noticed that my left hand tremor (that normally occurs when I take Depakote) has dissapeared now that I am taking dexedrine, SAMe, and flaxoil stuff.Nada on EEG's isn't exactly the last word. I thought the neuro I was seeing was filling me full of bull. But, he was doing this experimental BEAM mapping stuff (of which I had no clue about at the time). He was pushing me to do an ambulatory 24-hr EEG, and then an MRI. I never got to those, because I didn't want to PAY all of the difference he was charging me that the insurance wouldn't cover. I thought-well I am not falling asleep at the wheel and running into telephone poles, I have taken several anticonvulsants already and didn't get *miraculous* improvements on them, my Mom took a max dose of Dilantin for a couple of decades and lost all of her teeth and she still has OCD traits and just takes a sinus tablet now and then and seems to be fine----why get started on a bunch of meds when it likely won't make any difference anyways??? Well, I am on a combo of AED's now, and it *does* make a difference, so I guess I was full of crap.
Mitch
Posted by JohnX2 on April 5, 2002, at 0:45:55
In reply to Re: This is starting to scare me..sometimes :-) » JohnX2, posted by Ritch on April 5, 2002, at 0:17:45
Hey Mitch,
Your SSRI med response is a bit strange I will concur. I guess I have laughed so hard I felt pain in my gut, etc, it must be really annoying?
Be *very careful* about dxm and drug interactions.
Any medicine that inhibits cyp-2d6 will spike dxm in your body. This may include nortriptyline. At high doses dxm is toxic. The nmda receptor stimulates Gaba receptors in some parts of the brain, and so hypostimulation of nmda by antagonists causes less stimulation of Gaba neurons (and downstream toxicity of neurons that the Gaba protects). From this you can get something called an "Olney's Lesion".The rest looks quite interesting. Thanks for clarifying the temporal/frontal lobe differences.
BTW, that patent on emotional lability listed amantadine (another nmda antagonist and dopamine agonist) and L-dopa as treatments for ALS like induced lability.
Lately I have had some bouts of uncontrollable laughter reading mud-slinging, cantankerous, pbabble threads.
John
>
> > > I came across the concept of pathological laughing and crying in the context of the "pseudobulbar affect" in ALS and MS.
> > > Supposedly this is also related to some interactions in the frontal lobe, although I don't know all the nitty gritty details.
>
>
> Gee thanks John, for replying. I *really* don't think (and hope not) that I am an ALS or MS candidate. Although I *do* wonder about the Parkinson's stuff some. When I dug up all of those links it was rather hurried and the one about the hypothalamic tumors was neato because it got into the endocrine system and all of its hormones. It plays into my seasonal depressions big time. I never get the laugh..until ya..cry type *episodes* without medication help for the most part. I am just wondering: Why is it that teensy-tinsy doses of SSRI's have such a powerful effect and turn me into a total gigglebox standup comedian (depending on what time of year it is-neuroendocrine setting?), and then when I stop them I am all fatigued and humourless? Well.. that "sense of humor" link gave me a good clue. It says that our sense of humor is in the right frontal lobe. I conclude that SSRI's are triggering something in my right hemisphere somehow (or "switching" control or dominance of the left hemisphere to the right). Maybe that is why they are so effective for OCD-because they tend to diminish ruminative thinking (from the left). One interesting thing as well is the rap about frontal versus temporal lobe involvement in "pathological" laughter. Frontal lobe involvement tends to be mechanical, whereas temporal (right temporal) lobe involvement tends to contain mirth or an uncontrollable sense of funniness. Well, that is what happens with me. And..most hypomanic symptoms (elation) tends to arise from that area. In the link from France they found that the gelastic epileptiform activity of that teen was abolished with sodium valproate. Hmmm..
>
>
> > >
> > > I did find one medicine that was in clinical trials to treat this phenomina, but I don't know if it would help "gelastic epilepsy". This is a new one for me.
> > >
> > > The medicine i was looking at was Neurodex. (Maybe you've seen some posts I've made on it).
> > >
> > > http://www.avanir.com/product/product.php?ID=3
> > >
> > > I read through some of your links swiftly, where did you find information that dexedrine helps with "gelastic epilepsy" (or was this just your own observation). ?
> > >
> > > PS, I once did an EEG and it turned up nada.
> > >
> > > I wonder if Lamictal would help you (given its activity at the nmda receptor)? (SWAG)
> > >
> > > John
> > >
> > >
>
>
> Thanks for the dextromethorphan links. That is very interesting. I used to have a chronic cough working in this factory a long time ago and took DXM tabs every so often-I don't remember anything *unpleasant* from taking them. I may retry that-my pharmacist is already starting to question me a bit lately-despite their pill-raking frenzied distraction.
>
> Lamictal... Well, I think it would be a great compliment to Neurontin and Klonopin (without the Depakote). I have to say that the last few days one of my coworkers has been starting to pick loose hairs off my shirt. I asked her what it was-and she said "Oh, just a hair". Well, here comes the Selenium and Zinc it looks like, or just run out of Depakote... and try some DXM? The only thing that doesn't keep me from bringing that one (Lamictal) up is the skin trips. I get an itchy reaction from about 1 out of 4 or 5 meds that I take. Plus I take allergy shots already for molds/dust, and see an immunologist every six months.
>
> Dexedrine: There is an Ontario Epilepsy.org thing that mentioned that (I just remembered it at last!), also, the mentalhealth.com link didn't take you to the (old) dexedrine monograph on that site. If you click on the medications...dexedrine link you will see the indications include Parkinsonism, Epilepsy, and the ADHD stuff (minimal brain dysfunction I think). SSRi's make me laugh, Dexedrine and other pstims (Adderall), make me focused, serious, and relatively humorless. I think the dexedrine *turns on* the *left* frontal lobe and facilitates language processing. I notice when I go in a grocery store in the afternoon after I take a 2.5mg dose (and SAMe seems to do this some, too), my eyes are "clicking" or "snapping" across all of the *lexical* information (the letters, words, etc.) of the products on the shelves which are the topics of my attention. Otherwise, (taking an SSRI, i.e., with no stimulant), I walk in there and see a big panoramic rectangle of mosaic(ed) colors like a Joan Mirro thingie, and I have a hell of a time picking *anything* out of it. I have to hold a couple of fingers out in front of me and force my eyes to track the names that go flitting by as I move my fingers horizontally and scan the shelves to find someting -whew what a hassle!
> ALso: I have noticed that my left hand tremor (that normally occurs when I take Depakote) has dissapeared now that I am taking dexedrine, SAMe, and flaxoil stuff.
>
> Nada on EEG's isn't exactly the last word. I thought the neuro I was seeing was filling me full of bull. But, he was doing this experimental BEAM mapping stuff (of which I had no clue about at the time). He was pushing me to do an ambulatory 24-hr EEG, and then an MRI. I never got to those, because I didn't want to PAY all of the difference he was charging me that the insurance wouldn't cover. I thought-well I am not falling asleep at the wheel and running into telephone poles, I have taken several anticonvulsants already and didn't get *miraculous* improvements on them, my Mom took a max dose of Dilantin for a couple of decades and lost all of her teeth and she still has OCD traits and just takes a sinus tablet now and then and seems to be fine----why get started on a bunch of meds when it likely won't make any difference anyways??? Well, I am on a combo of AED's now, and it *does* make a difference, so I guess I was full of crap.
>
> Mitch
Posted by JohnX2 on April 5, 2002, at 1:00:29
In reply to Re: This is starting to scare me..sometimes :-) » Ritch, posted by JohnX2 on April 5, 2002, at 0:45:55
Mitch,From that patent:
"The best previously known therapies for treating emotional lability involve the drugs amitriptyline, amantadine, and levodopa. Although reports such as Udaka et al 1984 and Schiffer et al 1985 (complete citations are provided below, before the claims) indicate that these compounds may be effective in helping reduce pathological displays of emotion in some patients, they make it clear that none of these prior art drugs are effective in all patients, and even in patients who receive some benefit, the effect usually stops far short of an effective cure. A common practice for many clinical neurologists is to prescribe amitriptyline and amantadine, one at a time, in the hope that one of them might be able to provide any level of improvement in the patient's condition. However, all both fall short of offering an effective cure. In addition, levodopa is not satisfactory, since it has other effects and is a relatively powerful drug. "
I wonder what is so special about amitriptyline, amantadine, and levodopa in emotional lability?
What's the connection between those meds, hmmm? This patent filing was backdated to 1992. Would an amitriptyline response be similar to a nortriptyline response (one of your fav. meds)?John
>
> Hey Mitch,
>
>
> Your SSRI med response is a bit strange I will concur. I guess I have laughed so hard I felt pain in my gut, etc, it must be really annoying?
>
>
> Be *very careful* about dxm and drug interactions.
> Any medicine that inhibits cyp-2d6 will spike dxm in your body. This may include nortriptyline. At high doses dxm is toxic. The nmda receptor stimulates Gaba receptors in some parts of the brain, and so hypostimulation of nmda by antagonists causes less stimulation of Gaba neurons (and downstream toxicity of neurons that the Gaba protects). From this you can get something called an "Olney's Lesion".
>
> The rest looks quite interesting. Thanks for clarifying the temporal/frontal lobe differences.
>
> BTW, that patent on emotional lability listed amantadine (another nmda antagonist and dopamine agonist) and L-dopa as treatments for ALS like induced lability.
>
> Lately I have had some bouts of uncontrollable laughter reading mud-slinging, cantankerous, pbabble threads.
>
> John
>
>
> >
> > > > I came across the concept of pathological laughing and crying in the context of the "pseudobulbar affect" in ALS and MS.
> > > > Supposedly this is also related to some interactions in the frontal lobe, although I don't know all the nitty gritty details.
> >
> >
> > Gee thanks John, for replying. I *really* don't think (and hope not) that I am an ALS or MS candidate. Although I *do* wonder about the Parkinson's stuff some. When I dug up all of those links it was rather hurried and the one about the hypothalamic tumors was neato because it got into the endocrine system and all of its hormones. It plays into my seasonal depressions big time. I never get the laugh..until ya..cry type *episodes* without medication help for the most part. I am just wondering: Why is it that teensy-tinsy doses of SSRI's have such a powerful effect and turn me into a total gigglebox standup comedian (depending on what time of year it is-neuroendocrine setting?), and then when I stop them I am all fatigued and humourless? Well.. that "sense of humor" link gave me a good clue. It says that our sense of humor is in the right frontal lobe. I conclude that SSRI's are triggering something in my right hemisphere somehow (or "switching" control or dominance of the left hemisphere to the right). Maybe that is why they are so effective for OCD-because they tend to diminish ruminative thinking (from the left). One interesting thing as well is the rap about frontal versus temporal lobe involvement in "pathological" laughter. Frontal lobe involvement tends to be mechanical, whereas temporal (right temporal) lobe involvement tends to contain mirth or an uncontrollable sense of funniness. Well, that is what happens with me. And..most hypomanic symptoms (elation) tends to arise from that area. In the link from France they found that the gelastic epileptiform activity of that teen was abolished with sodium valproate. Hmmm..
> >
> >
> > > >
> > > > I did find one medicine that was in clinical trials to treat this phenomina, but I don't know if it would help "gelastic epilepsy". This is a new one for me.
> > > >
> > > > The medicine i was looking at was Neurodex. (Maybe you've seen some posts I've made on it).
> > > >
> > > > http://www.avanir.com/product/product.php?ID=3
> > > >
> > > > I read through some of your links swiftly, where did you find information that dexedrine helps with "gelastic epilepsy" (or was this just your own observation). ?
> > > >
> > > > PS, I once did an EEG and it turned up nada.
> > > >
> > > > I wonder if Lamictal would help you (given its activity at the nmda receptor)? (SWAG)
> > > >
> > > > John
> > > >
> > > >
> >
> >
> > Thanks for the dextromethorphan links. That is very interesting. I used to have a chronic cough working in this factory a long time ago and took DXM tabs every so often-I don't remember anything *unpleasant* from taking them. I may retry that-my pharmacist is already starting to question me a bit lately-despite their pill-raking frenzied distraction.
> >
> > Lamictal... Well, I think it would be a great compliment to Neurontin and Klonopin (without the Depakote). I have to say that the last few days one of my coworkers has been starting to pick loose hairs off my shirt. I asked her what it was-and she said "Oh, just a hair". Well, here comes the Selenium and Zinc it looks like, or just run out of Depakote... and try some DXM? The only thing that doesn't keep me from bringing that one (Lamictal) up is the skin trips. I get an itchy reaction from about 1 out of 4 or 5 meds that I take. Plus I take allergy shots already for molds/dust, and see an immunologist every six months.
> >
> > Dexedrine: There is an Ontario Epilepsy.org thing that mentioned that (I just remembered it at last!), also, the mentalhealth.com link didn't take you to the (old) dexedrine monograph on that site. If you click on the medications...dexedrine link you will see the indications include Parkinsonism, Epilepsy, and the ADHD stuff (minimal brain dysfunction I think). SSRi's make me laugh, Dexedrine and other pstims (Adderall), make me focused, serious, and relatively humorless. I think the dexedrine *turns on* the *left* frontal lobe and facilitates language processing. I notice when I go in a grocery store in the afternoon after I take a 2.5mg dose (and SAMe seems to do this some, too), my eyes are "clicking" or "snapping" across all of the *lexical* information (the letters, words, etc.) of the products on the shelves which are the topics of my attention. Otherwise, (taking an SSRI, i.e., with no stimulant), I walk in there and see a big panoramic rectangle of mosaic(ed) colors like a Joan Mirro thingie, and I have a hell of a time picking *anything* out of it. I have to hold a couple of fingers out in front of me and force my eyes to track the names that go flitting by as I move my fingers horizontally and scan the shelves to find someting -whew what a hassle!
> > ALso: I have noticed that my left hand tremor (that normally occurs when I take Depakote) has dissapeared now that I am taking dexedrine, SAMe, and flaxoil stuff.
> >
> > Nada on EEG's isn't exactly the last word. I thought the neuro I was seeing was filling me full of bull. But, he was doing this experimental BEAM mapping stuff (of which I had no clue about at the time). He was pushing me to do an ambulatory 24-hr EEG, and then an MRI. I never got to those, because I didn't want to PAY all of the difference he was charging me that the insurance wouldn't cover. I thought-well I am not falling asleep at the wheel and running into telephone poles, I have taken several anticonvulsants already and didn't get *miraculous* improvements on them, my Mom took a max dose of Dilantin for a couple of decades and lost all of her teeth and she still has OCD traits and just takes a sinus tablet now and then and seems to be fine----why get started on a bunch of meds when it likely won't make any difference anyways??? Well, I am on a combo of AED's now, and it *does* make a difference, so I guess I was full of crap.
> >
> > Mitch
Posted by Zo on April 5, 2002, at 4:42:19
In reply to Re: This is starting to scare me..sometimes :-), posted by JohnX2 on April 5, 2002, at 1:00:29
I hardly dare enter a word into this thread. . .if you guys are so goddamn brain damaged, tell me, how in hell do you *follow* each other! I ain't buyin' it!
But here's my little input, however tiny and irrelevant it may prove to be: Amantadine is used by my pdoc as a fairly mild dopaminergic agent.
He tried to palm it off on me when Wellbutrin went belly-up (allergic) but I wasn't having any of it, I needed the hard stuff. Began snorting Dex. And those capsules *hurt* in your nose.
Zo
Posted by Ritch on April 5, 2002, at 9:08:21
In reply to Re: This is starting to scare me..sometimes :-), posted by JohnX2 on April 5, 2002, at 1:00:29
>
> Mitch,
>
> From that patent:
>
> "The best previously known therapies for treating emotional lability involve the drugs amitriptyline, amantadine, and levodopa. Although reports such as Udaka et al 1984 and Schiffer et al 1985 (complete citations are provided below, before the claims) indicate that these compounds may be effective in helping reduce pathological displays of emotion in some patients, they make it clear that none of these prior art drugs are effective in all patients, and even in patients who receive some benefit, the effect usually stops far short of an effective cure. A common practice for many clinical neurologists is to prescribe amitriptyline and amantadine, one at a time, in the hope that one of them might be able to provide any level of improvement in the patient's condition. However, all both fall short of offering an effective cure. In addition, levodopa is not satisfactory, since it has other effects and is a relatively powerful drug. "
>
>
> I wonder what is so special about amitriptyline, amantadine, and levodopa in emotional lability?
> What's the connection between those meds, hmmm? This patent filing was backdated to 1992. Would an amitriptyline response be similar to a nortriptyline response (one of your fav. meds)?
>
> John
John,My guess is that they are all facilitating dopaminergic function via different mechanisms. Amantadine is a DA receptor agonist (I think), and levodopa does its part (I can't remember how), BUT amitripytline has a strong anticholinergic effect and anticholinergics indirectly boost dopaminergic function. The nortripytline doesn't seem to do that much good (at the doses I can tolerate-max 25mg/day) unless I throw in a "pinch" of an SSRI with it. What the nortrip. *does* do very well (with that tiny bit of SSRI) is improve ADHD symptoms a lot. My exotropia also goes away and my eyes "snap" together and stay together so I can read without one or the other wandering off all the time. Hmmm. That is interesting. Adderall did that too, but the plain dexedrine doesn't help as much (for exotropia) unless I up the dose to 5mg. The Adderall had a pronounced anticholinergic effect whereas the dexedrine doesn't seem to have any. Odd.
Mitch
This is the end of the thread.
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