![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by craig getty on July 7, 2004, at 12:31:59
I was curious which meds people have had success with for raising their motivation. I'm currenly on Wellbutrin SR, but need to add something that will help me get excited about things and follow through with projects.
I've tried Provigil, and although it keeps me awake, it doesn't give me motivation and actually makes me irritable.What has worked for you?
Posted by crazychickuk on July 7, 2004, at 17:33:37
In reply to Best Med for Motivation, posted by craig getty on July 7, 2004, at 12:31:59
any stimulant really, effexor? reboxatine? fluanxol? erm ritalin? you could try Provigil again? and add a benzo with it?
Posted by 1980Monroe on July 7, 2004, at 22:28:55
In reply to Re: Best Med for Motivation, posted by crazychickuk on July 7, 2004, at 17:33:37
obeserve the following very very closely:
A-D-D-E-R-A-L-L
It is the most absolute best med for getting you enthusiastic, wellbutrin, i take it also, i doenst even reach a 2 on a scale of 10 compared to Adderall.I'm soo glad you asked that question, two years ago i started noticing how motivated i was in doing projects, and general activies, it makes you very enthusatic and optimistic. You will know what im talking about, ask your doctor about it.
Posted by yoyoma on July 7, 2004, at 22:34:29
In reply to Re: Best Med for Motivation, posted by 1980Monroe on July 7, 2004, at 22:28:55
I am sure Adderal is great in motivating oneself in the short-term, but it is the opposite of being a cure in that the longer you take it, the more dependent you are on it for motivation. Once you stop taking it or take a break from it, you revert completely back to one's old self. Furthermore, the intense stimulant properties of Adderal probably cause brain damage in the long run.
Posted by 1980Monroe on July 7, 2004, at 22:52:14
In reply to long-term side-effects of Adderal?, posted by yoyoma on July 7, 2004, at 22:34:29
I've actually been on adderall for 4 years for add.
You are, i guess right, about the motivation part.
When i was in high school i really started to depend on it for motivation, and my grades dropped becuase i started to lose motivation.My main question is can i take short breaks from it, say like months at a time. And restart back to keep from depending on it excessivly. I'm pretty experienced with it, so but i may need to do that type of system. I can handle being my chaotic self for a while, but I get on my own nerves with my frivoulous mistakes i do from not paying attention, and i do some really intense stupid mistakes!
Matt
Posted by KaraS on July 7, 2004, at 23:24:22
In reply to Re: Best Med for Motivation, posted by 1980Monroe on July 7, 2004, at 22:28:55
You are too funny!! Seeing as motivation and energy are what I lack most, you make me want to get my hands on this stuff as soon as possible. What do you do to prevent tolerance or are you one of the lucky ones who don't have that problem?
Posted by craig getty on July 8, 2004, at 1:27:40
In reply to Re: Best Med for Motivation, posted by 1980Monroe on July 7, 2004, at 22:28:55
Thanks. Is it Adderall or Adderall XR that you take? And what dosage?
-CG
> obeserve the following very very closely:
>
>
> A-D-D-E-R-A-L-L
>
>
> It is the most absolute best med for getting you enthusiastic, wellbutrin, i take it also, i doenst even reach a 2 on a scale of 10 compared to Adderall.
>
> I'm soo glad you asked that question, two years ago i started noticing how motivated i was in doing projects, and general activies, it makes you very enthusatic and optimistic. You will know what im talking about, ask your doctor about it.
>
>
Posted by Emme on July 8, 2004, at 8:44:25
In reply to Re: Best Med for Motivation, posted by 1980Monroe on July 7, 2004, at 22:28:55
> obeserve the following very very closely:
>
>
> A-D-D-E-R-A-L-L
>
>
> It is the most absolute best med for getting you enthusiastic, wellbutrin, i take it also, i doenst even reach a 2 on a scale of 10 compared to Adderall.
>
> I'm soo glad you asked that question, two years ago i started noticing how motivated i was in doing projects, and general activies, it makes you very enthusatic and optimistic. You will know what im talking about, ask your doctor about it.
>
>
Does the Adderall make you jittery or racey physically? Does it increase anxiety?
Posted by 1980Monroe on July 8, 2004, at 10:26:28
In reply to Re: Best Med for Motivation » 1980Monroe, posted by Emme on July 8, 2004, at 8:44:25
I take 40mg of Adderall daily, but i switch between Dexedrine too, but there both amphetamine.
Adderall makes your heart race a bit at higher doses, but dexedrine does less stimulation on physical stimulation.
For me adderall does not give me anxiety at all becuase of the dopamine release. Noradrenaline is main chemical that causes anxiety, not really dopamine. Adderall gives you a warm feeling of enthusiasm, man, talk about cleaning the house! when i take it i get obsessed with cleaning becuase i have a good feeling to keep going, on going motivation, and im always have a positive mood about it.
It is a medication of choice by doctors, so maybe mention it to them for ADHD.
Posted by Emme on July 8, 2004, at 10:36:09
In reply to Re: Adderall Info, posted by 1980Monroe on July 8, 2004, at 10:26:28
Thanks for the feedback. Have you compared Adderall or Dexedrine to Provigil?
> I take 40mg of Adderall daily, but i switch between Dexedrine too, but there both amphetamine.
>
> Adderall makes your heart race a bit at higher doses, but dexedrine does less stimulation on physical stimulation.
>
> For me adderall does not give me anxiety at all becuase of the dopamine release. Noradrenaline is main chemical that causes anxiety, not really dopamine. Adderall gives you a warm feeling of enthusiasm, man, talk about cleaning the house! when i take it i get obsessed with cleaning becuase i have a good feeling to keep going, on going motivation, and im always have a positive mood about it.
>
> It is a medication of choice by doctors, so maybe mention it to them for ADHD.
Posted by JohnDoenut on July 8, 2004, at 11:36:41
In reply to Re: Adderall Info » 1980Monroe, posted by Emme on July 8, 2004, at 10:36:09
What about Strattera?
Posted by craig getty on July 8, 2004, at 16:43:46
In reply to Re: Adderall Info, posted by 1980Monroe on July 8, 2004, at 10:26:28
Well, I asked my pdoc about Adderall, and he didn't think it was the right thing at this time because: 1) I don't specifically fit the criteria for ADD, 2) I had tried ritalin in the past, and it didn't help me.
Instead, we're adding Effexor (to the Wellbutrin I'm currenly taking). I was on this combo a couple of years ago. It worked for a few months and then pooped out. I hope it doesn't poop again.
-cg
Posted by 1980Monroe on July 8, 2004, at 19:24:48
In reply to Re: Adderall Info, posted by craig getty on July 8, 2004, at 16:43:46
I have not tooken Provigil, but i know it defintly has a diffrent mechanism of action than Adderall or Dexedrine. Provigil is mainly for Excessive daytime sleepiness. I dont belive it would bring the same motivation as well as Dexedrine or Adderall, mainly because provigil does not directly stimulate dopamine into the synapse, dopamine is a neurotransmitter that deals much with exitment, motivation, and ambition. Back in school, in english class, reading some boring poem, i did not give a crap about it when i was unmedicated. Adderall gives a sense of arousal in what ever activity you are currently doing, I noticed more intrest and enthusiasm without any base reason, but i actually enjoyed doing tasks that i dont take intrest in when i'm unmedicated.
If you have been diagnosed with ADD, adderall will be a drug of choice to start with, but strattera is new and it wants to be tried, so you may have to start out with it.
I was on strattera for a 8 week period, it was not effective on me. Strattera doesnt provide the same since of intrest, it improves organizational skills a bit, and attention some, but not really motivation compared to adderall becuase it does not effect dopamine, only noradrenaline.
Wellbutrin, acutally i started it in the first place becuase i belived it would give me also a sense of motivation, since it is a dopamine reptake inhibitor, but i realized its not as direct, becuase really its main purpose is just an anti-depressant, not a psychostimulant. The motivation is somewhat noticable, but not at all reienforcing like adderall.
Good luck to you, and i hope you will find the medication of your need.
Matt
Posted by Emme on July 8, 2004, at 19:47:59
In reply to Re: Adderall Info, posted by 1980Monroe on July 8, 2004, at 19:24:48
> I have not tooken Provigil, but i know it defintly has a diffrent mechanism of action than Adderall or Dexedrine. Provigil is mainly for Excessive daytime sleepiness. I dont belive it would bring the same motivation as well as Dexedrine or Adderall,
I don't know if it brings the exact same quality of motivation as Adderall or Dexedrine, but it does definitely deliver a big healthy dose of motivational "get up and go"! I have often found the level of stimulation to be a bit much and have had to take incredibly small amounts.
> If you have been diagnosed with ADD, adderall will be a drug of choice to start with, but strattera is new and it wants to be tried, so you may have to start out with it.
I don't have ADD, although my concentration isn't the best during bad depression. I've tried stimulant-type drugs to help when my depression gets really sluggish and I have no motivation. Ritalin and Dexedrine were too physically stimulating for me. I've never actually tried Adderall, so maybe I might think about it some time. At the moment I'm tryng SAM-e to get some motivation-energizing effect.
I have to be incredibly careful with stimulating drugs because there's an incredibly fine line between perking me up and sending me into the stratosphere with jittery overstimulation. OTOH, when my anxiety is over the top, I need to use benzos and sometimes seroquel to simmer down. The joys of "bipolar-ish" depression.
> I was on strattera for a 8 week period, it was not effective on me. Strattera doesnt provide the same since of intrest, it improves organizational skills a bit, and attention some, but not really motivation compared to adderall becuase it does not effect dopamine, only noradrenaline.
I tried Strattera to see if it would help with depression and concentration. It wasn't doing much and we quit. But my pdoc and I later realized we might not have tried it for long enough. I'm not planning to try it again soon, but I wouldn't be averse to it at some point.
Thanks for your feedback.
Emme
Posted by Ktemene on July 9, 2004, at 23:23:19
In reply to Best Med for Motivation, posted by craig getty on July 7, 2004, at 12:31:59
> I was curious which meds people have had success with for raising their motivation. I'm currenly on Wellbutrin SR, but need to add something that will help me get excited about things and follow through with projects.
>
> I've tried Provigil, and although it keeps me awake, it doesn't give me motivation and actually makes me irritable.
>
> What has worked for you?*Neuropsychiatry: An Introductory Approach* (by David Arciniegas and Thomas Beresford) has the following list of medicines used to treat diminished motivation and apathy:
Bromocriptine 2.5 mg TID – 20mg TID (+) dopamine
Levodopa/carbidopa 10/100 mg BID – 50/250 mg QID (+) dopamine
Pergolide 00.5-1.5TID (+) dopamine
Amatadine 50mgBID – 100mgTID (+) dopamine
Methylphenidate 2.5-20 TID (+) dopamine/norepinephrine
Dextroamphetamine 2.5-20mg TID (+) dopamine/norepinephrine
Buproprion 75-150BID (+) dopamine/norepinephrine
Selegiline 5-10mg QD (+) dopamine/phenylethylamine
Protriptyline 15-60 QD (+) norepinephine, (-)acetylcholine/histamine
Tacrine 40mg QD-40mgQID (+) acetylcholine
Donepezil 5-10QD (+) acetylcholineI've tried Adderall, Selegiline and Buproprion (Wellbutrin), and I would say that all three are useful, but Adderall and Selegiline are more effective for motivation than Buproprion.
Posted by Dr. Bob on July 10, 2004, at 1:39:03
In reply to Re: Best Med for Motivation, posted by Ktemene on July 9, 2004, at 23:23:19
> *Neuropsychiatry: An Introductory Approach* (by David Arciniegas and Thomas Beresford)...
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by Just a little... on July 10, 2004, at 16:51:32
In reply to Re: Best Med for Motivation, posted by Ktemene on July 9, 2004, at 23:23:19
> > I was curious which meds people have had success with for raising their motivation. I'm currenly on Wellbutrin SR, but need to add something that will help me get excited about things and follow through with projects.
> >
> > I've tried Provigil, and although it keeps me awake, it doesn't give me motivation and actually makes me irritable.
> >
> > What has worked for you?
>
> *Neuropsychiatry: An Introductory Approach* (by David Arciniegas and Thomas Beresford) has the following list of medicines used to treat diminished motivation and apathy:
> Bromocriptine 2.5 mg TID – 20mg TID (+) dopamine
> Levodopa/carbidopa 10/100 mg BID – 50/250 mg QID (+) dopamine
> Pergolide 00.5-1.5TID (+) dopamine
> Amatadine 50mgBID – 100mgTID (+) dopamine
> Methylphenidate 2.5-20 TID (+) dopamine/norepinephrine
> Dextroamphetamine 2.5-20mg TID (+) dopamine/norepinephrine
> Buproprion 75-150BID (+) dopamine/norepinephrine
> Selegiline 5-10mg QD (+) dopamine/phenylethylamine
> Protriptyline 15-60 QD (+) norepinephine, (-)acetylcholine/histamine
> Tacrine 40mg QD-40mgQID (+) acetylcholine
> Donepezil 5-10QD (+) acetylcholine
>
> I've tried Adderall, Selegiline and Buproprion
>(Wellbutrin), and I would say that all three are
>useful, but Adderall and Selegiline are more >effective for motivation than Buproprion.My psychiatrist tells me there is no pill for motivation, instead he tells me I suffer from a... too low initiative. Reading this confirms what I previously held true, I already started doubting myself.
I started asking myself if I was imagining the effexor XR not working as good for me as it did, even at high dosage (I was very happy on it the first few months then *suddenly* my motivation dropped), I didn't get depressed though but I didn't feel like doing anything anymore *sigh*.
Anyone experience something similar like this?Anyway, ... he (my psychiatrist) told me it was probably my own "idea": the effexor working less on motivation. That I should have "pushed" through, because the anti depressive effect was still there.
Currently diagnosed as "light" autistic, previous diagnosis: Borderline personality disorder *sigh*.
Thanks and take care all. =)
Posted by KaraS on July 11, 2004, at 2:49:49
In reply to Re: Best Med for Motivation » Ktemene, posted by Just a little... on July 10, 2004, at 16:51:32
> > > I was curious which meds people have had success with for raising their motivation. I'm currenly on Wellbutrin SR, but need to add something that will help me get excited about things and follow through with projects.
> > >
> > > I've tried Provigil, and although it keeps me awake, it doesn't give me motivation and actually makes me irritable.
> > >
> > > What has worked for you?
> >
> > *Neuropsychiatry: An Introductory Approach* (by David Arciniegas and Thomas Beresford) has the following list of medicines used to treat diminished motivation and apathy:
> > Bromocriptine 2.5 mg TID – 20mg TID (+) dopamine
> > Levodopa/carbidopa 10/100 mg BID – 50/250 mg QID (+) dopamine
> > Pergolide 00.5-1.5TID (+) dopamine
> > Amatadine 50mgBID – 100mgTID (+) dopamine
> > Methylphenidate 2.5-20 TID (+) dopamine/norepinephrine
> > Dextroamphetamine 2.5-20mg TID (+) dopamine/norepinephrine
> > Buproprion 75-150BID (+) dopamine/norepinephrine
> > Selegiline 5-10mg QD (+) dopamine/phenylethylamine
> > Protriptyline 15-60 QD (+) norepinephine, (-)acetylcholine/histamine
> > Tacrine 40mg QD-40mgQID (+) acetylcholine
> > Donepezil 5-10QD (+) acetylcholine
> >
> > I've tried Adderall, Selegiline and Buproprion
> >(Wellbutrin), and I would say that all three are
> >useful, but Adderall and Selegiline are more >effective for motivation than Buproprion.
>
> My psychiatrist tells me there is no pill for motivation, instead he tells me I suffer from a... too low initiative. Reading this confirms what I previously held true, I already started doubting myself.
>
> I started asking myself if I was imagining the effexor XR not working as good for me as it did, even at high dosage (I was very happy on it the first few months then *suddenly* my motivation dropped), I didn't get depressed though but I didn't feel like doing anything anymore *sigh*.
> Anyone experience something similar like this?
>
> Anyway, ... he (my psychiatrist) told me it was probably my own "idea": the effexor working less on motivation. That I should have "pushed" through, because the anti depressive effect was still there.
>
> Currently diagnosed as "light" autistic, previous diagnosis: Borderline personality disorder *sigh*.
>
> Thanks and take care all. =)
>
>
>Ktemene,
I am also searching for the best medication for motivation. So far I haven't had much success but I have a lot of different things left to try. I am now in the process of withdrawing from Effexor. It helped a bit with depression but also left me feeling lethargic and completely unmotivated. It is mostly an SSRI and they are well-known for producing that emotional blunting effect. It is not unusual for someone on any of the medications in this class to react the way that we have. My opinion is that your pdoc is way off base here!If you had success with Adderall, selegiline and Wellbutrin, why did you go off of them? I would also suggest you add to the list of meds to try:
desipramine, reboxetine (not available in the U.S. but you can order from abroad with a prescription) and Parnate. (Imipramine and nortriptyline may also be stimulating for some people.)There are also alternative supplements that are supposed to be motivating. I've just started one of them now, Rhodiola Rosea. Also, the Perika brand of St. John's Wort is reportedly very motivating - though most other forms of SJW are not. Lastly, some people have found SAM-e to be very motivating though it did nothing for me.
Good luck!
Posted by Ktemene on July 12, 2004, at 23:26:02
In reply to Re: Best Med for Motivation, posted by KaraS on July 11, 2004, at 2:49:49
Hi Kara,
Thanks for your suggestions. Actually, I am still taking Selegiline (3-5 mg per day) and Adderall (10-20 mg per day), along with Provigil (200-400 mg per day). I have the anergic anhedonic sort of depression + ADD, so I need all the energy, motivation and focus I can get. I started Selegiline about six weeks ago when I gave up on Strattera (because it made me sleepy), and I am still getting used to Selegiline. Even at very low doses Selegiline is amazingly activating- after my first 5 mg dose I was awake and alert and feeling fine for 48 hours straight. At the time that I started Selegiline, I was very tempted to try instead two of the meds you mention, Parnate and desipramine. (I wasn't as interested in trying reboxetine because I suspect it is very similar to Strattera, since both are strong NRI's.) Parnate in particular attracted me because it has helped so many atypical depressives with ADD who were not helped by SSRI's and Effexor (SSRI's and Effexor just put me to sleep). After a lot of thought I decided to try Selegiline before trying Parnate for two reasons. Firstly, although Parnate's effect is more on dopamine and norepinephrine than on serotonin, it does increase serotonin since it inhibits MAO-A as well as MAO-B. But at low doses Selegiline only inhibits MAO-B. I saw this as a point in favor of Selegiline because all the meds that have helped me (Adderall, Wellbutrin and Strattera) have had a direct effect only on norepinephrine and dopamine. Secondly, the Selegiline patch may be available in six or eight months, while there will apparently never be any Parnate patch. I don't mind the dietary restrictions; I would happily live on bread and water for the rest of my life if I could be rid of depression. But my ADD brain makes me liable to the sort of silly thoughtless mistakes that would eventually result in a hypertensive crisis and a trip to the ER if I took Parnate.
So far the Selegiline is working out well. After six weeks I no longer have the truly epic insomnia I had at first. And I definitely have more motivation and focus; the Selegiline is helping with the anhedonia as well. I am thinking of asking my pdoc to increase the Selegiline dose to 10 mg. I am also thinking of perhaps adding a little Wellbutrin to the mix. It seems to me that low-dose Selegiline and Wellbutrin ought to work well together. When I was taking Wellbutrin (I gave Wellbutrin up to make a trial of Strattera) I always had the feeling that it was *almost* doing what I needed. In fact my pdoc and I kept increasing the dosage of Wellbutrin all the way up to 450 mg until we finally gave up and switched to Strattera. But maybe a dopamatergic med like Selegiline would provide enough dopamine in the right parts of the brain so that Wellbutrin's weak dopamine reuptake inhibition would have a strong antidepressant effect. On the other hand maybe using low-dose Selegiline to augment Wellbutrin isn't such a good idea- I haven't been able to find anyone on Psycho-Babble who has tried this combo.
Your experience with SAM-e was just what happened to me, or rather didn't happen. I took SAM-e for months and the only difference I noticed was that I had less money. I have been very tempted to try Rhodiola Rosea, mainly because of JohnL’s wonderful posts on it. He thought it was important to use a brand that had 4% or more of Rosavin from true Russian Rhodiola Rosea and so he only bought RR from a company in Europe (from Sweden I think). Are you using a brand that has some sort of standardized Rosavin content? Have you noticed any effect yet? I hope it works for you. Please let us know. Although you may have to post on the Alternative Board…Ktemene
>
> Ktemene,
> I am also searching for the best medication for motivation. So far I haven't had much success but I have a lot of different things left to try. I am now in the process of withdrawing from Effexor. It helped a bit with depression but also left me feeling lethargic and completely unmotivated. It is mostly an SSRI and they are well-known for producing that emotional blunting effect. It is not unusual for someone on any of the medications in this class to react the way that we have. My opinion is that your pdoc is way off base here!
>
> If you had success with Adderall, selegiline and Wellbutrin, why did you go off of them? I would also suggest you add to the list of meds to try:
> desipramine, reboxetine (not available in the U.S. but you can order from abroad with a prescription) and Parnate. (Imipramine and nortriptyline may also be stimulating for some people.)
>
> There are also alternative supplements that are supposed to be motivating. I've just started one of them now, Rhodiola Rosea. Also, the Perika brand of St. John's Wort is reportedly very motivating - though most other forms of SJW are not. Lastly, some people have found SAM-e to be very motivating though it did nothing for me.
>
> Good luck!
>
>
Posted by LastDyingWish on July 13, 2004, at 23:35:56
In reply to Re: Best Med for Motivation » KaraS, posted by Ktemene on July 12, 2004, at 23:26:02
Ktemene,
I was reading your post about selegiline and how you want to add wellbutrin to the mix. If you didnt already know, you can try preloading with DLPA or tyrosine to enhance selegilines effects. Just a thought
Posted by Ktemene on July 14, 2004, at 0:59:20
In reply to Re: Best Med for Motivation Ktemene, posted by LastDyingWish on July 13, 2004, at 23:35:56
> Ktemene,
> I was reading your post about selegiline and how you want to add wellbutrin to the mix. If you didnt already know, you can try preloading with DLPA or tyrosine to enhance selegilines effects. Just a thoughtThanks for the suggestions. During the first few weeks on Selegiline I did try preloading with DLPA, LPA and tyrosine and even Chocomine, but did not notice much difference. But I am glad that you mentioned it because I should try again now that the Selegiline side effects (especially insomnia) have lessened. If I notice any enhancement I will definitely let you know.
Posted by KaraS on July 14, 2004, at 1:27:29
In reply to Re: Best Med for Motivation » KaraS, posted by Ktemene on July 12, 2004, at 23:26:02
> Hi Kara,
> Thanks for your suggestions. Actually, I am still taking Selegiline (3-5 mg per day) and Adderall (10-20 mg per day), along with Provigil (200-400 mg per day). I have the anergic anhedonic sort of depression + ADD, so I need all the energy, motivation and focus I can get.Ktemene,
I'm in the same boat - anergia, no energy or motivation. I may also have ADD though I'm not sure. I haven't been diagnosed but I have a lot of the symptoms (trouble concentrating, slow thinking) but depression can cause these same symptoms. At any rate, I'm interested in many of the medications you mentioned.> I started Selegiline about six weeks ago when I gave up on Strattera (because it made me sleepy), and I am still getting used to Selegiline. Even at very low doses Selegiline is amazingly activating- after my first 5 mg dose I was awake and alert and feeling fine for 48 hours straight.
I tried selegiline for a couple of days at 5 mg. and found it mildly stimulating. I can't believe how activating it was for you although you did take it in combination with Adderall and Provigil. I only gave it up when I read that you can test positive for amphetamine usage because of its metabolites. I need to be job hunting right now so I figured I would delay that particular course of action. (I also play on trying it with the addition of DLPA (phenylalanine) as another poster recently suggested to you.)
> At the time that I started Selegiline, I was very tempted to try instead two of the meds you mention, Parnate and desipramine. (I wasn't as interested in trying reboxetine because I suspect it is very similar to Strattera, since both are strong NRI's.)
Reboxetine is supposed to be more like desipramine - stimulating. The two meds are often compared so I wouldn't cross that one off of your list just yet.
> Parnate in particular attracted me because it has helped so many atypical depressives with ADD who were not helped by SSRI's and Effexor (SSRI's and Effexor just put me to sleep).Effexor and the SSRIs were pretty neutral for me in terms of being not too sedating or energizing
(except that Prozac did give me some tremors) but the emotional dampening was not at all what I needed either.
> After a lot of thought I decided to try Selegiline before trying Parnate for two reasons. Firstly, although Parnate's effect is more on dopamine and norepinephrine than on serotonin, it does increase serotonin since it inhibits MAO-A as well as MAO-B. But at low doses Selegiline only inhibits MAO-B. I saw this as a point in favor of Selegiline because all the meds that have helped me (Adderall, Wellbutrin and Strattera) have had a direct effect only on norepinephrine and dopamine. Secondly, the Selegiline patch may be available in six or eight months, while there will apparently never be any Parnate patch. I don't mind the dietary restrictions; I would happily live on bread and water for the rest of my life if I could be rid of depression. But my ADD brain makes me liable to the sort of silly thoughtless mistakes that would eventually result in a hypertensive crisis and a trip to the ER if I took Parnate.Sounds like you've thought it through quite well. Also with the patch you'd be able to tolerate increasing your dosage more easily. The best thing going for Selegiline though is its action against neurotoxicity. It's good to know that you're taking something that will be good for you in the long run.
> So far the Selegiline is working out well. After six weeks I no longer have the truly epic insomnia I had at first. And I definitely have more motivation and focus; the Selegiline is helping with the anhedonia as well. I am thinking of asking my pdoc to increase the Selegiline dose to 10 mg. I am also thinking of perhaps adding a little Wellbutrin to the mix. It seems to me that low-dose Selegiline and Wellbutrin ought to work well together. When I was taking Wellbutrin (I gave Wellbutrin up to make a trial of Strattera) I always had the feeling that it was *almost* doing what I needed. In fact my pdoc and I kept increasing the dosage of Wellbutrin all the way up to 450 mg until we finally gave up and switched to Strattera. But maybe a dopamatergic med like Selegiline would provide enough dopamine in the right parts of the brain so that Wellbutrin's weak dopamine reuptake inhibition would have a strong antidepressant effect. On the other hand maybe using low-dose Selegiline to augment Wellbutrin isn't such a good idea- I haven't been able to find anyone on Psycho-Babble who has tried this combo.
There may be people here more versed in the science of it all who could theoretically tell you whether they agree with your thought process on combining those two meds.
> Your experience with SAM-e was just what happened to me, or rather didn't happen. I took SAM-e for months and the only difference I noticed was that I had less money.
I hear you. That emptied my pocketbook as well. I wouldn't have minded quite so much if I'd had even the slightest response.
> I have been very tempted to try Rhodiola Rosea, mainly because of JohnL’s wonderful posts on it. He thought it was important to use a brand that had 4% or more of Rosavin from true Russian Rhodiola Rosea and so he only bought RR from a company in Europe (from Sweden I think). Are you using a brand that has some sort of standardized Rosavin content? Have you noticed any effect yet? I hope it works for you. Please let us know. Although you may have to post on the Alternative Board…
>
> KtemeneI just started on 2 pills of the Rhodiola per day. I should know within a couple of weeks if it's going to work for me. I am taking that arctic brand from Sweden that you described above. The first day I took one pill I thought that I felt a bit more energized and more focussed but I haven't felt anything since. It may have been just wishful thinking that first day. I'm a little disappointed so far that I'm not feeling more energized but it's probably too early yet to tell if it's ultimately going to work for me or not. Even if this brand doesn't work, I might try the Solgar as well. Some people have had amazing results with that one as well. Anyway, I'll keep you posted.
Please keep me informed as to how you do with increasing to 10 mg. on the selegiline. Also, have you had any problem with tolerance on the Adderall? How long have you been on it?
Kara
>
>
> >
> > Ktemene,
> > I am also searching for the best medication for motivation. So far I haven't had much success but I have a lot of different things left to try. I am now in the process of withdrawing from Effexor. It helped a bit with depression but also left me feeling lethargic and completely unmotivated. It is mostly an SSRI and they are well-known for producing that emotional blunting effect. It is not unusual for someone on any of the medications in this class to react the way that we have. My opinion is that your pdoc is way off base here!
> >
> > If you had success with Adderall, selegiline and Wellbutrin, why did you go off of them? I would also suggest you add to the list of meds to try:
> > desipramine, reboxetine (not available in the U.S. but you can order from abroad with a prescription) and Parnate. (Imipramine and nortriptyline may also be stimulating for some people.)
> >
> > There are also alternative supplements that are supposed to be motivating. I've just started one of them now, Rhodiola Rosea. Also, the Perika brand of St. John's Wort is reportedly very motivating - though most other forms of SJW are not. Lastly, some people have found SAM-e to be very motivating though it did nothing for me.
> >
> > Good luck!
> >
> >
>
>
This is the end of the thread.
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