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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Maxime on March 12, 2006, at 19:08:29
Hi
Is there anything wrong with treating depression with a stimulant. What would be the reasons that someone would advise against it.
Adderall XR helped me a lot. But now my pdoc doesn't want me depending on stimulants. Is it any different to depend on a stimulant than an antidepressant. I mean if it works, then why not?
Maxime
Posted by Phillipa on March 12, 2006, at 19:20:26
In reply to Is it wrong to use a stimulant for depression?, posted by Maxime on March 12, 2006, at 19:08:29
Maxie it's about time you wokeup. It worked so well for you go back on it only you know your own body. Go Girl I back you all the way!!!!! Horray for Maxie she's coming back. Love Phillipa
Posted by Maxime on March 12, 2006, at 19:36:24
In reply to Re: Is it wrong to use a stimulant for depression? » Maxime, posted by Phillipa on March 12, 2006, at 19:20:26
> Maxie it's about time you wokeup. It worked so well for you go back on it only you know your own body. Go Girl I back you all the way!!!!! Horray for Maxie she's coming back. Love Phillipa
You may back me Phillipa, but you can't write a script for it. :-(
Maxime
Posted by linkadge on March 12, 2006, at 20:01:15
In reply to Re: Is it wrong to use a stimulant for depression? » Phillipa, posted by Maxime on March 12, 2006, at 19:36:24
The only issue is tollerance. Yes tollerance can built to antidepressants too, but it sometimes builds to stimulants faster.
Linkadge
Posted by Emily Elizabeth on March 12, 2006, at 22:35:00
In reply to Is it wrong to use a stimulant for depression?, posted by Maxime on March 12, 2006, at 19:08:29
I think w/ a lot of pdocs it's similar to their hesitation to rx benzos--partially based in some realistic concern about abuse, but also based in something else (fear?) Personally, dexedrine has been helpful w/ my depression. I do think that the way that they treat it makes you feel like a bit of a criminal or something (e.g., no refills, need dx on script, no call in rx's, etc.)
I think you need to press your pdoc for a more detailed explaination abt why he doesn't think that YOU should take it (not just a general, hypothetical patient). Also, what are his alternative solutions?
Best,
EE
Posted by rjlockhart on March 12, 2006, at 22:49:55
In reply to Re: Is it wrong to use a stimulant for depression?, posted by Emily Elizabeth on March 12, 2006, at 22:35:00
Alot of the doc's prescribe dexedrine for depression in 1960's and also dexamyl (dextroamphetmaine/amobarbital-barbiturate) to counteract the stimulant anxiety. Elvis Presly I have read imunsly abused this med in his years.
Stimulants work on dopamine, releaseing them and making you more alert and active, postive with life, some people lack that "stimulation" which causes depression, even other antidepressants such Prozac SSRI's because they dont give that stimulantion. I have noticed this since i used to use adderall, dexedrine for ADD and depression and it did help. But i am off it now, and it is hell, i just have to danm force myself. My mother took me off it. She extremely makes me angry.
Antidepressants dont really provide that "stimulation" dextroamphetamine produces, in some regions of the brain it lacks that. The antidepressants seem useless sometimes, unless potent antidepressants like parnate which are more activating but i dont know produce that "stimulation" that stimulants do.
Well that was my put, can post back?
Take Care
Matt
Posted by rjlockhart on March 12, 2006, at 22:51:41
In reply to Re: Is it wrong to use a stimulant for depression?, posted by rjlockhart on March 12, 2006, at 22:49:55
Posted by med_empowered on March 13, 2006, at 0:09:56
In reply to Re: Is it wrong to use a stimulant for depression?, posted by rjlockhart on March 12, 2006, at 22:49:55
stimulants were the mainstay of depression treatment until the TCAs/ MAOIs came around, and even then (even now) they remain useful. I think docs associated amphetamines for depression with "speed"--they consider it an artifical euphoria (I guess Prozac-induced happiness is somehow "natural) and associate it with drug abuse and what not.
Anyway, the stim+AD combo isn't well studied, but seems helpful for a lot of people. Just ask your doc in detail why he would deprive you of a medication that improves your quality of life significantly. I think he owes you an explanation.
Good luck!
Posted by TylerJ on March 13, 2006, at 7:10:33
In reply to Is it wrong to use a stimulant for depression?, posted by Maxime on March 12, 2006, at 19:08:29
> Hi
>
> Is there anything wrong with treating depression with a stimulant. What would be the reasons that someone would advise against it.
>
> Adderall XR helped me a lot. But now my pdoc doesn't want me depending on stimulants. Is it any different to depend on a stimulant than an antidepressant. I mean if it works, then why not?
>
> MaximeI asked my pdoc the same question about a year ago and he said absolutely no..pissed me off, I agree if it works, why not? He said they're highly addictive, the effects are short-lived, and there is often a "crash" after they wear off.
During the crash people usually become very depressed. Also, stimulants have the potential to induce tolerance rather quickly. Suicides have been reported in people who suddenly stop taking amphetamines...this is what my pdoc said anyway.Tyler
P.S. I'd still be willing to try them if nothing else works.
Posted by Racer on March 13, 2006, at 13:40:23
In reply to Re: Is it wrong to use a stimulant for depression? » Maxime, posted by TylerJ on March 13, 2006, at 7:10:33
I have no idea how accurate this information is, but I have read that stimulants can, over time, deplete your brain of dopamine, by stimulating its release into the synapse. That's what's known as A Bad Thing, if in fact it is true.
On the other hand, right now, I'd say that anything that kickstarts you out of this hole you're in would be good.
The other issue, of course, is your eating disorder. My doctor was willing to try a stimulant only because my weight is in a normal range, and even then she was pretty adamant about staying away from any amphetamine. (That's why she started with Ritalin.) It could be that your doctor wants to avoid problems in that area.
You know what, Maxie? There's a post over on Psychology about someone's doctor saying he cared about her. From what you've written here, your doctor cares about you, too. I think that's great, even though it may be frustrating at times when he's not going with what you think is best. I don't know if he's right, but I do think it's comforting to think that his decisions are based on caring about you.
On the other hand, as a temporary measure, if it works, it would be so good to have you feeling better.
Posted by Maxime on March 13, 2006, at 17:30:46
In reply to Re: Is it wrong to use a stimulant for depression?, posted by rjlockhart on March 12, 2006, at 22:49:55
Yes Matt. That was well put, of course you can post back.
Maxime
> Alot of the doc's prescribe dexedrine for depression in 1960's and also dexamyl (dextroamphetmaine/amobarbital-barbiturate) to counteract the stimulant anxiety. Elvis Presly I have read imunsly abused this med in his years.
>
> Stimulants work on dopamine, releaseing them and making you more alert and active, postive with life, some people lack that "stimulation" which causes depression, even other antidepressants such Prozac SSRI's because they dont give that stimulantion. I have noticed this since i used to use adderall, dexedrine for ADD and depression and it did help. But i am off it now, and it is hell, i just have to danm force myself. My mother took me off it. She extremely makes me angry.
>
> Antidepressants dont really provide that "stimulation" dextroamphetamine produces, in some regions of the brain it lacks that. The antidepressants seem useless sometimes, unless potent antidepressants like parnate which are more activating but i dont know produce that "stimulation" that stimulants do.
>
> Well that was my put, can post back?
>
>
>
> Take Care
> Matt
Posted by Maxime on March 13, 2006, at 17:33:44
In reply to Re: Is it wrong to use a stimulant for depression? » Maxime, posted by TylerJ on March 13, 2006, at 7:10:33
Thanks.
I can vouch for the crash... except with Adderall. Both Dexedrine and Ritalin send me into a crashing depression in the evening where I have self-injured.Thanks for your input.
Maxime
> > Hi
> >
> > Is there anything wrong with treating depression with a stimulant. What would be the reasons that someone would advise against it.
> >
> > Adderall XR helped me a lot. But now my pdoc doesn't want me depending on stimulants. Is it any different to depend on a stimulant than an antidepressant. I mean if it works, then why not?
> >
> > Maxime
>
> I asked my pdoc the same question about a year ago and he said absolutely no..pissed me off, I agree if it works, why not? He said they're highly addictive, the effects are short-lived, and there is often a "crash" after they wear off.
> During the crash people usually become very depressed. Also, stimulants have the potential to induce tolerance rather quickly. Suicides have been reported in people who suddenly stop taking amphetamines...this is what my pdoc said anyway.
>
> Tyler
>
> P.S. I'd still be willing to try them if nothing else works.
Posted by Maxime on March 13, 2006, at 17:36:59
In reply to Re: Is it wrong to use a stimulant for depression?, posted by Racer on March 13, 2006, at 13:40:23
Thanks Racer. Yup, depletion of Dopamine would be a bad thing. I guess that's why I am trying a dopamine agonist.
My doctor does care about me. He is very special ... different from other doctors I've had.
Maxime
> I have no idea how accurate this information is, but I have read that stimulants can, over time, deplete your brain of dopamine, by stimulating its release into the synapse. That's what's known as A Bad Thing, if in fact it is true.
>
> On the other hand, right now, I'd say that anything that kickstarts you out of this hole you're in would be good.
>
> The other issue, of course, is your eating disorder. My doctor was willing to try a stimulant only because my weight is in a normal range, and even then she was pretty adamant about staying away from any amphetamine. (That's why she started with Ritalin.) It could be that your doctor wants to avoid problems in that area.
>
> You know what, Maxie? There's a post over on Psychology about someone's doctor saying he cared about her. From what you've written here, your doctor cares about you, too. I think that's great, even though it may be frustrating at times when he's not going with what you think is best. I don't know if he's right, but I do think it's comforting to think that his decisions are based on caring about you.
>
> On the other hand, as a temporary measure, if it works, it would be so good to have you feeling better.
Posted by Racer on March 13, 2006, at 20:13:44
In reply to Re: Is it wrong to use a stimulant for depression? » Racer, posted by Maxime on March 13, 2006, at 17:36:59
> Thanks Racer. Yup, depletion of Dopamine would be a bad thing. I guess that's why I am trying a dopamine agonist.
>
>I've come across references to dopamine agonists, but don't know much about them. Let me know how it goes, yes?
Posted by med_empowered on March 13, 2006, at 20:45:12
In reply to I wanna hear more about this... » Maxime, posted by Racer on March 13, 2006, at 20:13:44
hi maxime..have you tried tianeptine? It accelerates serotonin re-uptake..its related to amineptine (Survector) and seems to be similarly pleasant and well-tolerated. I think its sold as Stablon.
Posted by Maxime on March 13, 2006, at 21:02:23
In reply to I wanna hear more about this... » Maxime, posted by Racer on March 13, 2006, at 20:13:44
I'll keep you posted. From what I have read on the board (did a search), Mirapex works well but it does poop out. Sigh.
Maxime
> > Thanks Racer. Yup, depletion of Dopamine would be a bad thing. I guess that's why I am trying a dopamine agonist.
> >
> >
>
> I've come across references to dopamine agonists, but don't know much about them. Let me know how it goes, yes?
Posted by Maxime on March 13, 2006, at 21:05:59
In reply to Have you tried tianeptine?, posted by med_empowered on March 13, 2006, at 20:45:12
> hi maxime..have you tried tianeptine? It accelerates serotonin re-uptake..its related to amineptine (Survector) and seems to be similarly pleasant and well-tolerated. I think its sold as Stablon.
Hi, I have wanted to try it, but it's not available in Canada. I don't even know if it's available in the US.
Maxime
Posted by Phillipa on March 13, 2006, at 21:41:34
In reply to Re: Have you tried tianeptine? » med_empowered, posted by Maxime on March 13, 2006, at 21:05:59
Med lives in the US near me. Love Phillipa
Posted by med_empowered on March 13, 2006, at 22:18:05
In reply to Re: Have you tried tianeptine? » Maxime, posted by Phillipa on March 13, 2006, at 21:41:34
no, its not in the us..i thought maybe canada had it. maybe you could give it a whirl--I know the US allows importation of meds sometimes, although it requires some paperwork.
Posted by fairywings on March 13, 2006, at 23:08:30
In reply to Is it wrong to use a stimulant for depression?, posted by Maxime on March 12, 2006, at 19:08:29
Hi Maxie,
You've gotten a lot of great advice here, and I don't know the specifics of your situation except I know I've read you've had so much trouble getting the depression to lift over a long period of time.
I know with some ADD/ADHD if you forget to take your meds you get depressed, so maybe there's some times people need the stimulant. (?) I know it's more of a problem for me when I forget, esp. when I forget for a couple of days.
I don't know the reasons why your pdoc won't rx the adderall if it helps, but you seem to trust him, and feel he has your best interest at heart, so maybe the antagonist will be the answer. I hope so. Good luck with it.
fairywings
Posted by San Diegan on March 15, 2006, at 23:32:44
In reply to Is it wrong to use a stimulant for depression?, posted by Maxime on March 12, 2006, at 19:08:29
this kind of thing makes me angry, because the antidepressants are every bit as harmful over the long term as stimulants. The ONLY difference is stimulants are somewhat more prone to be abused by some people. That's because they work well.
Posted by jerrympls on March 16, 2006, at 3:25:18
In reply to stims for depression, posted by med_empowered on March 13, 2006, at 0:09:56
Just ask your doc in detail why he would deprive you of a medication that improves your quality of life significantly. I think he owes you an explanation.
>
> Good luck!VERY well said!!!!
Posted by Maxime on March 17, 2006, at 20:33:42
In reply to Re: stims for depression » med_empowered, posted by jerrympls on March 16, 2006, at 3:25:18
I did and his response was "because you are too deep into your eating disorder (anorexia). Sigh. I wouldn't any less on Adderall and it's certainly not why I want it.
Thanks everyone for your input.
Maxime
> Just ask your doc in detail why he would deprive you of a medication that improves your quality of life significantly. I think he owes you an explanation.
> >
> > Good luck!
>
> VERY well said!!!!
Posted by San Diegan on March 17, 2006, at 20:41:30
In reply to Re: stims for depression » jerrympls, posted by Maxime on March 17, 2006, at 20:33:42
Ah, well there you go. It would be borderline malpractice to give you any.
Your only option I think would be to switch to a doc who doesn't know about your ED
Posted by Racer on March 17, 2006, at 23:53:15
In reply to Re: stims for depression » jerrympls, posted by Maxime on March 17, 2006, at 20:33:42
> I did and his response was "because you are too deep into your eating disorder (anorexia). Sigh. I wouldn't any less on Adderall and it's certainly not why I want it.
>
> Thanks everyone for your input.
>
> Maxime
>{sigh} I hate to say it, but that makes a lot of sense to me. You know I want you to feel better, but I also want to see you healthy. Which means getting that ED treated...
(Yeah, I know, but it's OK if the kettle really is black, isn't it?)
Is there any sort of contract that he might make with you about that? My pdoc told me that I'd be stepping on her scale from time to time, to see if I was losing weight, before she'd write the scrip. And my last pdoc said that he would choose a stim for me -- except that I had an ED, and he couldn't risk it, because it was too close to malpractice.
Sorry, Maxie. Signed, The Pot...
:-D
This is the end of the thread.
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