![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Keith Talent on July 31, 2006, at 12:58:20
Hi Babblers,
I can't seem to do without ridiculous amounts of espresso to get work done. Clomipramine works for my depressive episodes (I suffer MDD), but I can only tolerate it for four week stretches. Dextroamphetamine worked, but only for eight weeks; then it made me exhausted. At least I didn't need coffee during this time.
Is Focalin (dexmethylphenidate) likely to offer any greater sustainability of clinical benefits, due to its merely blocking dopamine reuptake, rather than both causing dopamine release AND blocking reuptake (a la the amphetamines)?
Any advice would be much appreciated,
Keith.
Posted by SLS on July 31, 2006, at 21:00:37
In reply to Focalin +/- clomipramine to function well? SLS?, posted by Keith Talent on July 31, 2006, at 12:58:20
Hi Keith.
I really don't have any answers for you at this point. I have a few questions though.
Have you been diagnosed as having ADD?
> I can't seem to do without ridiculous amounts of espresso to get work done.
What prevents you from getting work done?
> Clomipramine works for my depressive episodes (I suffer MDD), but I can only tolerate it for four week stretches.
How well does it work? What happens after four weeks?
> Dextroamphetamine worked, but only for eight weeks; then it made me exhausted.
In what ways did it work for you? Were you taking clomipramine at the same time?
> Is Focalin (dexmethylphenidate) likely to offer any greater sustainability of clinical benefits, due to its merely blocking dopamine reuptake, rather than both causing dopamine release AND blocking reuptake (a la the amphetamines)?
That is a very reasonable line of thinking. It might be worth a try.
My other two thoughts were to explore using Wellbutrin as an antidepressant or Provigil as an adjunct.
Sorry I couldn't be of more help.
- Scott
Posted by Keith Talent on August 1, 2006, at 0:00:52
In reply to Re: Focalin +/- clomipramine to function well? SLS, posted by SLS on July 31, 2006, at 21:00:37
> Have you been diagnosed as having ADD?
No, this was excluded.> What prevents you from getting work done?
When I'm depressed, I have the atypical pattern of hyper(somnia/phagia). When on an antidepressant, the anhedonia is helped much more than the anergia.> How well does it work?
It gets me to a point of subjectively feeling good, albeit with some residual lack of get up and go.> What happens after four weeks?
There's nothing significant about the four week point. The adverse effects start within one day. The problem is, the clomipramine (250 mg/d) makes me feel well enough that I can no longer tolerate the anorgasmia, tachycardia, sweating, dry mouth etc.
> > Dextroamphetamine worked, but only for eight weeks; then it made me exhausted.
> In what ways did it work for you?
It rounded out the recovery, if you will. The sluggishness vanished. Family and friends commented on this.> Were you taking clomipramine at the same time?
No, I was on sertraline and clonazepam during that time.> > Is Focalin (dexmethylphenidate) likely to offer any greater sustainability of clinical benefits, due to its merely blocking dopamine reuptake, rather than both causing dopamine release AND blocking reuptake (a la the amphetamines)?
>
> That is a very reasonable line of thinking. It might be worth a try.
>
> My other two thoughts were to explore using Wellbutrin as an antidepressant or Provigil as an adjunct.
>
> Sorry I couldn't be of more help.
On the contrary - thanks for taking the time to give your expert opinion, Scott.Keith
Posted by alohashirt on August 3, 2006, at 21:52:19
In reply to Re: Focalin +/- clomipramine to function well? SLS, posted by Keith Talent on August 1, 2006, at 0:00:52
I found that Focalin XR's positive effects were more consistent and long lasting than dexedrine's.
I found Wellbutrin to be stimulating and Provigil or Adrafinil great with daytime sleepiness.
Posted by Keith Talent on August 6, 2006, at 20:54:34
In reply to Re: Focalin +/- clomipramine to function well? SLS, posted by alohashirt on August 3, 2006, at 21:52:19
Thanks to both of you for your kind advice,
K.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.