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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 60. This is the beginning of the thread.
Posted by MARTY on November 13, 2006, at 19:09:44
I'm currently giving Dostinex (Cabergoline, a D2 dopamine agonist ) a try to treat my sexual dysfunctions caused by other meds and I found out that it help A LOT both my depression AND anxiety.Already tried one of those agonists ? what about L-DOPA (Levodopa) ?
Any of you ever saw concretely a link between social phobia dopamine dysfunction AND any med having an effect on dopamine (antagonist, agonist, reuptake inhibitor etc etc) ?
Hope you're having a good day --
Marty
Posted by blueberry on November 13, 2006, at 19:28:19
In reply to Dopamine - Do you care about those Agonists ?, posted by MARTY on November 13, 2006, at 19:09:44
I get the feeling dopamine has a lot more to do with anxiety and depression than it is given credit for. Though serotonin is involved to varying degrees from person to person, I do not believe it should get the spotlight.
Posted by Phillipa on November 13, 2006, at 23:04:22
In reply to Re: Dopamine - Do you care about those Agonists ?, posted by blueberry on November 13, 2006, at 19:28:19
Is dopamine in wellbutrin? Love Phillipa
Posted by tensor on November 14, 2006, at 7:28:04
In reply to Re: Dopamine - Do you care about those Agonists ? » blueberry, posted by Phillipa on November 13, 2006, at 23:04:22
> Is dopamine in wellbutrin? Love Phillipa
It is among other things a dopamine RI.
/Mattias
Posted by med_empowered on November 14, 2006, at 7:48:27
In reply to Re: Dopamine - Do you care about those Agonists ? » Phillipa, posted by tensor on November 14, 2006, at 7:28:04
adderall helped my social phobia so I kind of saw the dopamine connection there...neuroleptics usually made it much, much worse, and SSRIs weren't of much help, but didn't hurt me all that much, either.
I kind of think that if docs would give patients benzos for the first couple weeks, Wellbutrin could turn out to be a pretty useful treatment for anxiety disorders, especially if it was coupled with buspar or as-needed benzos.
Posted by yxibow on November 14, 2006, at 14:17:30
In reply to Dopamine - Do you care about those Agonists ?, posted by MARTY on November 13, 2006, at 19:09:44
>
> I'm currently giving Dostinex (Cabergoline, a D2 dopamine agonist ) a try to treat my sexual dysfunctions caused by other meds and I found out that it help A LOT both my depression AND anxiety.
>
> Already tried one of those agonists ? what about L-DOPA (Levodopa) ?
>
> Any of you ever saw concretely a link between social phobia dopamine dysfunction AND any med having an effect on dopamine (antagonist, agonist, reuptake inhibitor etc etc) ?
>It is definately offlabel but I'm glad it is helping you.
One should place caution with dopamine agonists, especially with anyone who has features of psychosis associated with depression (or even not), because overactivity at D2 could cause hallucinations and psychosis. These were made originally for parkinson's patients and that is something that happens.
Posted by yxibow on November 14, 2006, at 14:19:36
In reply to Re: Dopamine - Do you care about those Agonists ? » blueberry, posted by Phillipa on November 13, 2006, at 23:04:22
> Is dopamine in wellbutrin? Love Phillipa
Wellbutrin mediates dopamine among other things but isnt a specific target for D2. Still, enough of phenylamine stimulants can also cause psychosis as well, although in a different way. That's more a concern of methamphetamine salts.
Posted by Tom Twilight on November 14, 2006, at 15:14:18
In reply to Re: Dopamine - Do you care about those Agonists ? » Phillipa, posted by yxibow on November 14, 2006, at 14:19:36
I think dopamine is implicated in depression and anxiety way more than people realise!
I personally suspect that stimulants are not a good standalone treatment for SA for most people.
Dexedrine made my SA worse in the long term!
Anyway here's a little something on Dopamine, Anxiety and Parkinsons
Posted by Phillipa on November 14, 2006, at 19:22:59
In reply to Re: Dopamine - Do you care about those Agonists ?, posted by med_empowered on November 14, 2006, at 7:48:27
Med what if you've been on benzos for years already? What can you do then? Love Phillipa
Posted by stargazer on November 15, 2006, at 1:32:33
In reply to Re: Dopamine - Cofidence and Anxiety, posted by Tom Twilight on November 14, 2006, at 15:14:18
Very interesting article on Parkinson's Personality. My father just passed away from it and had the classic "parkinson's" personality...orderly, risk averse, but loved coffee, a good party and people. He also was very confident and had no anxiety that was evident. He had no depression that I know of and was extremely resilient to stress, the opposite of my personality, although in between deprssions, I had the same traits so perhaps I do have a dopamine issue more than a serotonin one. All of the SSRI's worked by deadening my emotions over the long term.
I'll be starting Emsam tomorrow so my dopamine system should be ready to start working.
SG
Posted by erik98225 on November 15, 2006, at 10:27:26
In reply to Dopamine - Do you care about those Agonists ?, posted by MARTY on November 13, 2006, at 19:09:44
> Any of you ever saw concretely a link between social phobia dopamine dysfunction AND any med having an effect on dopamine (antagonist, agonist, reuptake inhibitor etc etc) ?
Well, I have SP and CANNOT tolerate anything having a dopamine antagonist effect (I tried Haloperidol and it was the most frightening, horrific experience of my life).
I take Klonopin and Lyrica for my SP (which has a touch of GAD mixed in). The Lyrica is very prosocial which I suspect is due to its dopamine agonist side effects. Klonopin doesn't do this but helps with the generalised anxiety.
Posted by MARTY on November 15, 2006, at 11:01:00
In reply to Re: Dopamine - Do you care about those Agonists ? » MARTY, posted by erik98225 on November 15, 2006, at 10:27:26
>> Lyrica is prosocial which I suspect is due to its dopamine agonist side effects.
You think Lyrica has a dopamine agonist effect ?
If so, have you seen this described in some medical literature ?Marty
Posted by erik98225 on November 15, 2006, at 11:09:23
In reply to Re: Dopamine - Do you care about those Agonists ? » erik98225, posted by MARTY on November 15, 2006, at 11:01:00
> >> Lyrica is prosocial which I suspect is due to its dopamine agonist side effects.
>
> You think Lyrica has a dopamine agonist effect ?
> If so, have you seen this described in some medical literature ?I didn't read this in any medical literature; just my personal experience with the drug. The effects of Lyrica are kinda weird. In low doses it's sedating, but in high doses (300mg+) it's stimulating, prosocial and pleasurable. My gut instinct and B.A. Psychology degree says it must be doing SOMETHING to enhance dopamine.
Could be wrong, though. :)
Posted by MARTY on November 15, 2006, at 11:15:47
In reply to Re: Dopamine - Do you care about those Agonists ? » MARTY, posted by erik98225 on November 15, 2006, at 11:09:23
hi--
> The effects of Lyrica are kinda weird.
You bet.. very different of everything else I've tried (over 20 meds)> In low doses it's sedating, but in high doses (300mg+) it's stimulating, prosocial and pleasurable.
That reflects my own experience. I'm taking 300mg BID (600mg total by day)
>My gut instinct and B.A. Psychology degree says >it must be doing SOMETHING to enhance dopamine.
My smart *ss says it doesn't.. joking ;)
It doesn't make me feel like any other dopaminergic med. I've read it's related more to Alpha-1. I'm not sure what it is but thank god for it! :)Marty
> Could be wrong, though. :)
Posted by Quintal on November 15, 2006, at 12:32:53
In reply to Dopamine - Do you care about those Agonists ?, posted by MARTY on November 13, 2006, at 19:09:44
Hi Marty,
Did you ever try Solian (amisulpride)? At low doses it too has a D2 agonist action and many people find it very efective for social phobia, depression and dysthymia/dysphoria. It is the only drug that has an instant mood brightening effect on me and makes me pro-social with no anxiety. It is a wonerful drug for SA and reading so many stories of others who have found this too has made me more determined to get me GP to re-prescribe it. It is very stimulating and motivating - can cause insomnia but unlike most other stimulants it is strangely anxiolytic.
I suspect many would have a hard time convincing their pdocs to try a drug licensed for Parkinson's like cabergoline but I know many feel more comfortable prescribing low-dose antipsychotics. It's a real shame this drug isn't licenced in the US. It's strange the manufacturers Sanofi-Aventis haven't pushed for a licence other than psychosis given the size of the potential market in the US for a drug of this kind. Does anyone know why Solian is not approved for use by the FDA?
Posted by tgo on November 15, 2006, at 13:34:07
In reply to Dopamine - Do you care about those Agonists ?, posted by MARTY on November 13, 2006, at 19:09:44
I had an interesting experience with risperdal (combined with gabitril and prozac). I had no problems socializing, even looked forward to it, and also became hypomanic.
I believe risperdal is a D2 antagonist. I believe it was due to the combined punch of addressing the serotonin, gaba and dopamine.
Posted by MARTY on November 16, 2006, at 0:03:52
In reply to Re: Dopamine - Do you care about those Agonists ?, posted by Quintal on November 15, 2006, at 12:32:53
> Did you ever try Solian (amisulpride)? At low doses it too has a D2 agonist action and many people find it very efective for social phobia, depression and dysthymia/dysphoria. It is the only drug that has an instant mood brightening effect on me and makes me pro-social with no anxiety.Very interesting.. I'm definitively looking into it. Can I ask you where you live and how much it cost you ? What are the other meds that you tried before ?
Thanks!
Marty
Posted by Quintal on November 16, 2006, at 3:29:44
In reply to Re: Dopamine - Do you care about those Agonists ? » Quintal, posted by MARTY on November 16, 2006, at 0:03:52
>
> > Did you ever try Solian (amisulpride)? At low doses it too has a D2 agonist action and many people find it very effective for social phobia, depression and dysthymia/dysphoria. It is the only drug that has an instant mood brightening effect on me and makes me pro-social with no anxiety.
>
> Very interesting.. I'm definitively looking into it. Can I ask you where you live and how much it cost you ? What are the other meds that you tried before ?
>
>
> Thanks!
> Marty
>Hi Marty,
I live in the UK where I can get amisulpride (Solian) free on prescription if my pedantic doctor so chooses to prescribe it. I think it is reasonably priced compared to most other antipsychotic meds of this kind, especially since you only need small doses (50mg) to get the D2 agonist effect. Solian has no current licence in the US, but I have heard of people using it legally with the co-operation of their pdoc in America, though I don't know how they obtain it.
I've tried..... well, nearly everything. MAOIS, benzos, TCAs, antipsychotics, SSRIs etc, etc, etc and many obscure remedies. So if you have questions about any bizzare treatments you are considering it's a fair bet I've taken it or at least considered taking it at some point, and I'm always happy to help fellow sufferers.
Q
Posted by stargazer on November 16, 2006, at 7:00:50
In reply to Re: Dopamine - Do you care about those Agonists ?, posted by Quintal on November 16, 2006, at 3:29:44
Marty,
Let me know if you can get some of that med, Solian, in the U.S., it does sound like it could be one for me to try at some point.
I bet you can get it on the internet but I have no experience with ordering anything online and really don't think it's a good practice, but then again, if I can regain my mental function, it would be worth getting it that way, or another
Stargazer(SG)
Posted by yxibow on November 17, 2006, at 3:30:38
In reply to Re: Dopamine - Do you care about those Agonists ? » MARTY, posted by erik98225 on November 15, 2006, at 10:27:26
> > Any of you ever saw concretely a link between social phobia dopamine dysfunction AND any med having an effect on dopamine (antagonist, agonist, reuptake inhibitor etc etc) ?
>
> Well, I have SP and CANNOT tolerate anything having a dopamine antagonist effect (I tried Haloperidol and it was the most frightening, horrific experience of my life).
Haloperidol with an anxiety disorder would be in my mind the most horrific experience after the sedation wore off, the akathisia, which is not anxiety but a side effect consisting of skin crawling need to move, would be interpreted as anxiety. Something much lower on the totem pole like Zyprexa would not have nearly this effect.-- Jay
Posted by naughtypuppy on November 17, 2006, at 10:29:52
In reply to Re: Dopamine - Do you care about those Agonists ? » erik98225, posted by yxibow on November 17, 2006, at 3:30:38
> > > Any of you ever saw concretely a link between social phobia dopamine dysfunction AND any med having an effect on dopamine (antagonist, agonist, reuptake inhibitor etc etc) ?
> >
> > Well, I have SP and CANNOT tolerate anything having a dopamine antagonist effect (I tried Haloperidol and it was the most frightening, horrific experience of my life).
>
>
> Haloperidol with an anxiety disorder would be in my mind the most horrific experience after the sedation wore off, the akathisia, which is not anxiety but a side effect consisting of skin crawling need to move, would be interpreted as anxiety. Something much lower on the totem pole like Zyprexa would not have nearly this effect.
>
> -- JayMy excuse for a pdoc used to give me Haloperidol until I was crawling up the walls. When I kept telling him about it , he just said "I'm the expert, so do what you're told". What a cruel thing to do to a 14 year old kid. Small wonder I had nothing to do with the mental health system for the next 30 years, and will be telling my pdoc (the broken record)where to go the next and final appointment!
Posted by yxibow on November 18, 2006, at 3:46:22
In reply to Re: Dopamine - Do you care about those Agonists ?, posted by naughtypuppy on November 17, 2006, at 10:29:52
> > > > Any of you ever saw concretely a link between social phobia dopamine dysfunction AND any med having an effect on dopamine (antagonist, agonist, reuptake inhibitor etc etc) ?
> > >
> > > Well, I have SP and CANNOT tolerate anything having a dopamine antagonist effect (I tried Haloperidol and it was the most frightening, horrific experience of my life).
> >
> >
> > Haloperidol with an anxiety disorder would be in my mind the most horrific experience after the sedation wore off, the akathisia, which is not anxiety but a side effect consisting of skin crawling need to move, would be interpreted as anxiety. Something much lower on the totem pole like Zyprexa would not have nearly this effect.
> >
> > -- Jay
>
> My excuse for a pdoc used to give me Haloperidol until I was crawling up the walls. When I kept telling him about it , he just said "I'm the expert, so do what you're told". What a cruel thing to do to a 14 year old kid. Small wonder I had nothing to do with the mental health system for the next 30 years, and will be telling my pdoc (the broken record)where to go the next and final appointment!
Haldol for a 14 year old with an anxiety disorder ??No, I repeat that, Haldol for a 14 year old?? Maybe a 14 year old with an unfortunate very early onset huge case of a schizophreniform disorder and then only very cautiously (because of the theory that catching schizophrenia early may help possible deleterious brain changes -- yes, this is a debatable subject)...
I'm sorry you had this experience.
Unfortunately 30 years ago, Clozaril was the only atypical in the labs and was just being introduced in Europe only to be withdrawn soon after because of deaths from low white blood cell count. It wasn't until nearly 1990 that it was reintroduced in the US and elsewhere with strict guidelines to monitor and subsequently discontinue the approximately 1-2% of people that would develop this condition (initially, it drops in treatment).
-- Jay
Posted by erik98225 on November 18, 2006, at 4:28:52
In reply to Re: Dopamine - Do you care about those Agonists ?, posted by naughtypuppy on November 17, 2006, at 10:29:52
> My excuse for a pdoc used to give me Haloperidol until I was crawling up the walls. When I kept telling him about it , he just said "I'm the expert, so do what you're told". What a cruel thing to do to a 14 year old kid. Small wonder I had nothing to do with the mental health system for the next 30 years, and will be telling my pdoc (the broken record)where to go the next and final appointment!
Fully agreed -- antipsychotics are DYSPHORIA IN PILL FORM. The inner torture is indescribable.
I have a schizophrenic cousin who is court ordered to get injections of Thorazine or some crap like that. I suspect it's injected not because he likes the schizophrenia, but because he hates the Thorazine.
Posted by erik98225 on November 18, 2006, at 4:31:46
In reply to Re: Dopamine - Do you care about those Agonists ? » erik98225, posted by MARTY on November 15, 2006, at 11:15:47
> > The effects of Lyrica are kinda weird. In low doses it's sedating, but in high doses (300mg+) it's stimulating, prosocial and pleasurable.
> That reflects my own experience. I'm taking 300mg BID (600mg total by day)I too am taking 300mg BID... finally convinced my pdoc to increase the useless 150 dose. Thank God for Lyrica; it's the *miracle drug* for SP.
Posted by Quintal on November 18, 2006, at 10:31:35
In reply to Re: Dopamine - Do you care about those Agonists ?, posted by erik98225 on November 18, 2006, at 4:28:52
I agree the antipsychotics are horrible for people who are dysphoric to begin with. That said, I can tolerate them better than the SSRIs, not that they're more effective though. I think the antipsychotics just distract me from my usual problems by forcing me to battle with that leaden sedation.
Does anyone else find that dopamine agonists generally make them feel light and energetic while antagonists make them feel heavy and tired? I find the mood brightening effect of amisulpride (D2 agonist) more satisfying and substantial than that produced by the SSRIs.
Q
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