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Dr. Bob is Robert Hsiung, MD,
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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
Posted by erik98225 on November 18, 2006, at 13:23:05
In reply to Re: Dopamine - Do you care about those Agonists ? » erik98225, posted by Quintal on November 18, 2006, at 10:31:35
> 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.
You couldn't have said it better; I fully agree with this. Taking Haldol or Seroquel was miserable -- in the case of Seroquel, I took one pill and about 10 minutes later I wished I was dead and flushed the rest of the Seroquel down the toilet. I REALLY don't tolerate the anticholinergic crap. (I am a smoker; not trying to quit right now because I'm recently quit the much more dangerous Alcohol. I've heard that nicotine is a PROCHOLINERGIC.)
High dose Lyrica (600 mg taken as 300 BID) definitely makes me more energetic, and I suspect it has some sort of dopamine agonist effect.
SSRI's work for me (I've been on paroxetine and citalopram in various times in the past), but they make you gain weight and they ruin your sex life. Not worth it for me; the Lyrica is moch better. I have primary SP with secondary depression and "possible" tourettes.
Erik
Posted by Quintal on November 18, 2006, at 14:14:21
In reply to Re: Dopamine - Do you care about those Agonists ? » Quintal, posted by erik98225 on November 18, 2006, at 13:23:05
I was thinking about trying a nicotine inhaler a while ago myself for anxiety and depression as tobacco seems to help many people with these problems, but I would prefer to avoid the tar. I was put off by the addiction potential but I found a few other things that may be an acceptable substitute such as the Alzhimer's drug Galantamine. I may still try it now you've brought it to mind. Galantamine is a acetylcholinesterase inhibitor that also acts at nicotinic cholinergic receptor sites. I imagine that is a complicated way of saying it acts like nicotine?
Tobacco smoke also contains harmaline, a mild MAOI which no doubt plays a role in its antidepressant action? I think I would stick with the tobacco rather than risk a relapse into alcohol too.
SSRIs do work for me, up to a point, but I start to hate the fake saccharine sweet happiness after a while, and even that tends to fade and leave me flat and emotionless like a robot. I was 17 when I took my first SSRI - paroxetine - the anorgasmia scared me as I'd read a letter from a guy asking the manufacturer when he would be able to have an orgasm again since he'd stopped the drug six months previously and still could not ejaculate. They totally blanked him and that made me wary so I came off it, and looking back I think that was a wise decision.
I have been wondering if I have a form of Tourettes myself after reading a book called 'Life, interrupted' by James McConnel this summer. I recognised some of my own eccentric traits and mannerisms, and also the intrusive thoughts and desires. I often get an overwhelming urge to do or say something very offensive in public, but thankfully this usually dissolves in to a fit of giggles, which is bad enough in itself though. In a more conservative family I may well have been locked up and put on haloperidol myself by now.
Q
Posted by erik98225 on November 18, 2006, at 15:41:55
In reply to Re: Dopamine - Do you care about those Agonists ? » erik98225, posted by Quintal on November 18, 2006, at 14:14:21
> Galantamine is a acetylcholinesterase inhibitor that also acts at nicotinic cholinergic receptor sites. I imagine that is a complicated way of saying it acts like nicotine?
Plausible, especially if it's an alzheimers drug (I know that nicotine prevents alzheimers). But you'd better consult a doctor on this one -- I'm not too knowledgeable about enzyme inhibitors.
> I think I would stick with the tobacco rather than risk a relapse into alcohol too.On the first day of treatment, the counselor actually told me: "Don't quit smoking." You need to get off the alcohol first and stay off it a long time before you even think about trying to quit smoking.
> I have been wondering if I have a form of Tourettes myself after reading a book called 'Life, interrupted' by James McConnel this summer. I recognised some of my own eccentric traits and mannerisms, and also the intrusive thoughts and desires. I often get an overwhelming urge to do or say something very offensive in public, but thankfully this usually dissolves in to a fit of giggles, which is bad enough in itself though. In a more conservative family I may well have been locked up and put on haloperidol myself by now.My tourettes isn't the hollywood version where you're spouting obscenities all the time. It's characterized by vocal tics -- my speech sounds odd, which no doubt contributes to my social phobia. The haloperidol did improve my speech noticeably, but the inner torture (akathesia) was so awful that I discontinued it within a few weeks.
Erik
Posted by Quintal on November 18, 2006, at 16:03:09
In reply to Re: Dopamine - Do you care about those Agonists ? » Quintal, posted by erik98225 on November 18, 2006, at 15:41:55
>Plausible, especially if it's an alzheimers drug (I know that nicotine prevents alzheimers). But you'd better consult a doctor on this one -- I'm not too knowledgeable about enzyme inhibitors.
The only doctor that I have access to has no interest in anything like this so it's pointless to mention it :-( Fortunately Galantamine is available as a supplement since it is a natural plant extract: http://www.vitaminexpress.com/product_info.php/products_id/590?gclid=COijguzI0YgCFShREgodpA2saA
Q
Posted by yxibow on November 18, 2006, at 23:33:19
In reply to Re: Dopamine - Do you care about those Agonists ? » Quintal, posted by erik98225 on November 18, 2006, at 13:23:05
> > 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.
>
> You couldn't have said it better; I fully agree with this. Taking Haldol or Seroquel was miserable -- in the case of Seroquel, I took one pill and about 10 minutes later I wished I was dead and flushed the rest of the Seroquel down the toilet. I REALLY don't tolerate the anticholinergic crap. (I am a smoker; not trying to quit right now because I'm recently quit the much more dangerous Alcohol. I've heard that nicotine is a PROCHOLINERGIC.)
Its not the nicotine so much, but the 100+ other things in tobacco and cancer... but at any rate...
Some psychiatrists have been musing about other possibilities for the new smoking cessation drug Chantix (varenicline), antagonizing a4b2 nicotinic acetylcholine receptors, as a possible antidepressant. This isn't clear as to whether it actually has any function, although it has been noted that some sufferers of schizophrenia who also smoke seem to do better in general (and with neuroleptics) than those who don't smoke. This isn't a cause celebre to start smoking, but it is worth scientific pursuit.-- Jay
Posted by linkadge on November 19, 2006, at 13:33:22
In reply to Re: Dopamine - Do you care about those Agonists ? » erik98225, posted by Quintal on November 18, 2006, at 14:14:21
The beta carbolines in coffee and tobacco smoke have actually been found to be neurotoxic, they are gaba inverse agonists, and structurally related to MPTP. MAOI's are not in general neuroprotective. This is a property of segeline and derivitives only, and does not extend to other MAO-B inhibitors.
The antiparkinsons actions of coffee and tobacco smoke are likely related to caffine and nicotine.
Linkadge
Posted by naughtypuppy on November 19, 2006, at 13:55:03
In reply to Re: Dopamine - Do you care about those Agonists ? » naughtypuppy, posted by yxibow on November 18, 2006, at 3:46:22
> > > > > 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.Actually, I'm not exagerating at all I showed no schizophrenic tendencys whatsoever. Today I probably would have been diagnosed ADHD or just a kid that wouldn't sit still. In the early 70's it was very trendy to use anti-psycotics for just about everything, just like atypicals are trendy today which is why I shudder when I hear people mention using them for depression. I think I still have a very subtile form of TD and that was after only a year of treatment. Look at the way we are today. ECT is back in style. Psycosurgery is rearing it's ugly head again. The AD's of today are generally no more effective than the ones developed 50 years ago. And so the circle goes round and round. Next I expect to be picked up, put in an asylum and fed fish heads!
>
> 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 MARTY on November 19, 2006, at 14:29:43
In reply to Re: Dopamine - Do you care about those Agonists ? » yxibow, posted by naughtypuppy on November 19, 2006, at 13:55:03
Dont be negative about it: fish heads are full of OMEGA-3 isn't ? it's trendy, so it MUST be good! ;)Marty
Posted by linkadge on November 19, 2006, at 17:56:16
In reply to Re: Dopamine - Do you care about those Agonists ? » naughtypuppy, posted by MARTY on November 19, 2006, at 14:29:43
I suspect they're happy if they can sell drugs, but do they know that their medications are relatively useless?
Linkadge
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