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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Bob on April 5, 2011, at 20:18:48
I've been thinking about dopaminergic drugs lately and how they might affect or treat depressive disorders. There is nothing quite like a shot of Mirapex to get me off my *ss and doing things - even to experience a deep joy in things like I haven't felt in years. Then it quickly fades away and turns into angry, irritable depression. Then the attacks of fatigue and sleepiness set in.What I wonder is how other medicines with dopaminergic action, such as MAOIs or the yet to be seen dopamine reuptake inhibitor drugs might act differently? I mean, is there a difference between the dopaminergic effects of something like Parnate vs. a dopamine agonist such as Mirapex? Wouldn't these drugs be just as likely to cause irritability, sudden sleepiness and the like?
Bob
Posted by floatingbridge on April 6, 2011, at 19:44:55
In reply to The nature of dopaminergic meds?, posted by Bob on April 5, 2011, at 20:18:48
>
> I've been thinking about dopaminergic drugs lately and how they might affect or treat depressive disorders. There is nothing quite like a shot of Mirapex to get me off my *ss and doing things - even to experience a deep joy in things like I haven't felt in years. Then it quickly fades away and turns into angry, irritable depression. Then the attacks of fatigue
and sleepiness set in.
>
> What I wonder is how other medicines with dopaminergic action, such as MAOIs or the yet to be seen dopamine reuptake
inhibitor drugs might act differently? I mean, is there a difference between the dopaminergic effects of something like Parnate vs. a dopamine agonist such as Mirapex? Wouldn't these drugs be just as likely to cause irritability, sudden sleepiness and the like?
>
> BobBob, I'd love to know, having done well on dopamine agonists. Latest study shows stimulant therapy might increase early onset Parkinson's. Not sure how the miraprex fits into that.
I had wanted to try an maoi (parnate, then emsam), but right now am sitting everything out.
Waving from the slow lane,
fb
Hope you get some useful replies.
Posted by Bob on April 7, 2011, at 0:20:49
In reply to Re: The nature of dopaminergic meds?, posted by floatingbridge on April 6, 2011, at 19:44:55
> >
> > I've been thinking about dopaminergic drugs lately and how they might affect or treat depressive disorders. There is nothing quite like a shot of Mirapex to get me off my *ss and doing things - even to experience a deep joy in things like I haven't felt in years. Then it quickly fades away and turns into angry, irritable depression. Then the attacks of fatigue
> and sleepiness set in.
> >
> > What I wonder is how other medicines with dopaminergic action, such as MAOIs or the yet to be seen dopamine reuptake
> inhibitor drugs might act differently? I mean, is there a difference between the dopaminergic effects of something like Parnate vs. a dopamine agonist such as Mirapex? Wouldn't these drugs be just as likely to cause irritability, sudden sleepiness and the like?
> >
> > Bob
>
> Bob, I'd love to know, having done well on dopamine agonists. Latest study shows stimulant therapy might increase early onset Parkinson's. Not sure how the miraprex fits into that.
>
> I had wanted to try an maoi (parnate, then emsam), but right now am sitting everything out.
>
> Waving from the slow lane,
>
> fb
>
> Hope you get some useful replies.
>
>
So you stopped all stimulant type drugs because you have fears of Parkinsons, or is there another reason?
Posted by floatingbridge on April 13, 2011, at 6:32:36
In reply to Re: The nature of dopaminergic meds? » floatingbridge, posted by Bob on April 7, 2011, at 0:20:49
Hey Bob,
For some reason, I didn't see your response. My apologies. I think I didn't tick the follow this thread box.
The answer is no, not really, but the news of the study came at a time when I was really burnt out on dexedrine.
I topped at a max dose of 60mgs per day. Some days less, but it didn't really matter. My health just pooped out. Long story. Maybe dexedrine was involved in the poop out, maybe not. I washed out of everything to try emsam, then, after all the washes (and a few pain med trials, cymbalta and lyrica--total busts) I just said no more AD's.
However, I was always suspect of dexedrine, probably because of it's reputation as a street drug; flipped me out. I didn't go to med school, but by counting on my fingers, like dumb grunt arithmathic, it had occurred to me that a med that agonized dopamine *could* *possibly* contribute to Parkinson's in suceptible individuals.
So, no. I was stopping anyway for the allure of an maoi. :-/
Apologies for the delay.
How are you doing these days?
fb
Posted by floatingbridge on April 13, 2011, at 6:34:30
In reply to Re: The nature of dopaminergic meds? » Bob, posted by floatingbridge on April 13, 2011, at 6:32:36
What are your thoughts on maoi's and dopamine agonists in your own situation?
Thanks,
fb
Posted by Bob on April 13, 2011, at 16:47:07
In reply to Re: The nature of dopaminergic meds? » Bob, posted by floatingbridge on April 13, 2011, at 6:32:36
> Hey Bob,
>
> For some reason, I didn't see your response. My apologies. I think I didn't tick the follow this thread box.
>
> The answer is no, not really, but the news of the study came at a time when I was really burnt out on dexedrine.
>
> I topped at a max dose of 60mgs per day. Some days less, but it didn't really matter. My health just pooped out. Long story. Maybe dexedrine was involved in the poop out, maybe not. I washed out of everything to try emsam, then, after all the washes (and a few pain med trials, cymbalta and lyrica--total busts) I just said no more AD's.
>
> However, I was always suspect of dexedrine, probably because of it's reputation as a street drug; flipped me out. I didn't go to med school, but by counting on my fingers, like dumb grunt arithmathic, it had occurred to me that a med that agonized dopamine *could* *possibly* contribute to Parkinson's in suceptible individuals.
>
> So, no. I was stopping anyway for the allure of an maoi. :-/
>
> Apologies for the delay.
>
> How are you doing these days?
>
> fb
>
>I'm about the same as always, which is to say not real good. I know what you mean about your health pooping out - I've spent plenty of time in that situation.
Are you currently on an MAOI?
Bob
Posted by Bob on April 13, 2011, at 16:53:12
In reply to Re: The nature of dopaminergic meds? » floatingbridge, posted by floatingbridge on April 13, 2011, at 6:34:30
> What are your thoughts on maoi's and dopamine agonists in your own situation?
>
> Thanks,
>
> fb
FB,I am very frustrated with the dopamine modifying meds as I am with a few other treatments. These meds in particular provide a robust immediate response which maddeningly fades away all too quickly giving me an ephemeral glimpse of health. This short duration response is probably the closest I've come in a long time to feeling normal but only lasts a day or two.
It seems to me sometimes like dopamine is one of the keys to a successful treatment, but it needs to be modified only in certain areas of the brain - something we don't know how to do. One of my main problems has always been that my brain seems to adapt to whatever treatment it gets and then the therapeutic effect fades. This adaptation also seems to get faster and faster as time goes on and exposure to treatments increases producing what could now be called a "tardive dysphoria" and a truly treatment-resistant patient.
Bob
Posted by floatingbridge on April 13, 2011, at 17:01:14
In reply to Re: The nature of dopaminergic meds? » floatingbridge, posted by Bob on April 13, 2011, at 16:47:07
No. I'm currently sweating out a norco taper and feeling like real cr*p. I take 1.5 mg xanax xr or cr. Last night I woke up after two hours, and finally dashed a sonata and 1mg regular release xanax. That's all that's cooking over here.
What are you currently taking?
Btw, I didn't mean to take a pot-shot at that article you linked to. I truly spend a great deal, or at least I used to, envying those few who others hold up as the gold standard for optimal human health. I have to do a lot of self-talk to handle a link like that. I wish I had thanked you for posting it at the time because it made me think.
fb
Let me know how you're doing if you will.
Posted by floatingbridge on April 13, 2011, at 17:04:50
In reply to Re: The nature of dopaminergic meds? » floatingbridge, posted by Bob on April 13, 2011, at 16:53:12
I guess I can't say I *love* your coinage--but it did make me almost lol. Very poignant. I am sorry.
Our emails crossed paths....
Posted by Bob on April 13, 2011, at 20:00:34
In reply to tardive dysphoria » Bob, posted by floatingbridge on April 13, 2011, at 17:04:50
> I guess I can't say I *love* your coinage--but it did make me almost lol. Very poignant. I am sorry.
>
> Our emails crossed paths....
I actually read that in an article where they were claiming that non-responders to long term antidepressant treatment is becoming more common... to the point where they apparently have a term for it now.
Posted by Bob on April 13, 2011, at 20:01:27
In reply to Re: The nature of dopaminergic meds?, posted by floatingbridge on April 13, 2011, at 17:01:14
>
> Btw, I didn't mean to take a pot-shot at that article you linked to. I truly spend a great deal, or at least I used to, envying those few who others hold up as the gold standard for optimal human health. I have to do a lot of self-talk to handle a link like that. I wish I had thanked you for posting it at the time because it made me think.
>
> fb
>
> Let me know how you're doing if you will.
I wasn't aware that you took a pot shot. Either way... no offense taken.
Bob
Posted by floatingbridge on April 13, 2011, at 20:33:55
In reply to Re: The nature of dopaminergic meds? » floatingbridge, posted by Bob on April 13, 2011, at 20:01:27
>
> I wasn't aware that you took a pot shot. Either way... no offense taken.
>
>
> Bob
>I didn't. Afterwards, I thought my post was a little brisk and maybe, therefore, insensitive. So no harm no foul. Cool.
Posted by floatingbridge on May 11, 2011, at 10:04:19
In reply to Re: tardive dysphoria » floatingbridge, posted by Bob on April 13, 2011, at 20:00:34
I just bumped into that article. The term isn't quite as humorous today. I wasn't able to access the full text--it was $31 dollars for one days access.
Rif S. Mallakh, "Tardive dysphoria: the role of long term antidepressant use in inducing chronic depression."
If anyone gets access to this link please
let me know. Not that I imagine the authors have any suggestions. Least
someone is asking the question.
Posted by floatingbridge on May 11, 2011, at 10:20:59
In reply to Re: tardive dysphoria » Bob, posted by floatingbridge on May 11, 2011, at 10:04:19
I just wrote the author. Who knows? If anyone is interested, and I get a copy, I'll share.
Posted by floatingbridge on May 11, 2011, at 12:07:20
In reply to Re: tardive dysphoria » Bob, posted by floatingbridge on May 11, 2011, at 10:04:19
I just wrote the author. Who knows? If anyone is interested, and I get a copy, I'll share.
Posted by desolationrower on May 11, 2011, at 22:02:20
In reply to Re: tardive dysphoria, posted by floatingbridge on May 11, 2011, at 10:20:59
If you are 'affiliated' with a university, you can usually get access through the school library. I go look for stuff once in a long while, usually i can get someone to email me a copy. I use the computer lab as an alum and can access via the terminals and email to myself & get ahold of things that way, its a bit shady but useful when i have built up a list of things i'd like. If there is a university nearby i'd ask a librarian if there is a way for community to access library materials. Sometimes if you just pull the link back up in google scholar on a terminal, you can read it since hte library has the right IP range.
-d/r
Posted by floatingbridge on May 11, 2011, at 23:02:37
In reply to Re: tardive dysphoria, posted by desolationrower on May 11, 2011, at 22:02:20
Thanks d/r. I did get a copy. One of the researchers answered my query and sent me a copy. When I get to a computer, I'll post it. It's, *sigh*, interesting, what I can make out so far.
This is the end of the thread.
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