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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by uncouth on September 27, 2011, at 21:53:29
Hi,
I'm thinking about trying amineptine for treatment resistant bipolar2 depression. i am struggling with motivation, drive, libido, anhedonia. i have been through the ringer, and feel like i've been on every psych med in every combination over the past 7 years. I am currently on a combination of bupropion xl 600mg, mirapex 1.5mg, adderall, saphris, cerefolin and a bunch of supplements. i am up and out of bed and somewhat functional but life still really sucks and even with all this dopamine action going on, i feel like something is missing -- the drive and initiation and caring is so lacking, and the apathy, resignedness, hopelessness, givingup is so present.I know i know, it's not all about neurochemistry. I'm doing the psychology stuff. My testosterone levels are low, trying to treat that as well.
But anyway THE QUESTION I HAVE IS:
Does anyone have experience with amineptine, compared to other dopaminergic agents? How does the subjetive experinece compare say between amineptine and bupropion, and compared to adderall or mirapex. Would I conceivably have to stop the stimulant if I tried amineptine?Has anyone had good results with it? Or heard of anyone with good results?
I've tried MAOIs before, they help somewhat, but I have other problems with them.
7 years ago in college, I had so many ideas, ran a business out of my dorm room while getting three engineering degrees. Now at age 31, I f*ck*d up the great job I had in technology, i am broke, living at home with parents and still can't find a job despite ivy league education because of my illness. So yeah, my apathy might be situational, but I'd like to think its more complex than that, and I know the amotivation killed my job performance.Personally I think years of ephedra diet pills, then SSRI use f*ck*d up my dopamien system pretty badly.
Also, last year I got highly addicted to PEA + MAOI...but that was the only thing that kicked the depression in the butt...at least before it caused hypomania and destruction, so I had to go off of it.
Anyway, please, any feedback would be appreciated.
Posted by Christ_empowered on September 27, 2011, at 22:14:24
In reply to Recent amineptine experience?, posted by uncouth on September 27, 2011, at 21:53:29
The stuff hasn't been around for years. Do you have a supplier? Or a personal chem lab?
Posted by creepy on September 28, 2011, at 0:41:52
In reply to Recent amineptine experience?, posted by uncouth on September 27, 2011, at 21:53:29
seems to me that the SSRIs screw with your motivation more than anything else. But they do help the depression.
Ever consider trying other therapies like TMS? It seems to work for some folks. I may consider trying it myself when I get insurance again.
Sounds like you really went into dopamine overload with the MAOI + PEA. Ive taken bupropion with tyrosine and phenylalanine, without any real results. PEA is pretty short-lived in the body though I think.
Posted by uncouth on September 28, 2011, at 8:01:00
In reply to Re: Recent amineptine experience?, posted by creepy on September 28, 2011, at 0:41:52
i have tried everything. rTMS was minimally effective but i used it when i was SUPER depressed. would consider it again, if insurance paid this time, but the psychs who are doing it kind of seem like hucksters to me.
yeah PEA was a mess...it was great while it worked, but had to redose it 5-6x a day...in increasing amounts.
may try parnate again who knows, but yeah, this bupropion really isnt' diong the trick at all.
Posted by SLS on September 28, 2011, at 8:14:00
In reply to Re: Recent amineptine experience?, posted by uncouth on September 28, 2011, at 8:01:00
> may try parnate again who knows, but yeah, this bupropion really isnt' diong the trick at all.
What drugs would you consider taking in combination with Parnate?
- Scott
Posted by Phillipa on September 28, 2011, at 10:40:14
In reply to Re: Recent amineptine experience? » uncouth, posted by SLS on September 28, 2011, at 8:14:00
Uncouth three engineering degrees at the same time were you manic? Phillipa
Posted by uncouth on September 28, 2011, at 11:15:22
In reply to Re: Recent amineptine experience? » uncouth, posted by SLS on September 28, 2011, at 8:14:00
No clue, probably not bupropion. Possibly mirapex, maybe low dose vyvanse or adderall. Other than that any atypical antipsychotic or mood stabilizer.
We'll see doctor calls MAOIs the "shotgun" approach, less ability to tailor specifics, which I agree.
Posted by SLS on September 28, 2011, at 11:37:10
In reply to Re: Recent amineptine experience?, posted by uncouth on September 28, 2011, at 11:15:22
> We'll see doctor calls MAOIs the "shotgun" approach, less ability to tailor specifics, which I agree.
I lost you here. What things would you need to tailor that a MAOI would prevent you from doing?
- Scott
Posted by uncouth on September 28, 2011, at 11:49:30
In reply to Re: Recent amineptine experience? » uncouth, posted by SLS on September 28, 2011, at 11:37:10
i guess the idea is MAOI hits all three neurotransmitters, where multiple more selective medications let you tailor dose for each SE, NE, and DA
Posted by SLS on September 28, 2011, at 12:16:11
In reply to Re: Recent amineptine experience?, posted by uncouth on September 28, 2011, at 11:49:30
> i guess the idea is MAOI hits all three neurotransmitters, where multiple more selective medications let you tailor dose for each SE, NE, and DA
At this point in human history, I think we are better off observing more and theorizing less when it comes to working clinically with psychotropic drugs.
- Scott
Posted by creepy on September 28, 2011, at 20:40:40
In reply to Re: Recent amineptine experience?, posted by Phillipa on September 28, 2011, at 10:40:14
I was thinking the same thing.. maybe what the OP is missing is hypomania which has passed.
I also wonder this about myself sometimes. How do you prove it? Not sure if you can. =(
Posted by Phillipa on September 28, 2011, at 21:15:15
In reply to Re: Recent amineptine experience?, posted by creepy on September 28, 2011, at 20:40:40
Sometimes I wonder how for over 20 years I was so successful in life and work and then crashed? Strange. I had energy but always needed sleep. Phillipa
Posted by creepy on September 30, 2011, at 1:06:15
In reply to Re: Recent amineptine experience? » creepy, posted by Phillipa on September 28, 2011, at 21:15:15
Right, sleep is supposedly a big red flag for bipolar.. if your need for sleep becomes very low or non-existent.
Posted by Chairman_MAO on October 1, 2011, at 15:41:42
In reply to Recent amineptine experience?, posted by uncouth on September 27, 2011, at 21:53:29
A general rule is not to use more than three medications at once if you can avoid it.
That said--unless your doctor wants to raise the dose of one of the dopaminergic drugs--really don't add another one.
Look into Lamictal, maybe memantine as add-ons? The mirapex dose could be higher.
Amineptine is not worth the price you have to pay to get it.
Posted by zonked on October 5, 2011, at 21:15:04
In reply to Recent amineptine experience?, posted by uncouth on September 27, 2011, at 21:53:29
> I know i know, it's not all about neurochemistry. I'm doing the psychology stuff. My testosterone levels are low, trying to treat that as well.
>Me too. It's made a difference for me. What was your total T before you started therapy and what form of therapy are you on now, and have you had a lab since? How long have you been on TRT?
I started at ~410 total (average for a 70 year old man, I'm 29) and am on Androgel 2.5gm/25mg packets, once per day. Haven't had my first follow-up lab yet.
-z
Posted by uncouth on October 5, 2011, at 22:02:57
In reply to Re: Recent amineptine experience? » uncouth, posted by zonked on October 5, 2011, at 21:15:04
hey dude
i'm 31, my T was 550 at the beginning of this year. i did some HCG and androgel neither of which i thought did anything, so i stopped in the spring. in june i got tested becuase thigns were definitely "not right" although I could have orgasms, I had low energy, definitely low mood, and low "libido", drive, and INTEREST...like, looking at a girl and feeling that "stir".got retested in june and was at 340! i went even lower! my life kinda sucks right now so I'm sure this is psychologically drive, learned helplessness, social defeat sorta sh*t. i went on Axiron, which my endo said was much better than androgel, regular dose, and did that for 6 weeks. retested, and it went DOWN again, 330!
so now he said triple the dose of axiron, which i've been doing. retested last week, haven't gotten numbers yet.
can you describe more your experiene, before/after, how you feel subjectively, what your problems were, etc.?
Posted by zonked on October 5, 2011, at 22:55:06
In reply to Re: Recent amineptine experience? » uncouth, posted by Chairman_MAO on October 1, 2011, at 15:41:42
Chairman_MAO:
What's your regime these days?
-z
Posted by Chairman_MAO on October 5, 2011, at 23:15:38
In reply to Re: Chairman: What are you taking? » Chairman_MAO, posted by zonked on October 5, 2011, at 22:55:06
4mg/day clonazepam + 60mg/day dextroamphetamine.
Posted by Chairman_MAO on October 5, 2011, at 23:32:56
In reply to Re: Chairman: What are you taking? » zonked, posted by Chairman_MAO on October 5, 2011, at 23:15:38
And I _really_ want to get back on an MAOI. He wanted me to try Viibryd first. Well, I'm glad it's working well for some people, but by day 7 I was so ill, anxious, and dysphoric that I could not bear to try raising the dose. At day 10 it was no different and I dropped it.
Yeah, I know, the MAOI + psychostimulant thing is risky. He did it in the past. I just want it back (but not with Nardil if possible, the weight gain was just ludicrous).
This is the end of the thread.
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