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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by gritslad on May 8, 2012, at 20:05:51
I'm currently taking prozac and lamictal. I think I need something that will affect my dopamine as well. When I take adderall as needed, my brain works so much more efficiently and my mood improves significantly. My PC prescribes my meds but is not keen on prescribing the adderall (I have it left over from an old doc). Any suggestions that I might make to him? Wondering about abilify or seroquel.
Posted by Novelagent on May 8, 2012, at 20:39:05
In reply to Need an AD that works like adderall, posted by gritslad on May 8, 2012, at 20:05:51
I suggest Emsam and Provigil, although your insurance may not cover Provigil-- it's expensive. I've heard from depressives that Provigil works well for their mood. Selegiline changed my life and let me enter remission from depression, which I suspect was caused by the over-prescription of amphetamine for me... I take a lower dose of Dexedrine now.
> I'm currently taking prozac and lamictal. I think I need something that will affect my dopamine as well. When I take adderall as needed, my brain works so much more efficiently and my mood improves significantly. My PC prescribes my meds but is not keen on prescribing the adderall (I have it left over from an old doc). Any suggestions that I might make to him? Wondering about abilify or seroquel.
Posted by Novelagent on May 8, 2012, at 20:39:59
In reply to Need an AD that works like adderall, posted by gritslad on May 8, 2012, at 20:05:51
I suggest Emsam and Provigil, although your insurance may not cover Provigil-- it's expensive. I've heard from depressives that Provigil works well for their mood. Selegiline changed my life and let me enter remission from depression, which I suspect was caused by the over-prescription of amphetamine for me... I take a lower dose of Dexedrine now.
> I'm currently taking prozac and lamictal. I think I need something that will affect my dopamine as well. When I take adderall as needed, my brain works so much more efficiently and my mood improves significantly. My PC prescribes my meds but is not keen on prescribing the adderall (I have it left over from an old doc). Any suggestions that I might make to him? Wondering about abilify or seroquel.
Posted by rjlockhart04-08 on May 8, 2012, at 23:50:36
In reply to Re: Need an AD that works like adderall » gritslad, posted by Novelagent on May 8, 2012, at 20:39:59
Wellbutrin - at 450mg it maybe will memic about 10-[maybe] 20mg of adderall, but still it has complications with anxiety if you already have it. It's a weak dopamine reuptake inhibitor and is the only one on the market besides Ritilin, and Adderall. Still its useful with adderall when it wears off.
Parnate - never taken this med but heard various times it works similar to Adderall, but it doesnt have psychostimulant effects really, just the
feeling...Vivicil - have not taken this either..but it has stimulating effects but it does not work on dopamine. Serotonin and Noradrenaline..its more for wakefulness.
Provigil - useful but is not a psychostimulant, more wakefulness action, it doesnt directly release dopamine like amphetamine.
Strattera - this can be the best thing you can take with adderall because its effects are 24 hours when adderall wears off, and you will still be able to sustain attention, but it doesnt directly work .. well not at all on dopamine, its actions are on norephinehrine. Gives you more alertness and vigilance, yet not a stimulant.
Good luck!
Posted by Alexei on May 9, 2012, at 8:13:33
In reply to Need an AD that works like adderall, posted by gritslad on May 8, 2012, at 20:05:51
Seroquel is a good med, but I do not think it will give you the effect you want.
I'm finding abilify to be a two edged sword. It actually makes my vyvanse much less effective. It may help though since it's a d2 agonist. But it also antagonizes dopamine, so it might take you the wrong way
> I'm currently taking prozac and lamictal. I think I need something that will affect my dopamine as well. When I take adderall as needed, my brain works so much more efficiently and my mood improves significantly. My PC prescribes my meds but is not keen on prescribing the adderall (I have it left over from an old doc). Any suggestions that I might make to him? Wondering about abilify or seroquel.
Posted by Novelagent on May 9, 2012, at 14:14:09
In reply to Re: Need an AD that works like adderall, posted by rjlockhart04-08 on May 8, 2012, at 23:50:36
Provigil is not a stimulant only in the sense your heart rate won't go up from it; that says absolutely zero about how it feels for your mind. Also, it's given for meth addicts to cone off of meth, which is something Wellbutrin has failed miserably at.
It works for meth addicts; the only problem docs have is making sure patients comply with it, but when the patiet complies with it, they don't tend to bother taking meth. If you didn't feel speedy (yet not euphoric) you probably went on too low of a dose; dose range is 200-600mg per dose...
> Wellbutrin - at 450mg it maybe will memic about 10-[maybe] 20mg of adderall, but still it has complications with anxiety if you already have it. It's a weak dopamine reuptake inhibitor and is the only one on the market besides Ritilin, and Adderall. Still its useful with adderall when it wears off.
>
> Parnate - never taken this med but heard various times it works similar to Adderall, but it doesnt have psychostimulant effects really, just the
> feeling...
>
> Vivicil - have not taken this either..but it has stimulating effects but it does not work on dopamine. Serotonin and Noradrenaline..its more for wakefulness.
>
> Provigil - useful but is not a psychostimulant, more wakefulness action, it doesnt directly release dopamine like amphetamine.
>
> Strattera - this can be the best thing you can take with adderall because its effects are 24 hours when adderall wears off, and you will still be able to sustain attention, but it doesnt directly work .. well not at all on dopamine, its actions are on norephinehrine. Gives you more alertness and vigilance, yet not a stimulant.
>
> Good luck!
Posted by Novelagent on May 9, 2012, at 14:18:06
In reply to Re: Need an AD that works like adderall, posted by rjlockhart04-08 on May 8, 2012, at 23:50:36
provigil does release dopamine-- it releases a part if the dopamine receptors responsible for wakefullness and feeling stimulated and alert, yet not the part of dopamine responsible for psychosis and euphoria (the two are dopamine 1 and dopamine 2). It fails in ADD trials because they don't prescribe up to what the FDA even lets them prescribe to...
> Wellbutrin - at 450mg it maybe will memic about 10-[maybe] 20mg of adderall, but still it has complications with anxiety if you already have it. It's a weak dopamine reuptake inhibitor and is the only one on the market besides Ritilin, and Adderall. Still its useful with adderall when it wears off.
>
> Parnate - never taken this med but heard various times it works similar to Adderall, but it doesnt have psychostimulant effects really, just the
> feeling...
>
> Vivicil - have not taken this either..but it has stimulating effects but it does not work on dopamine. Serotonin and Noradrenaline..its more for wakefulness.
>
> Provigil - useful but is not a psychostimulant, more wakefulness action, it doesnt directly release dopamine like amphetamine.
>
> Strattera - this can be the best thing you can take with adderall because its effects are 24 hours when adderall wears off, and you will still be able to sustain attention, but it doesnt directly work .. well not at all on dopamine, its actions are on norephinehrine. Gives you more alertness and vigilance, yet not a stimulant.
>
> Good luck!
Posted by rjlockhart04-08 on May 9, 2012, at 14:30:05
In reply to Re: Need an AD that works like adderall, posted by Novelagent on May 9, 2012, at 14:18:06
I wrote it doesnt directly release dopamine...I didnt say it didnt release dopamine, I mean the main reason for activation is to have dopamine being somewhat release, as for caffeine too, it does release it but it doesnt release it the way adderall, and amphetamines do. But that is intresting you put dopamine terminals 1 and 2...i do know that 2 is used for pleasure, i didnt know that terminal 1 is responsible for psychosis, thanks for the info...:) Maybe they need to make a nueroleptic that only works on terminal 1...maybe that will be more selective and have less side effects of blocking thoughts.
rj
Posted by Christ_empowered on May 9, 2012, at 18:16:27
In reply to Re: Need an AD that works like adderall, posted by rjlockhart04-08 on May 9, 2012, at 14:30:05
I'd avoid neuroleptics. Prozac can be kind of flattening, especially once the start up stimulation has subsided. Provigil, Ritalin, wellbutrin...
What's the issue with your doc avoiding daily adderall? I have a relative who takes Adderall to help with depression...20mgs XR works like a charm. It seems that docs (shrinks, at least) are more comfortable using Provigil or Ritalin/Focalin for sadness than Adderall, but man, those amphetamines will beat the blues for some people, and the doses can be kept fairly low.
Good luck!
Posted by Dinah on May 9, 2012, at 19:54:52
In reply to Re: Need an AD that works like adderall, posted by Novelagent on May 9, 2012, at 14:14:09
I don't think Provigil feels like a stimulant to my mind either. It doesn't give me energy and it doesn't make me anxious. Generally everything the teensiest bit stimulating makes me anxious.
The only difference is that I stay awake. Which is a pretty big difference to me.
On the other hand, my pdoc considers it a stimulant. FWIW.
Posted by phidippus on May 9, 2012, at 22:12:35
In reply to Need an AD that works like adderall, posted by gritslad on May 8, 2012, at 20:05:51
Executive disfunction covers a lot of things from concentration and focus to labile mood. Maybe you have ADHD.
Effexor and Cymbalta both act as reuptake inhibitors on dopamine. Wellbutrin is a full on dopamine enhancer.
Abilify and Seroquel are going to ANTAGONIZE dopamine. Smack down those D2 receptors. They willl probably make you feel befudddled.
Posted by Gritslad on May 12, 2012, at 16:56:05
In reply to Re: Need an AD that works like adderall, posted by Dinah on May 9, 2012, at 19:54:52
You know after reading these posts, I just need to get some Adderall to take as needed. I don't want to go through all the experimentation of finding the right dose of new drugs.A
Posted by novelagent on May 15, 2012, at 0:21:43
In reply to Re: Need an AD that works like adderall, posted by rjlockhart04-08 on May 9, 2012, at 14:30:05
Posted by novelagent on May 15, 2012, at 0:21:59
In reply to Re: Need an AD that works like adderall, posted by rjlockhart04-08 on May 9, 2012, at 14:30:05
> I wrote it doesnt directly release dopamine...I didnt say it didnt release dopamine, I mean the main reason for activation is to have dopamine being somewhat release, as for caffeine ...:) Maybe they need to make a nueroleptic that only works on terminal 1...maybe that will be more selective and have less side effects of blocking thoughts.
>
> rjLatuda. It's not perfect, but most of the side effects come from blocking one dopamine terminal that doesn't need to be blocked, and so yes, they're getting drugs that do this more and more-- Latuda has had the greatest success at not diminishing IQ like the other atypicals, although when I took it, it still caused akathsia (immer restlessness)-- which Dexedrine combats beautifully.
Also, Vyvanse is in Phase II trials for negative symptoms and cognitive impairment in schixophrenia on similar grounds. Shire is presenting a poster this month at the AMA conference highlighting their success so far.
Posted by creepy on May 16, 2012, at 8:06:35
In reply to Need an AD that works like adderall, posted by gritslad on May 8, 2012, at 20:05:51
If you have ADD symptoms you should be able to get a prescription for a stim of some sort.
Tried wellbutrin? Theres also some supplements that can have similar effects, like tyrosine, phenylalanine and l-dopa. Be careful chasing the antidepressant effects of stims, it can lead to escalating doses and tolerance.
Posted by psychobot5000 on May 19, 2012, at 18:42:28
In reply to Re: Need an AD that works like adderallxor and » gritslad, posted by phidippus on May 9, 2012, at 22:12:35
> Effexor and Cymbalta both act as reuptake inhibitors on dopamine. Wellbutrin is a full on dopamine enhancer.
>Neither effexor or cymbalta acts as a dopamine reuptake inhibitor. They are serotonin-noradrenaline reuptake inhibitors, both, with no meaningful effect on the DA transporter. Effexor's action on the noradrenaline transporter is pretty weak, too.
> Abilify and Seroquel are going to ANTAGONIZE dopamine. Smack down those D2 receptors. They willl probably make you feel befudddled.
>Abilify is probably not an optimal choice, here, but it's not a D2 blocker. Rather, it's a partial agonist, meaning its actions are a mix of agonism and antagonism at the D2 receptor. It can be activating for some people, particularly certain depressed folk. Still, as mentioned above, vivactil, desipramine, and wellbutrin are better choices. They don't directly act on the dopamine pathways--more on the noradrenaline system (which adderall/amphetamine actually acts on more than it does the dopamine transporter). They can be helpful for energy, alertness, etc.
Posted by jjjaspar on May 30, 2012, at 9:32:21
In reply to Re: Need an AD that works like adderall, posted by creepy on May 16, 2012, at 8:06:35
Wellbutrin may help. Or, as I learned from someone else whose doctor replaced the the Wellbutrin with supplements, apparently a product called Vital Adapt may do the trick. Rhodiola helps some people, but really, you should be asking a doctor about this. Preferably, the doctor should have taken the extra classes to know integrative or functional medicine as well. Oh and another medication that some people take that gives both stimulating and mood-enhancing effects are provigil and nuvigil. But again, a doctor must prescribe it and monitor it. All have pros and cons. All have their potential benefits and potential dangers.
Posted by creepy on June 7, 2012, at 6:56:26
In reply to Need an AD that works like adderall, posted by gritslad on May 8, 2012, at 20:05:51
If you are ADD and the doc wont prescribe the adderall, you could try to work with them to try methylphenidate, vyvanse or some NRI's like strattera and desipramine.. or wellbutrin.
Otherwise Id see another doc. Some are just brainwashed by the anti-drug folks into thinking everyone is an addict. Or their liability insurance is sky-high. Some of us have a legit need for these medications and use them responsibly.
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