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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by krybrahaha78 on February 25, 2006, at 13:55:55
Are there any alternative meds i can try to augment the luvox im on?
Posted by krybrahaha78 on February 25, 2006, at 13:55:56
In reply to alternative meds to augment ad's, posted by krybrahaha78 on February 21, 2006, at 13:41:56
For example: St john wort or Trytophan? ---any suggestions?
> Are there any alternative meds i can try to augment the luvox im on?
Posted by vainamoinen on February 25, 2006, at 13:55:56
In reply to Re: alternative meds to augment ad's, posted by krybrahaha78 on February 21, 2006, at 13:44:02
I have tried St Johns wort and 5HTP. The SJW I found completely ineffective except that it did make me sensitive to sunlight which is a well documented side effect.
The 5HTP was very helpful especially with sleep at first but pooped out in a few months. Who knows it might work better for you.
I think most people her are going to suggest a more traditional approach like...
Possibly another antidepressant with a different mechanism of action like Wellbutrin or Remeron.
Or an old school tricyclic antidepressant like imipramine.
Or maybe low dose Lithium?
Posted by blueberry on February 25, 2006, at 13:55:56
In reply to alternative meds to augment ad's, posted by krybrahaha78 on February 21, 2006, at 13:41:56
Here are some ideas, if you don't mind reading for a couple minutes...
You might want to consider things that do more than just raise serotonin. If that mechanism alone was going to help a lot, luvox would probably already be doing that. Maybe take a look at things that affect dopamine and norepinephrine.
St Johns Wort is a reuptake inhibitor of serotonin, dopamine, norepinephrine, gaba, and glutamate. To avoid excess serotonin, you would want to start low like maybe 150mg for a week and then increase by 150mg per week up to maybe 600mg. With its lag time and slow titration, it would probably be 6 to 8 weeks before you knew how much you liked it or not. Though much literature and most doctors would warn against it, my doctor says it is a good combination and is being used. SJW's track record from trials is generally about the same as other antidepressants, sometimes better. In one trial with major depression it was ineffective, but then, so was the zoloft it was being compared to.
Rhodiola rosea. It prevents the breakdown of serotonin, dopamine, and norepinephrine, and also stimulates the release of them, and helps support the adrenal glands. Unlike SJW, rhodiola can have an effect beginning the first day. Trials were mostly on the other side of the world, so there isn't much literature here. Though the trials were not as scientifically controlled as ours are, they did look pretty good.
If you are looking for stimulation and energy and support for the adrenal glands, then take a look at combination panax ginseng and siberian ginseng. The more relaxing ashwaganda is another type of ginseng that goes well with the others.
Sometimes ginkgo biloba can be helpful, but mostly I don't personally think it would make any huge difference.
Here is an odd one, but it can work. Pycnogenol, in addition to its powerful antioxidant effect, somehow controls the enzymes that breakdown dopamine and norepinephrine. It is being used with modest success in replacing ritalin in ADD.
Vinpocetine, viagra for the brain, an extract from the periwinkle plant, steps up energy in the brain, increases brain circulation, and stimulates the noradrenergic system.
Sorry to go so long here. Any of these are decent possibilities. I would stay away from 5htp, because I just really don't think more serotonin all by itself is going to make any dramatic difference. There are actually plenty of other alternatives, but these were simply my personally biased top picks.
I would start with rhodiola, simply because it works fast if it is going to work, and it has successfully been combined with antidepressants in a hospital setting. Next would be SJW. You could add the ginsengs in any time. They are healthy and protective against the bad effects of stress for both us ill people and healthy people.
And of course, lots of vitamins and minerals, and go especially heavy on the Bs, C, zinc, and chromium. And as much fish oil as you can handle.
In the pharmaceutical world, options for starters might include wellbutrin, remeron, or zyprexa.
Posted by vainamoinen on February 25, 2006, at 13:55:56
In reply to Re: alternative meds to augment ad's, posted by blueberry on February 21, 2006, at 15:31:49
Ahhh yes, I forgot about fish oil. That did work exceptionally well for me. I was able to reduce to 10mg of Prozac a day from 60 mg. I took six grams of fish oil a day, only side effect was...well there were none. Maybe a fishy burp occasionally.
SAMe is worth a try although its quite expensive and not much bang for the buck. Folate, folic acid supplements.
Also, a ketogenic diet was helpful for me. I think I read that it downregulates certain receptors in the long term.
Exercise and lots of bright natural light are helpful IMO. Ah...California sunshine.
Posted by jakeman on February 25, 2006, at 13:55:56
In reply to alternative meds to augment ad's, posted by krybrahaha78 on February 21, 2006, at 13:41:56
You may want to include folic acid in your regimen and B-12. There's some old posts about this you may want to check (thanks to Larry H.)
http://www.psychologytoday.com/articles/pto-20030305-000002.html
warm regards ~Jake
Posted by Phillipa on February 25, 2006, at 13:55:56
In reply to Re: alternative meds to augment ad's, posted by jakeman on February 21, 2006, at 19:11:15
My Thread came from the same source. Fondly, Phillipa
Posted by tizza on February 25, 2006, at 13:55:56
In reply to Re: alternative meds to augment ad's » jakeman, posted by Phillipa on February 21, 2006, at 20:22:54
While I was on luvox my pdoc tried zyprexa, seroquel and epilim but none of them help me, they made me worse. He was desperate to keep this drug working for me but alas it didn't and I was sick of taking so many pills. I suppose trial by error is the only way because everyone is so different, good luck, I hope you find something that works for you.
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