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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by James (I do a mean Elvis though . . ) on October 7, 2000, at 10:46:02
Yo!,
I'm not sure where to start, it seems I've struggled with this problem for quite some time.
I was diagnosed with ADD about 8 months ago, and prescribed Adderall to mitigate the symptoms, which it did beautifully and heartily at first, but over time became nearly useless as a pharmacological agent. Indeed, the depression and lethargy induced by only half of my initial dose has led to my abstinence.
However, the medicine changed my life so greatly, and, until now as I may be switching doctors, my doctor decided against Ritalin when the Adderall lost its efficacy. With my comparitevely elementary psychiatric insight, as much as I can, I disagree with this, as it has been thought (what in science is known beyond doubt?) that Ritalin and Adderall act through different pharmacological mechanisms, viz., methylphenidate on vesicle NT, and Amphetamine on Cytoplasmic NT.
So, do make a long story short and painful, I ventured out on my own to rectify whatever caused the Adderall to fail, though I had no idea what it was, and still don't- though I have many ideas.
My first step, after learning the basics, was the most obvious assuming Taxyphyliasis(sp?) as the culprit, viz., I procured an Anti-Parkinsonian agent (L-DOPA with a peripheral decarboxylase inhibitor), in an attempt to replase depleted NT. This worked briefly, however, soon thereafter I experienced the most potent depression, lethargy, and slowness of movement commonly ascribed to psychostimulant overdose, or at least a dosage to strong. After consideration, I believe that this depression or general placidness follow exactly the symptomology of Parkinson's Disease. Therefore, I now seek to show, as I am not sure of my idea's validity, that the Parkinson's-like symptoms of stimulant excess are caused by Striatal inhibition of DA transmitter, via the post-synaptic DA autoreceptors.
I will study this, in one of my more foolish ventures, with DS-121: a DA autoreceptor antagonist. It is my hope that the de-inhibition of striatal DA transmitter will restore the efficacy of the mixed Amphetamine salts combined with the L-DOPA. Somehow, I believe with due reservation, I've come to know the difference between cortial and striatal stimulation, as I usually have some sort of hyper-mild headache in absence of cortical stimulation.
I have many more ideas other than these, and not only limited to Adderall, which are in part listed on my website: http://eccentrix.com/misc/madscientist.
However, my question is thus: Are my efforts merely reliving the progression of someone's past folly, that is, has someone already attempted what I am about to attempt with failure. I can hardly think so, since DS-121 is a new agent. I can supply a technical sheet to someone if they desire and are interested in this agent. (myfriendharvey2@hotmail.com)
I would appreciate any opinions on my endeavours: something I overlooked or am ignorant of, just in case.
Thanks!
Rock On,
-James
P.S.- I know I'm not a doctor, etc., etc., but mine is an act of desperation, not an act of carefully weighed consequence.
Posted by CarolAnn on October 7, 2000, at 16:52:23
In reply to I need help playing doctor . . ., posted by James (I do a mean Elvis though . . ) on October 7, 2000, at 10:46:02
James, did you try Adderall again after being off it for a while? My doctor advised me to stop taking it for five days whenever it stopped helping. It never comes back as strong as it did during the first couple months, but after several days off I do feel some improvement again.
Also, if you find out anything interesting, would you mind posting it here? There are quite a few people, besides me, who take Adderall and would like any additional info we can get. Thanx! CarolAnn
Posted by James (I do a mean Elvis though . . ) on October 8, 2000, at 14:15:03
In reply to Re: question » James (I do a mean Elvis though . . ) , posted by CarolAnn on October 7, 2000, at 16:52:23
Hi Carol!
I've waited up to three weeks in regards to the Adderall, with some effect, but certainly not the one initially found in the first two months of treatment. Wouldn't it be wonderful if there was a way to keep that up, to erase everything bothersome in ADD?
Anyways, I should have results of this new agent within the month, as I am fairly assured that, given the novelty of this agent, both in time and property, it has not been studied in ADD/ADHD subjects. I will certainly let everyone know if it works, however, one persons subjective experiments cannot be referenced as a posit of any rigour. I can still try!
Thanks,
-James
check out my page, too, as I will update that if anything new comes about
http://eccentrix.com/misc/madscientist
Posted by JohnL on October 10, 2000, at 5:04:54
In reply to I need help playing doctor . . ., posted by James (I do a mean Elvis though . . ) on October 7, 2000, at 10:46:02
James,
Interesting and well thoughtout. I do not have a grasp of the technical expertise you display, but I would suggest in simple terms that what you have experienced is the not-so-uncommon build up of tolerance to the medication's effects. Why that happens, I think you understand better than I.I do know of a couple medications however that can do much the same thing as stimulants, except without the tolerance buildup. Unfortunately your doctor won't know about them or be able to prescribe them. That's because they are widely used throughout the world, but not in the USA. The two medications are Amisulpride and Adrafinil.
Amisulpride blocks presynaptic D2 receptors at low doses and stimulates dopamine function. Except over time there is no tolerance buildup, usually (not always). But usually. Adrafinil is an alpha-1 agonist. There is some debate at this board as to whether that's actually what it is or not, but all literature including the manufacturer's insert says it is.
These two meds I discovered after years and years of being disappointed with dozens of other meds my doctors tried on me. I have tried Ritalin, Adderall, and Modafinil, so I do have some experience to compare. Either Amisulpride or Adrafinil can work to:
-Cure depression, especially the apathetic anhedonic blah type
-Increase vigilance and interest in life
-Increase motivation
-Increase focus and concentration
-Increase mental functionIn my own experience with these meds, they are outstanding for treating depression and ADD or ADHD symtoms or any combination of them. How or why I don't know. I just know they work. I've discovered over time that often our best thoughtout explanations and theories don't pan out in reality anyway, so I go by results instead.
It's a totally different arena, ordering your own medications from abroad, and not having to see a doctor. It takes some getting used to. And it's definately not an option for someone who doesn't know what they're doing. But you sound like you are well aware of things. That's why I mention these options to you.
John
Posted by JohnL on October 10, 2000, at 5:59:59
In reply to I need help playing doctor . . ., posted by James (I do a mean Elvis though . . ) on October 7, 2000, at 10:46:02
Though my previous post focused on offshore med options, here is some interesting info to ponder concerning USA meds...
These are statistics of what worked completely on symptoms of your diagnosis in one doctor's offic. N=41. It shows what percentage of the population was cured by which med class. Granted the population was small. But what deserves notice is that certain meds worked completely even when there was no clinical justification that they should have.
Stimulants 49%
Norepinephrine antidepressants 7%
Dopamine antidepressant 2%
Serotonin antidepressant 10%
Mixed antidepressants 5%
GABA (benzos) 17%
Antipsychotic 15%
Lithium 12%
Tegretol 10%
Depakote 5%
Thyroid 26%
Blends of the above 35%
Stimulant required antipsychotic 25% of the timeOther notes:
Even though Ritalin and Adderall are the most common choices, there are other less common choices that have just enough molecular difference to be perfect fits. Such as Ionamine or Tenuate. And of course Cyclert.My last pdoc was outstanding. Recently retired though. But he had decades of expertise, going all the way back to the days before antidepressants were even invented. His favorite ways to restore, or 'stabilize' stimulants?....addition of small dose Lithium; and if not helpful, then addition of small dose antipsychotic. Both just so happen to fit into the statistics above. Hmmm.
Anyway, thought this might be interesting.
John
This is the end of the thread.
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