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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by linkadge on July 5, 2021, at 17:20:27
My phenylethylamine (PEA) arrived today. I took a very small quantity (as it was later in the day) perhaps 5-10mg. I am not taking an MAOI per-se, but may have some MAO-B inhibition via the herbs I take.
There was definitely an effect. It seemed to cause some visual brightness and alertness and improvement in mood. I had a sudden urge to go for a run.
I will report back after some more trials.
I understand that you need to be careful with this supplement.
Linkadge
Posted by linkadge on July 5, 2021, at 17:22:29
In reply to PEA arrived today, posted by linkadge on July 5, 2021, at 17:20:27
Just to add. I had some PEA from another supplement called "Brain Boost". It contained 90mg of PEA from AFA blue green algae. Although, AFA contains other trace amines as well. This is why I ordered some pure PEA to see the difference.
Posted by rjlockhart37 on July 5, 2021, at 17:52:18
In reply to PEA arrived today, posted by linkadge on July 5, 2021, at 17:20:27
link i've tried PEA, it has a mood lift but what i wanted to tell you is there's something called D-L phenylanine, it produces endorphins and increaes synthisis of dopamine and norepinephrine. It's similar to PEA. Try to check it out online google, it's an amino acid.....
Posted by undopaminergic on July 6, 2021, at 7:27:22
In reply to Re: PEA arrived today, posted by rjlockhart37 on July 5, 2021, at 17:52:18
> link i've tried PEA, it has a mood lift but what i wanted to tell you is there's something called D-L phenylanine, it produces endorphins and increaes synthisis of dopamine and norepinephrine. It's similar to PEA. Try to check it out online google, it's an amino acid.....
>L-phenylalanine is the metabolic precursor of PEA, through decarboxylation. Through hydroxylation, it is also a precursor of tyrosine, which is the precursor of L-dopa, which is of course the precursor of dopamine.
If I recall correctly, D-phenylalanine may inhibit the metabolism of some endogenous opioid.
-undopaminergic
Posted by linkadge on July 6, 2021, at 7:31:36
In reply to Re: PEA arrived today, posted by undopaminergic on July 6, 2021, at 7:27:22
Yeah, D-phenylalanine is an enkephalinase inhibitor, which would increase the levels of endorphin.
I have tried l-phenylalanine which was helpful, but I haven't tried d-phenylalanine.
I get a significant boost from exercise, so I wondered to what extent PEA was involved.
Linkadge
Posted by SLS on July 6, 2021, at 11:14:25
In reply to Re: PEA arrived today, posted by linkadge on July 5, 2021, at 17:22:29
> Just to add. I had some PEA from another supplement called "Brain Boost". It contained 90mg of PEA from AFA blue green algae. Although, AFA contains other trace amines as well. This is why I ordered some pure PEA to see the difference.
That sounds encouraging. You might consider taking it in the background while you continue searching for complementary drugs that work synergistically with PEA. When I first started adding Lamictal, I felt a great antidepressant response. However, it waned after a week or so, but it did not stop working completely. Lithium definitely didn't make me feel worse. Because the purported mechanisms of action of Lamictal are so different from anything else, I thought I would keep taking it in the "background" at 300 mg/day while trying other treatments. When I first added lithium to Parnate and Lamictal about 10 years ago, I experienced a significant improvement after my very first dose of lithium at 150 mg. I continued, and went up to 300 mg/day and remained happy with what that dosage. When I increased lithium to 450 mg/day, my response had been reversed. Lithium at 450 mg/day made my depression worse, and included a sort of apathy and lack of creativity.This was pure empirical observation. My response to lithium follows a bell-shaped curve. Perhaps not so coincidentally, scientists found that the effect of lithium on glutamate concentrations in the hippocampus also follows a bimodal (biphasic) pattern.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438538/
In the past, my greatest degree of response came from a combination of TCA + MAOI. A robust remission was achieved using a combination of Parnate + desipramine. However, in retrospect, I realized that there was residual anhedonia. The response I glean from Nardil + nortripyline is broader, and produces a more "pleasant" state of mind, and the anhedonia all but disappeared (MAO-A)?
I experienced several severe, delusional manias in association with MAOIs. This is the diagnostic qualifier that determines my diagnosis being Bipolar Disorder, even though I never experienced a single manic episode without some sort of biological intervention.
I chose to continue with low-dosage lithium, despite my being dubious that it was necessary for my improvement in depression. However, for over 15 years, scientists have reported a lower risk of contracting Alzheimer's Dementia in people who take very low dosages of lithium.
For me, the choice to continue taking lithium at 300 mg/day was obvious.
- Scott
Posted by jay2112 on July 7, 2021, at 18:11:33
In reply to Re: PEA arrived today, posted by SLS on July 6, 2021, at 11:14:25
(Linkadge...I am sorry for hijacking your thread..lol)
> > Just to add. I had some PEA from another supplement called "Brain Boost". It contained 90mg of PEA from AFA blue green algae. Although, AFA contains other trace amines as well. This is why I ordered some pure PEA to see the difference.
>
>
> That sounds encouraging. You might consider taking it in the background while you continue searching for complementary drugs that work synergistically with PEA. When I first started adding Lamictal, I felt a great antidepressant response. However, it waned after a week or so, but it did not stop working completely. Lithium definitely didn't make me feel worse. Because the purported mechanisms of action of Lamictal are so different from anything else, I thought I would keep taking it in the "background" at 300 mg/day while trying other treatments. When I first added lithium to Parnate and Lamictal about 10 years ago, I experienced a significant improvement after my very first dose of lithium at 150 mg. I continued, and went up to 300 mg/day and remained happy with what that dosage. When I increased lithium to 450 mg/day, my response had been reversed. Lithium at 450 mg/day made my depression worse, and included a sort of apathy and lack of creativity.
>
> This was pure empirical observation. My response to lithium follows a bell-shaped curve. Perhaps not so coincidentally, scientists found that the effect of lithium on glutamate concentrations in the hippocampus also follows a bimodal (biphasic) pattern.Hi Scott:
Your story sounds so, so very encouraging! I honestly am happy for you, because you have given *so* much to this board since the beginning! It takes true bravado to tackle mental illness with such creativity, and you always backup your findings with very sound science.
Coincidentally, I think I buried this in my last post, but I actually started nortriptyline, as your mention of a positive response with it and Nardil gave me the impetus. I was *really* hurting, almost to the point of hospitalization, and when I read your use with it (nortriptyline), I had recalled many years ago how it provided me such a full, robust response, in combination with fluoxetine. But, fluoxetine turned out to not provide much benefit for me. Fast forward to today, and I am on 225mg's of venlafaxine, after going all the way up to 450mgs, with nothing but side-effects. I am BP2, with a major tendency towards deep, intense depression. And, venlafaxine still was leaving me down...the bottom of hell..lol. At 225mgs, venlafaxine mainly is a serotogenic med. So, I got nortiptyline from my pdoc, combined with 225mg of venlafaxine, and knock on wood, both my anxiety and depression have greatly receded...for the first time since...well when I was last on nortriptyline! I have been on 25mg's for a few weeks, and am going to possibly push to 50mg next week. Oh...and I also take a small dose of risperidone, as it's strong 5-ht2c antagonism seems to work very smoothly in reducing my sensitivity to serotonin.
I worry a bit about aging and the anticholinergic properties of nortriptyline, but from my experience with cholinergic nootropics, I responded very badly to any type of choline supplement. So, my hypothesis is that, as the research mentions, hyper-cholinergic activity has many co-relations to depression and anxiety. Plus, nortriptyline has been shown to increase, ontopic (lol), PEA, as well as other smaller neurochemicals. I may also try supplemental PEA, as a bonus.
>
>
> In the past, my greatest degree of response came from a combination of TCA + MAOI. A robust remission was achieved using a combination of Parnate + desipramine. However, in retrospect, I realized that there was residual anhedonia. The response I glean from Nardil + nortripyline is broader, and produces a more "pleasant" state of mind, and the anhedonia all but disappeared (MAO-A)?I'd love to try a traditional MAOI, but am honestly holding up quite good...and my anhedonia, as well as my aggravated grief (and self-injurious intrusive thoughts) have faded away, as well. I still have a good cry once in awhile, and it feels good to do so, and the sexual dysfunction and metabolic effects are a bit of a pain in the butt, but exercise and Viagra help. And, my pdoc is open to the idea of an MAOI, so if I do end up back in my vegetative state, I have another option. And, I also take lamotrigine, which seems to even me out, once the hell-bottom depression and anxiety are looked after.
> I experienced several severe, delusional manias in association with MAOIs. This is the diagnostic qualifier that determines my diagnosis being Bipolar Disorder, even though I never experienced a single manic episode without some sort of biological intervention.
>
> I chose to continue with low-dosage lithium, despite my being dubious that it was necessary for my improvement in depression. However, for over 15 years, scientists have reported a lower risk of contracting Alzheimer's Dementia in people who take very low dosages of lithium.
>
> For me, the choice to continue taking lithium at 300 mg/day was obvious.
>
>
>
> - ScottI'd love to go back on my 300mg's a day lithium, but unfortunately I have kidney disease. Even in low doses, I nearly die from direct pain in my kidney area. I have gone into spasms of pain from my kidneys due to taking lithium. Plus I get intense pruitis (which is a symptom of kidney failure) and nausea so bad I used to throw up blood. (I had it all checked out, though. No cancer or anything...) Plus, my creatine levels would be through the roof when I took lithium.
So, my doctor said *absolutely not* to the stuff. I am checking into small dose lithium orotate, though.Thanks kindly,
Jay
Posted by linkadge on July 8, 2021, at 6:43:04
In reply to Re: PEA arrived today » SLS, posted by jay2112 on July 7, 2021, at 18:11:33
Hi Jay,
Yeah, I could never get that high on venlafaxine. I found 75mg very hard to tolerate. Interestingly, I found nortriptyline helpful too. Unfortunately, I stopped it (for some stupid reason and relapsed).
From my research, nortriptyline is much better for depression that is accompanied by inflammation. I think nortriptyline can reduce microglia inflammation. Venlafaxine just feels like it is putting a large wall between me and my emotions. Interestingly too, venlafaxine gives me way more heart palpitations and chest tightness than nortriptyline which doesn't make sense 'on paper'.
I have some alternatives that have been helping me lately:
- agmatine
- PEA / licorice
- magnets
- cyproheptadine
- peppermint extract
- belladonna extract (careful with this one)
Linkadge
Posted by undopaminergic on July 9, 2021, at 4:21:53
In reply to Re: PEA arrived today, posted by SLS on July 6, 2021, at 11:14:25
>
> I experienced several severe, delusional manias in association with MAOIs. This is the diagnostic qualifier that determines my diagnosis being Bipolar Disorder, even though I never experienced a single manic episode without some sort of biological intervention.
>I wouldn't classify it as bipolar if it were purely in response to drugs. On the other hand, maybe it *would* warrant a "bipolar approach" to medication, so as to avoid drug-induced episodes of mania.
-undopaminergic
Posted by undopaminergic on July 9, 2021, at 4:56:09
In reply to Re: PEA arrived today » jay2112, posted by linkadge on July 8, 2021, at 6:43:04
>
> I have some alternatives that have been helping me lately:
>
> - cyproheptadine
> - belladonna extract (careful with this one)You know this, but both of them are anticholinergic (antimuscarinic), so maybe that is a particularly useful approach for you. Incidentally, cyproheptadine is a serotonin 5-HT2A antagonist, which is used as an antidote to serotonin syndrome. It shares this action with mirtazapine, which you said you were also taking, so that might be another key mechanism for you. Additionally, maybe this serotonin antagonism could allow you to tolerate higher doses of serotonergic drugs.
-undopaminergic
Posted by SLS on July 9, 2021, at 22:19:20
In reply to Re: PEA arrived today » jay2112, posted by linkadge on July 8, 2021, at 6:43:04
> Hi Jay,
>
> Yeah, I could never get that high on venlafaxine. I found 75mg very hard to tolerate. Interestingly, I found nortriptyline helpful too. Unfortunately, I stopped it (for some stupid reason and relapsed).I am SO sorry, Linkadge. You couldn't have known.
So many psychiatrists still adhere to a protocol of a time-limited course of antidepressant therapy. Some psychiatrists change someone's treatment regime on the patient's very first visit, even if they are doing well. I'm not sure that adhering to a "school of thought" is always in the patient's best interests. Both diagnosis and treatment need to be flexible in mental illness. The brain is just too complex to be treated by a monolithic school of thought. "Life charting" sometimes finds a pattern.
A friend of mine who suffered from chronic depression for years finally achieved remission and remained well for about 8 years. The only drug she was taking was lithium. When she moved from North Carolina to California, she found a local psychiatrist. The first thing he said was that she was on lithium long enough and that he wanted her to discontinue it. She did. Three weeks later, she relapsed. When the lithium was restarted, it didn't work at all. It couldn't "recapture" the antidepressant response. She descended into a severe and treatment resistant depression that has lasted for 32 years so far. My guess is that she has a bipolar diathesis, despite her unipolar presentation. Some diagnostic models include depression-only as a subtype of bipolar disorder. With all of the focus and advertisements for Latuda to treat bipolar depression, they never mention mania. I wonder just how common depression-only bipolar disorder really is - where not a single manic episode has occurred.
My presentation is of a chronic severe (treatment-resistant) depression with no history of spontaneous mania. However, I have been severely delusionally and/or psychotically manic as a reaction to taking medication on a handful of occasions. All of them were in association with an MAOI - both Parnate and Nardil. This presentation is described in the DSM-5 as being bipolar with drug-induced mania as a qualifier.
Right now, I'm having trouble maintaining an optimal antidepressant response to Nardil at any one dosage. I might be forced to take 90 mg/day on most days with taking 105 mg/day twice a week. My doctor has another patient that did this with. I have never read nor heard anything indicating that there was a dosage window for Nardil as there is for nortriptyline. I actually lose a qualitatively robust response when I remain at 105 mg/day for longer than 5 consecutive days. Overall, my conscious experience is dramatically different in some ways and very familiar in others. It has changed my life. It is now fun to participate with others and be in control in almost all situations. I don't really have that many years left at this point. I know 61 sounds young by modern standards, but my adolescence and adulthood were stolen from me. They didn't exist but for both pain and numbness every waking moment. Your stories are probably not much different.
At age 61, I am absolutely blessed to be able to spend any time at all in my life experiencing a normal human state of conscious. For some reason, no one uses the phrase "an altered state of consciousness" to describe mental illness. I have for quite awhile. My doctor hasn't warmed up to the idea yet. I have become adamant in my use of this phrase. It adds a realness to how the mentally ill experience existence. Being intoxicated with alcohol is a purposeful alteration in one's state of consciousness. It is manifestly true. The strategic use of words can help mitigate stigma and promote understanding.
Does anyone else find the phrase "altered state of consciousness" to be an accurate characterization of their illness?
I think I can now live out my years with intellectual and emotional exploration, adventure, and lots of sex. However, this does not come without a sense of guilt. I wish I could take you all along with me.
- Scott
Posted by undopaminergic on July 10, 2021, at 5:46:31
In reply to Re: PEA arrived today » linkadge, posted by SLS on July 9, 2021, at 22:19:20
>
> Does anyone else find the phrase "altered state of consciousness" to be an accurate characterization of their illness?
>Yes, it *is* an altered state of consciousness, but I don't use the phrase, for whatever reason. I sometimes talk about "depressive thinking" or "it's the depression speaking".
-undopaminergic
Posted by SLS on July 11, 2021, at 8:37:39
In reply to Re: PEA arrived today, posted by undopaminergic on July 10, 2021, at 5:46:31
> >
> > Does anyone else find the phrase "altered state of consciousness" to be an accurate characterization of their illness?
> >
>
> Yes, it *is* an altered state of consciousness, but I don't use the phrase, for whatever reason. I sometimes talk about "depressive thinking" or "it's the depression speaking".
>
> -undopaminergic
>I would be curious to know how your doctor reacts to your using that term?
I think using the term "altered state of consciousness" is valuable. Number one, it's a fact. Number two, it brings non-sufferers closer to understanding how you experience life. It also demonstrates the autonomous nature of psychobiological brain disorders.
"Depression" is too generic a word to describe the phenomenology of what you and I suffer from. When describing the illnesses that we suffer from, "depression" - Major Depressive Disorder or Bipolar Depression - are disorders devoid of any attempt to categorize their etiologies.
- Scott
Posted by undopaminergic on July 11, 2021, at 10:12:17
In reply to Re: PEA arrived today, posted by SLS on July 11, 2021, at 8:37:39
> > >
> > > Does anyone else find the phrase "altered state of consciousness" to be an accurate characterization of their illness?
> > >
> >
> > Yes, it *is* an altered state of consciousness, but I don't use the phrase, for whatever reason. I sometimes talk about "depressive thinking" or "it's the depression speaking".
> >
> > -undopaminergic
> >
>
> I would be curious to know how your doctor reacts to your using that term?
>I'm afraid the phrase is not the same after I translate it.
> I think using the term "altered state of consciousness" is valuable. Number one, it's a fact. Number two, it brings non-sufferers closer to understanding how you experience life.
>It leads me to think of psychedelic drugs. I don't think that's a good description of how depression makes me feel.
Maybe I'd say it's an "altered perspective on life/reality". You could also say it is much the opposite of what the phrase "rose-tinted glasses" means.
> It also demonstrates the autonomous nature of psychobiological brain disorders.
>
> "Depression" is too generic a word to describe the phenomenology of what you and I suffer from. When describing the illnesses that we suffer from, "depression" - Major Depressive Disorder or Bipolar Depression - are disorders devoid of any attempt to categorize their etiologies.
>Yes, but I don't see how your advocated phrase addresses etiology either, unless maybe if you mean that the altered state of consciousness is the source of the disorder rather than a manifestation of it.
-undopaminergic
Posted by SLS on July 11, 2021, at 11:44:16
In reply to Re: PEA arrived today, posted by undopaminergic on July 11, 2021, at 10:12:17
I know about the association of "altered state of consciousness" with LSD and psychedelics. I just felt that the term was generic enough to be an accurate descriptor for depression and other mental illness. Being intoxicated when using alcohol or marijuana produces altered states of consciousness. The medical descriptor "altered mental status", or "altered" for short, is a medical term to describe changes in mental status.
I intend to use the term extensively on behalf of all of us. I think it might be a good stigma-killer. Not only that, but it should also foster empathy in addition to understanding.
I have had success in using the term to convey to unaffected individuals the phenomenology of depressive disorders.
- Scott
Posted by sigismund on July 11, 2021, at 20:31:07
In reply to Re: PEA arrived today » undopaminergic, posted by SLS on July 11, 2021, at 11:44:16
Opiates or gabapentin occurred to me rather than psychedelics. That is to say after taking low doses of the first two I feel willing and able to do things rather than cringing inside myself.
This is the end of the thread.
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