Psycho-Babble Medication Thread 311776

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psychotic on ritalin, not on caffeine

Posted by linkadge on February 10, 2004, at 16:09:43

I understand that caffeine and ritalin work in through different mechanisms, but I had a psychotic reaction to ritalin, but I can tolerate 10 cups of coffee a day. In fact ritalin depresses me, makes my mood very dark and serious, coffee does not do the same thing.

Linkadge

 

Re: psychotic on ritalin, not on caffeine linkadge

Posted by Chairman_MAO on February 10, 2004, at 17:19:32

In reply to psychotic on ritalin, not on caffeine, posted by linkadge on February 10, 2004, at 16:09:43

Caffeine increases NE release through an indirect mechanism (adenosine antagonism), and then causes some DA release because of NE/DA co-release. It is worthy of mention that benzos increase adenosine activity, as does l-theanine.

Ritalin is a potent reuptake blocker of NE and DA, a completely different world than caffeine's [utterly lame] psychostimulant mechanism.

BTW, 10 cups of coffee a day is quite toxic for your body over time; it inhibits the release of vasopressin, thereby preventing the proper storage of water in your body EVEN IF YOU DRINK MORE TO COMPENSATE. Ritalin has much more potent CNS effect than peripheral effect, so it is much less dehydrating per unit of stimulation.

 

Re: psychotic on ritalin, not on caffeine

Posted by linkadge on February 10, 2004, at 17:55:07

In reply to Re: psychotic on ritalin, not on caffeine linkadge, posted by Chairman_MAO on February 10, 2004, at 17:19:32

Well just to provide a little counter argument :)

It has well been shown in animal studies that tolerance to the stimulant effect of ritalin/ampetamines does occur over time. Ritalin is not a compelte reputake inhibitor, it does cause a dose dependant release of ne and dopamine as well.

Also, coffee has a statistically significant anti-suicide effect, that has not been proven to be shared by any of the stimulants. Adenosne inhibition also has antianxiety effect not shared by the stimulants.

It is noteworthy to mention that chronic use of classic stimulants at high doses leads to downregulation of the D2 receptor which mirrors a clinical model of schitsophrenia.

Coffee has an antiparkinsons/anticancer/antialheimer's effect that has also not shared by the classic stimulants.

For somebody like me, who does not have true ADD, coffee will suffice.

Linkadge


 

Re: psychotic on ritalin, not on caffeine linkadge

Posted by Chairman_MAO on February 10, 2004, at 20:54:49

In reply to Re: psychotic on ritalin, not on caffeine, posted by linkadge on February 10, 2004, at 17:55:07

> It has well been shown in animal studies that tolerance to the stimulant effect of ritalin/ampetamines does occur over time.

Yes, some degree of tolerance occurs to certain effects of any drug. Up to 60mg of d-amphetamine a day is quite safe as a mood brightener and psychomotor stimulant for anyone that does not suffer from or is predisposed to a serious psychiatric disorder. Tolerance to coffee also occurs; anything that changes the way our brains use ATP and increases NE release the way coffee does is bound to tolerance.


Nihon Shinkei Seishin Yakurigaku Zasshi. 2000 Nov;20(5):223-31.


Caffeine as a model drug of dependence: recent developments in understanding caffeine withdrawal, the caffeine dependence syndrome, and caffeine negative reinforcement.

Griffiths RR, Chausmer AL.

Department of Psychiatry, Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA. rgriff@jhmi.edu

Caffeine is an excellent model compound for understanding drugs of abuse/dependence. The results of self-administration and choice studies in humans clearly demonstrate the reinforcing effects of low and moderate doses of caffeine. Caffeine reinforcement has been demonstrated in about 45% of normal subjects with histories of moderate and heavy caffeine use. Recent studies provide compelling evidence that caffeine physical dependence potentiates the reinforcing effects of caffeine through the mechanism of withdrawal symptom avoidance. Tolerance to the subjective and sleep-disrupting effects of caffeine in humans has been demonstrated. Physical dependence as reflected in a withdrawal syndrome in humans has been repeatedly demonstrated in adults and recently demonstrated in children. Withdrawal severity is an increasing function of caffeine maintenance dose, with withdrawal occurring at doses as low as 100 mg per day. Increased cerebral blood flow may be the physiological mechanism for caffeine withdrawal headache. Case studies in adults and adolescents clearly demonstrate that some individuals meet DSM-IV diagnostic criteria for a substance dependence syndrome on caffeine, including feeling compelled to continue caffeine use despite desires and recommendations to the contrary. Survey data suggest that 9% to 30% percent of caffeine consumers may be caffeine dependent according to DSM-IV criteria.

Eur J Clin Pharmacol. 1991;40(3):273-8.

Effects of caffeine with repeated dosing.

Denaro CP, Brown CR, Jacob P 3rd, Benowitz NL.

Department of Medicine, University of California, San Francisco.

We have recently demonstrated dose-dependency of caffeine metabolism under multiple dosing conditions. Whether there are persistent pharmacodynamic actions of caffeine under such circumstances is the focus of this report. Nine healthy subjects were given, in randomized 5 day blocks, placebo, 4.2 (low) and 12 (high) mg.kg-1.day-1 of caffeine in 6 divided doses. After 5 days, complete tolerance developed to the effects of caffeine on blood pressure, heart rate and plasma glucose concentrations. The 24-h area under the curve (AUC) for plasma norepinephrine and the AUC for the total sum of free fatty acids (FFA) both demonstrated a trend to increase with the high dose caffeine treatment. When the AUC for norepinephrine was split into 12 h time periods, a significant difference between the placebo and the high dose treatment block was seen. We conclude that regular consumption of 12 mg.kg-1 of caffeine per day (equivalent to approximately 6 to 11 cups of coffee per day) may produce pharmacodynamic effects not completely compensated for by the development of tolerance. Mechanisms of tolerance may be overwhelmed by the nonlinear accumulation of caffeine and other methylxanthines in the body when caffeine metabolism becomes saturable.

This corresponds roughly to the ~300-400mg/day generally considered to be the maximum amount of caffeine anyone should take in per day. At 10 cups of coffee day, you are most likely doing a number on your esophagus--do you take any antacid medication to compensate for this? ;)
The dehydration at your dosage is also extreme, at least as bad as sane doses of methylphenidate/amphetamine, and I'll bet that it's worse.

NOTE: There is a little-known (because caffeine is a social institution) term called "caffeineism", just like alcoholism. It's a DSM-IV disorder. Check out this page:

http://www.acnp.org/g4/GN401000165/CH161.html

If you want I'll find out more about caffeine and ATP, I have some references stashed away somewhere.

>Ritalin is not a compelte reputake inhibitor, it does cause a dose dependant release of ne and dopamine as well.

But does this effect occur at clinically relevant dosing conditions ... ? I don't know.

> Also, coffee has a statistically significant anti-suicide effect, that has not been proven to be shared by any of the stimulants.

It hasn't been proven, yes, but then again, who's going to fund a study showing that SPEED used by healthy controls ILLICITLY has an anti-suicide effect? I'll bet you could find many people who'd tell you that stimulants make it a lot easier for them to feel life is worth living.

J Clin Psychiatry. 2000 Jun;61(6):436-40.


Effects of dextroamphetamine on depression and fatigue in men with HIV: a double-blind, placebo-controlled trial.

Wagner GJ, Rabkin R.

Department of Psychiatry, New York State Psychiatric Institute, New York, USA. gwagner@rand.org

BACKGROUND: This report documents findings from a small placebo-controlled trial of dextroamphetamine for depression and fatigue in men with the human immunodeficiency virus (HIV). Dextroamphetamine offers the potential for rapid onset of effect and activation properties, both of which are important to persons with medical illness and an uncertain, but limited, life expectancy. METHOD: Primary inclusion criteria included the presence of a DSM-IV depressive disorder, debilitating fatigue, and no history of dependence on stimulants. The study consisted of a 2-week randomized, placebo-controlled trial, with the blind maintained until week 8 for responders, followed by open treatment through the completion of 6 months. RESULTS: Of 23 men who entered the study, 22 completed the 2-week trial. Intent-to-treat analysis indicated that 73% of patients (8/11) randomly assigned to dextroamphetamine reported significant improvement in mood and energy, compared with 25% (3/12) among placebo patients (Fisher exact test, p < .05). Both clinician- and self-administered measures indicated significantly improved mood, energy, and quality of life among patients taking dextroamphetamine. There was no evidence of the development of tolerance of, abuse of, or dependence on the medication. CONCLUSION: These results suggest that dextroamphetamine is a potentially effective, fast-acting antidepressant treatment for HIV patients with depression and debilitating fatigue.

I'd think that any substance which is a robust, fast-acting antidepressant in AIDS patients has a profound anti-suicide effect. :)


>Adenosne inhibition also has antianxiety effect not shared by the stimulants.

Which caffeine _negates_ through adenosine _antagonism_.

>
> It is noteworthy to mention that chronic use of classic stimulants at high doses leads to downregulation of the D2 receptor which mirrors a clinical model of schitsophrenia.

All the more reason to use the amphetamine at SANE doses! It's so potent that you can get a good effect with minimal peripheral side effects, unlike caffeine.

>
> Coffee has an antiparkinsons/anticancer/antialheimer's effect that has also not shared by the classic stimulants.

True, but you'd do a lot better by taking small doses of selegiline if you're into life-extension. And with 1000mg/day of caffeine, the damage caused by the systemic dehydration will far outweigh the benefits.

>
> For somebody like me, who does not have true ADD, coffee will suffice.

It's really just a matter of preference (and absurd laws).

 

Re: caffeine, correction to my post linkadge

Posted by Chairman_MAO on February 10, 2004, at 20:58:37

In reply to Re: psychotic on ritalin, not on caffeine, posted by linkadge on February 10, 2004, at 17:55:07

>>Adenosne inhibition also has antianxiety effect not shared by the stimulants.

>Which caffeine _negates_ through adenosine _antagonism_.

I misread what you wrote. But adenosine antagonism has an antianxiety effect? Do you have refs? I never heard of that, but am interested. I always thought that adenosine agonism was anxiolytic, as the benzodiazepines and l-theanine both share that and are anxiolytic.

 

Re: caffeine, correction to my post

Posted by linkadge on February 11, 2004, at 7:08:10

In reply to Re: caffeine, correction to my post linkadge, posted by Chairman_MAO on February 10, 2004, at 20:58:37

Yes, I am mistaken this time. The reference I am looking for is on biopsychiatry.com. However, I think you are right that adenosine antagonists are anxiogenic.

Linkadge

 

Re: caffeine, correction to my post

Posted by Mid-Life Crisis on February 14, 2004, at 0:13:56

In reply to Re: caffeine, correction to my post, posted by linkadge on February 11, 2004, at 7:08:10

Wow! What a battle of intelligent minds this website is...and I love it! It is never dull here!
However, I either missed it or Linkadge did not mention the very important recent good news about coffee (and lots of it a day, at that)actually preventing diabetes Type II. This news has been on most of the medical websites recently and is truly something to celebrate in a country where both children and adults are developing Type II diabetes at alarming rates.
I say hooray for coffee! Without it, some of us with ADHD would probably not feel life was worth living anyway, what with our brains being in such a fog without a pot or so a day. And I agree with Linkadge that ritalin can cause some people to go psychotic, as it pretty much affected me that way, and coffee does not. (Alas, the downside is the constant proximity to the rest room needed for the quantity of coffee it is necessary to ingest to take the place of ADHD meds all day! Otherwise, I'd say coffee compares pretty favorably.)


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