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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Mr.Scott on May 2, 2001, at 14:53:11
Hi John,Wouldn't Zyprexa, or Amisulpiride, or Risperdal only make SSRI induced apathy worse? They Block even more Dopamine than SSRI's..no? I could understand the Ritalin, Wellbutrin, Adrafinil/Modafinil approach.. but the new antipsychotics??? It's not that I don't believe you, but rather am curious if you have postulated any theories on How this can be??
Intrigue and Curiousity
mr.scott
From what I've seen over the years, the best odds for success in dealing with those apathetic feelings is to focus on dopamine and/or norepinephrine drugs. SSRIs can make apathy worse through an emotional numbing mechanism. On one hand it's good because it numbs away the depression, but on the other hand isn't good because you're nowhere near being recovered. Not only are the depressed feelings numbed, but so are the desired good feelings.
In your shoes I would put Zyprexa, then Risperdal, then Amisulpride at the top of the list. Forget everything else until you've tried them for two to three weeks each. In the unlikely event that none of them work out, then stimulants like Ritalin or Adderall could be next.And of course my personal favorite is Adrafinil from overseas. After years and years of depression and apathy unresponsive to antidepressants, I feel better than ever in my life with 20mg Prozac, 300mg Adrafinil, and 5mg Zyprexa. None of them alone does much. But combined they are like magic.
John
Posted by SalArmy4me on May 3, 2001, at 1:46:14
In reply to John L, posted by Mr.Scott on May 2, 2001, at 14:53:11
See this discussion I started entitled, "If Zyprexa BLOCKS dopamine, then what good is it?": http://www.dr-bob.org/babble/20010327/msgs/57880.html
>
> Wouldn't Zyprexa, or Amisulpiride, or Risperdal only make SSRI induced apathy worse? They Block even more Dopamine than SSRI's..no? I could understand the Ritalin, Wellbutrin, Adrafinil/Modafinil approach.. but the new antipsychotics??? It's not that I don't believe you, but rather am curious if you have postulated any theories on How this can be??
>
Posted by JohnL on May 3, 2001, at 3:17:31
In reply to John L, posted by Mr.Scott on May 2, 2001, at 14:53:11
>
> Hi John,
>
> Wouldn't Zyprexa, or Amisulpiride, or Risperdal only make SSRI induced apathy worse? They Block even more Dopamine than SSRI's..no? I could understand the Ritalin, Wellbutrin, Adrafinil/Modafinil approach.. but the new antipsychotics??? It's not that I don't believe you, but rather am curious if you have postulated any theories on How this can be??
>
> Intrigue and Curiousity
>
> mr.scott
>Hi Mr Scott,
I used to be real intrigued with theory and mechanism and such. But over time it dawned on me that theories have no relation at all to whether a drug will work for someone or not. When a drug works, we really can't pinpoint exactly why. Same thing when it doesn't work. I have shifted into a pattern of thinking where I just go with what works, dump what doesn't, and leave theory to the academic world.At low doses the antipsychotics actually enhance rather than block dopamine. Presynaptic receptors are blocked which stimulates increased dopamine. At higher doses postsynaptic receptors are blocked causing a decrease of dopamine function. And like I said, theory is just theory. I cannot explain why my cocktail works. I don't really care either. Just as long as it works.
I tried a lot of drugs that looked absolutely perfect on paper. I could have told you how a drug was going to work and why it was going to work for me. The problem is, they didn't work as expected and in fact many of them made me much worse very fast. How can that be? It went against all logic. Theory predicted these drugs were for me. In fact the ones that made the most sense turned out being the worst.
John
This is the end of the thread.
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