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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by LAURA777 on February 1, 2003, at 17:40:25
hi , i have several questions about the meds for deression , i suffer with no motivation , no pleasure and am tired but i have no anxiety .. i see many meds that act on the seratonin and noradrenaline but no meds that work on the dopamine .. except the stimulants . also why are there no meds that work on the endorphins ?? why are dopamine and endorphine products such taboo ??? has anyone out here on this board expierience this type of depression and if so what meds work for you ??? please help !! this sucks .. so far prozac and welbutrin are not working .. i hope you guys can give me some of your time and your input to educate me ... thanks laura
Posted by wingedcat on February 1, 2003, at 17:50:41
In reply to QUESTIONS ON DOPAMINERGICS AND OTHER MEDS , posted by LAURA777 on February 1, 2003, at 17:40:25
Hi!
My type of depression sounds similar to yours. I posted right after yours about my success with a non-stimulant med that works on dopamine and phenylethylamine, Deprenyl (aka Selegiline, Eldepryl). Check it out -
http://www.dr-bob.org/babble/20030130/msgs/138787.html
I hope you find something that works for you!
Posted by Caleb462 on February 1, 2003, at 22:17:33
In reply to QUESTIONS ON DOPAMINERGICS AND OTHER MEDS , posted by LAURA777 on February 1, 2003, at 17:40:25
> but no meds that work on the dopamine .. except the stimulants . also why are there no meds that work on the endorphins ?? why are dopamine and endorphine products such taboo ???
The reason drugs that work on the dopamine and/or opiod systems are not as plentiful is because these drugs are sometimes, but not always, "abusable." The most popular, and most addictive drugs in the world are dopaminerics - alcohol, cocaine, methamphetamine, nicotine, etc.
Anyway... there *are* anti-depressant drugs that work on dopamine. Most of them are stimulating, because that is the nature of the dopamine chemical.
You said you are taking Wellbutrin, Wellbutrin inhibits the reuptake of dopamine. It is a relatively weak drug, however, so that may be why you haven't had any success. You might need a higher dose. There are others too... Effexor, at the highest doses, is a dopamine reuptake inhibitor. I can't say I reccomend that at all though. Still, it's something to think about. It's also worth knowing that Zoloft, the SSRI, has weak dopaminergic activity as well.
There is also Fish Oil. As I understand it, taking Fish Oil supplements boosts dopamine levels in the brain.
Also, taking other supplements, like say L-tyrosine, can boost dopamine levels.
Stimulants CAN be used to treat depression, particularly if the depression seems to be related to low dopamine activity (anhedonia, fatigue, etc.). Maybe you should look into them.
Anti-histamines have a positive effect on dopamine function, which may be why tricyclic ADs are sometimes superior to the SSRIs. Perhaps you could try a tricylic.
Also there are the MAOIs. Nardil, Parnate, etc. These drugs can have a very strong effect on dopamine, but of course MAOIs pose the biggests risks and side effect profiles.
Anti-psychotics, suprisingly, can boost dopamine function by blocking the 5-HT2c receptor. Low doses only.
The herbal anti-depressant, St. John's Wort, is a mild dopaminergic.
As for improving your opiod/endorphin system - well, do you exercise?? Try that! As far as boosting opiod levels chemically, you don't have many options, but there IS d-phenylalaine and DL-phenylalaine. These prevent the descruction of the endorphins.
Posted by JohnL on February 2, 2003, at 6:27:31
In reply to QUESTIONS ON DOPAMINERGICS AND OTHER MEDS , posted by LAURA777 on February 1, 2003, at 17:40:25
Laura,
In your shoes I would keep the Prozac, drop the Wellbutrin, and add 2.5mg to 5mg Zyprexa around 5:00 to 6:00pm. Prozac and Zyprexa happen to go real well together, far better than either alone. My Prozac did nothing for me until I added Zyprexa. And then what a difference. Zyprexa increases dopamine function in parts of your brain and decreases it in other parts. Eli Lilly is actually considering making a pill that is both Prozac and Zyprexa in one for the purpose of treating treatment resistent depression.A few other things that are generally good for your symptom cluster. The herb Rhodiola Rosea (a brand with 4% Rosavin) is a powerful antidepressant, antianxiety, pro-sex, and mild stimulant. I really like it. Have tried everything on the planet. Rhodiola increases serotonin, dopamine, and beta endorphins.
The TCA Desipramine can be good for your symptoms, because it has direct action on norepinephrine and indirect action on dopamine d2. For me and my symptoms (similar to yours), Desipramine worked with just a tiny dose on the very first day. It made me impotent though, so I had to stop it.
At anti-aging websites there is a med called Adrafinil that is excellent for your symptoms, especially when combined with Prozac. You might want to do a Google search on it to learn more. I've taken the minimum dose 300mg for a long time and it is very helpful for motivation. It is a popular med in Europe, but it is a non FDA approved med in the USA.
I believe there is good potential for you with some combination of a few or all of these:
Prozac, Zyprexa, Rhodiola Rosea, Adrafinil.JohnL
> hi , i have several questions about the meds for deression , i suffer with no motivation , no pleasure and am tired but i have no anxiety .. i see many meds that act on the seratonin and noradrenaline but no meds that work on the dopamine .. except the stimulants . also why are there no meds that work on the endorphins ?? why are dopamine and endorphine products such taboo ??? has anyone out here on this board expierience this type of depression and if so what meds work for you ??? please help !! this sucks .. so far prozac and welbutrin are not working .. i hope you guys can give me some of your time and your input to educate me ... thanks laura
Posted by Jacob on February 2, 2003, at 21:59:40
In reply to Re: QUESTIONS ON DOPAMINERGICS AND OTHER MEDS , posted by JohnL on February 2, 2003, at 6:27:31
John,
Wouldn't you think Zoloft would mix well with those others too? If not, why? Thanks.> I believe there is good potential for you with some combination of a few or all of these:
> Prozac, Zyprexa, Rhodiola Rosea, Adrafinil.
>
> JohnL
>
Posted by not exactly on February 3, 2003, at 1:24:06
In reply to QUESTIONS ON DOPAMINERGICS AND OTHER MEDS , posted by LAURA777 on February 1, 2003, at 17:40:25
Laura,
Another med to try is Mirapex (pramipexole). It's a dopamine receptor agonist used to treat Parkinson's Disease. I enroled in a pre-marketing trial to test its effectiveness as an antidepressant, and found it to be a miracle cure. It failed to get FDA approval for AD use because it only helps a small percentage of depressed folks (namely the low-dopamine types like you & me). However, you can probably convince your pdoc to prescibe it for this off-label use.
- Bob
Posted by wingedcat on February 3, 2003, at 11:34:18
In reply to Re: QUESTIONS ON DOPAMINERGICS AND OTHER MEDS , posted by not exactly on February 3, 2003, at 1:24:06
not exactly/Bob, you've been in a couple trials (this and selegiline) then that although they worked for you, they failed to approve them. What a shame. I'm the same, only meds that work on dopamine tend to work for me. It's sad that if they don't see profit in a med that they refuse to approve it for the few of us who it could be a lifesaver for.
Despite my insistance that selegiline has helped me, my psychiatrist won't give me a prescription for it. I guess it costs the same through insurance anyway. It is just an extra hassle in that if I ever get drug tested, I have to explain why there is l-methamphetamine in my urine :(
This is the end of the thread.
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