Posted by AndrewB on June 13, 2000, at 12:50:57
In reply to Andrew B., posted by harry b. on June 13, 2000, at 10:56:04
Some people like their psych.s to have the ball all the time, but other patients want a more active role in their recovery. If you are of the latter group, maybe you should let her know that if she doesn't have time for your input, you don't have time for her. Fact is, certain depressives have hypofunction of the D2/D3 receptor systems, most notably dysthymics. Moreover, amisulpride is the best studied and, probably, in general, the most efficacious of the meds out there to deal with D2/D3 dysfunction.
A couple more thoughts:
+While dysthymia I think is a broad spectrum of different chronic low grade conditions, it is something physically separate from major depression. For example, while platelet serotonin is decreased in endogonous depression, it is increased in dysthymia.+In dysthymia, while dopaminergic drugs are not necessarily the first line therapy, they should be considered soon afterwords, due to the frequency of D2/D3 hypofunction in dysthymics.
+Dysthymia is poorly understood and, in my opiniion, a bit overlooked by the research community. Psychiatrists often have little idea what a proper treatment approach for dysthymia may be.
+A high % of dysthymics also have mood disorders that perhaps predated the onset of dysthymia. It is my guess that often these mood disorders have a part in the chronicity of the depression, being a driver for depressive modifications of the brain by continually delivering stress upon it. Regardless, it is important to determine if comorbid personality disorders exist and deal with them. In my case amisulpride took away my dysthymia. However some fatigue remained and some social anxiety remained. Rebox. took away the fatigue, 2 down one to go. I am currently trying to remedy the social anxiety. I am optimistic that I will find a solution but my point is that it sometimes helps to view yourself as having separate conditions that will require different medications.
+You can take the amisulpride with ritalin and I see no reason why you can't take it with Wellbutrin too. Remember though, one drug trial at a time. Amisulpride also goes well with reboxetine and adrafinil and probably provigil. You might want to try the naphazoline eye drops to see how you respond to alpha 1 stimulation and how that relates to your fatigue. It is a great diagnostic tool in this man's opinion.
AndrewB
poster:AndrewB
thread:37157
URL: http://www.dr-bob.org/babble/20000610/msgs/37164.html