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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by iforgotmypassword on August 30, 2005, at 15:30:12
ugh. this is terrible. i am always even more tired and fatigued now and it just makes my inability to fuction so much worse. and it comes it bouts that i completely cannot control. i am now likely unable to sign up for fall courses at my school. this is just a nightmare. i can't do anything. i haven't shaved. i haven't had a shower in god knows how long. i am wearing the same clothes that i have been since last thursday and i stink. speaking is difficult. i can never remember what i'm supposed to say. i cannot articulate. every sentence i try to make has to be forced out leaving me exhausted every time i try. i am currently on 0.625mg 3x a day, will this ever get better on a higher dose or would it be better if i could jump ship.
when i forget to take a dose on time on a weekend pass i notice i am pepped up a little. same late at night when its been a while since the last dose (as i only take it for the first three intervals in the day, not the fourth i imagine.)
:( does anyone have any advice/experience when it comes to mirapex (pramipexole)? thanx.
Posted by linkadge on August 30, 2005, at 16:28:54
In reply to mirapex is NOT helping, posted by iforgotmypassword on August 30, 2005, at 15:30:12
Are you on mirapex monotherapy ?
Linkadge
Posted by iforgotmypassword on August 30, 2005, at 16:33:48
In reply to Re: mirapex is NOT helping, posted by linkadge on August 30, 2005, at 16:28:54
well i'm not taking a conventional AD, but am taking lamotrigine (100mg).
Posted by Phillipa on August 30, 2005, at 18:06:03
In reply to Re: mirapex is NOT helping, posted by iforgotmypassword on August 30, 2005, at 16:33:48
Since I'm not a med expert the only thing I can say is I'm so very sorry. Fondly, Phillipa
Posted by linkadge on August 31, 2005, at 7:28:22
In reply to Re: mirapex is NOT helping » iforgotmypassword, posted by Phillipa on August 30, 2005, at 18:06:03
it is an interesting combination, but kinda unorthadox.
What about lamictal and selegeline (which would agonize all serotonin receptors)
Linkadge
Posted by iforgotmypassword on August 31, 2005, at 12:15:06
In reply to Re: mirapex is NOT helping, posted by linkadge on August 31, 2005, at 7:28:22
> it is an interesting combination, but kinda unorthadox.
>
> What about lamictal and selegeline (which would agonize all serotonin receptors)
>
>
> Linkadgedo you mean dopamine, or does lamotrigine agonize the 5-ht2 receptors? ugh, that would be counterproductive. :(
Posted by iforgotmypassword on August 31, 2005, at 12:17:47
In reply to Re: mirapex is NOT helping, posted by linkadge on August 31, 2005, at 7:28:22
that i am getting the urges to contort my face again, and the feeling that my body is trying to force me to move in every direction but i cant (akithisia?). this is really making me wonder if the drug isn't cannibalizing my dopamine system.
Posted by Declan on August 31, 2005, at 15:38:36
In reply to mirapex is NOT helping, posted by iforgotmypassword on August 30, 2005, at 15:30:12
I think Linkadge must have been referring to dopamine not seratonin receptors with the deprenyl thing. The nice thing about low dose deprenyl is that it won't bring you any grief, even though it is not an effective AD, so it's said. I've taken it for 10 years or so. I just feel a little younger than I might, which isn't to be sneezed at.
Declan
Posted by linkadge on August 31, 2005, at 16:23:08
In reply to Re: mirapex is NOT helping, posted by linkadge on August 31, 2005, at 7:28:22
Yeah, I totally meant dopamine receptors.
Anyhow, mirapexa is pretty strong on the d3 agonism. Some anticonvulsants directly hamper dopamine mediated neurotransmission. I know benzo's attenuate d2 mediated neurotransmission.
Lamictal may be decreasing the net mirapex effect.
What is your primary diagnosis ?
Personally I would die to hear what a combination of mirapex + buspar would do. 5-ht1a + d3 agonism.
Linkadge
Posted by Chairman_MAO on September 2, 2005, at 9:22:10
In reply to mirapex is NOT helping, posted by iforgotmypassword on August 30, 2005, at 15:30:12
You should try switching to cabergoline (Dostinex, Cabaser) with a target dose of ~2.5mg/day. Daytime sedation and other side effects are minimal with this agent as compared to others. In fact, the only side effect that people seem to get with this on occasion is edema. If your primary symptoms are anhedonia, lack of drive, etc. it may work very well. It does not have the D3 agonist activity of pramipexole, but since pramipexole isn't helping, I wouldn't be too worried.
The most activating DA agonist I can think of offhand is pirebedil, which is an A2 autoreceptor antagonist as well (yohimbine-like effect).
Babblemail me if you need advice on how to procure this medication.
Posted by pro_social_soon on September 8, 2005, at 11:47:36
In reply to Re: mirapex is NOT helping » iforgotmypassword, posted by Chairman_MAO on September 2, 2005, at 9:22:10
> You should try switching to cabergoline (Dostinex, Cabaser) with a target dose of ~2.5mg/day. Daytime sedation and other side effects are minimal with this agent as compared to others. In fact, the only side effect that people seem to get with this on occasion is edema. If your primary symptoms are anhedonia, lack of drive, etc. it may work very well. It does not have the D3 agonist activity of pramipexole, but since pramipexole isn't helping, I wouldn't be too worried.
>
> The most activating DA agonist I can think of offhand is pirebedil, which is an A2 autoreceptor antagonist as well (yohimbine-like effect).
>
> Babblemail me if you need advice on how to procure this medication.Do you think piribedil is the best choice for Nardil's side effects (weight gain/sexual side effects) ?
How much piribedl should one take to counteract this?
Posted by Chairman_MAO on September 9, 2005, at 8:53:16
In reply to Nardil, Mirapex, piribedil - to Chairman?, posted by pro_social_soon on September 8, 2005, at 11:47:36
It depends upon what the problem is. I may nto be the best one to ask, because I have not had long-term success treating my onw sexual dysfunction; then again, I cannot write my own scripts. :(
I think the therapeutic dose of peribidil(sp?) is arond 250mg/day, but you can check a monograph. I'd imagine simply start with the Parksinon's starting dose and work up as need be.
I do think Trivestal (notice I used the brand name because I cannot spell it, heh) is a better choice than mirapex et al because of its a2 antagonism. This is all theory, of course, as I've never tried it.
Another great drug I've heard for certain sexual side effects of phenelzine is bethanechol; it doesn't cross the BBB so you have the advantage of no CNS side effects such as worsened depression, insomnia, etc. Galantamine I have used personally for psychogenic impotence and it works great, too.
This is the end of the thread.
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