![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by satsumas on May 29, 2008, at 17:49:24
Hi, few questions for those of you who are using or who have tried Mirapex, either on its own (did it work for depression?) or as an augmentation therapy (why did you do choose mirapex, and did it have an affect, and at what dose?) -- did the sleepyness that Mirapex can cause ever go away with prolonged use?
I'm at 0.5 in the morning and 0.5 when I go to sleep at night. The 0.5 in the morning feels like im popping a benadryl. Luckily it is fairly responsive to caffeine, but I am still not sure if I'll be able to take it in the long term if the sleepyness doesn't go away, especially since to give this an adequate trial, I'd like to get up to at least 1.0 3x a day.
For the record, I'm trying mirapex as an augmentor to 300mg of Effexor, as Effexor has caused incredible apathy, amotivation, cravings, and emotional flatness, which I'm hoping the mirapex can help allievate.
Posted by garylee on May 29, 2008, at 21:23:48
In reply to Mirapex sleepyness question, posted by satsumas on May 29, 2008, at 17:49:24
> Hi, few questions for those of you who are using or who have tried Mirapex, either on its own (did it work for depression?) or as an augmentation therapy (why did you do choose mirapex, and did it have an affect, and at what dose?) -- did the sleepyness that Mirapex can cause ever go away with prolonged use?
>
> I'm at 0.5 in the morning and 0.5 when I go to sleep at night. The 0.5 in the morning feels like im popping a benadryl. Luckily it is fairly responsive to caffeine, but I am still not sure if I'll be able to take it in the long term if the sleepyness doesn't go away, especially since to give this an adequate trial, I'd like to get up to at least 1.0 3x a day.
>
> For the record, I'm trying mirapex as an augmentor to 300mg of Effexor, as Effexor has caused incredible apathy, amotivation, cravings, and emotional flatness, which I'm hoping the mirapex can help allievate.
Hi thereI tried Mirapex for the first time around four years ago now. I am diagnosed Bipolar II/NOS. My main problem is mnot soo much the depression but the serious lack of motivation (getting out of bed, finishing jobs off etc). Mirapex worked for me after about 5 days, I raely get side effects to meds so increased the dose to max of 4.5mg a day (1.5 x 3 due to it's shortish half life). At 4.5mg I felt great! Sleep was regulised, motivation was high and it had a very good antidepressant effect too. I stopped to try another DA (stupidly!) and second time around it didn't seem to work anymore...
I never experienced any drowsiness, but I'd recommend persevering to a higher dose and see what happens. I hear the drowsiness passes after a while as you raise the dose.
BTW, my other meds at the moment are Lamictal 400mg, Sulpiride 200mg. I take Seroquel 50mg and 1mg Clonazepam at night. I'm now actively looking for an Opiate or a different Doperminergic to augmentate (any suggestions??).
Good luck, let us know how it goes?
Gary
Posted by satsumas on May 29, 2008, at 22:07:01
In reply to Re: Mirapex sleepyness question, posted by garylee on May 29, 2008, at 21:23:48
Thanks, Gary. Could you describe a bit more how mirapex felt? Was it similar to Ritalin (if you tried that) or different? Did it resolve anhedonia if that was a problem?
My issue is also lack of motivation, but i've come to realize it is more than that. I am also addicted to the internet. There is something screwed up in my "reward" system, such that natural rewards, even things I "know" I like (like playing squash, going for a bike ride, calling friends), I am not motivated to do. I don't know if it is an affect of the SSRIs I ahve been on, part of the depression itself, or a result of the 3 years I was on ephedra supplements in college, or if it's just my genes (dad was an alcoholic/abused cocaine).
But I've come to realize that natural rewards and desires, things like romance, sex, success, achievement, fun, hobbies -- I am simply apathetic about. And in response or as substitution, I use the internet far too much. It has affected every corner of my life, including my career.
And after a 3 week suicidal depression after coming off Emsam and switching back to Effexor (Emsam did help with the motivation, gave me more "free will"), I realize that this has to change, and thus, wan tto try some dopaminergic agents.
Hence the mirapex.
Interested in knowing why you think the mirapex didn't work 2nd time around? Do you think it did a down/upregulation? What other DA things did you try?
Posted by garylee on May 30, 2008, at 4:01:10
In reply to Re: Mirapex sleepyness question » garylee, posted by satsumas on May 29, 2008, at 22:07:01
> Thanks, Gary. Could you describe a bit more how mirapex felt? Was it similar to Ritalin (if you tried that) or different? Did it resolve anhedonia if that was a problem?
>
> My issue is also lack of motivation, but i've come to realize it is more than that. I am also addicted to the internet. There is something screwed up in my "reward" system, such that natural rewards, even things I "know" I like (like playing squash, going for a bike ride, calling friends), I am not motivated to do. I don't know if it is an affect of the SSRIs I ahve been on, part of the depression itself, or a result of the 3 years I was on ephedra supplements in college, or if it's just my genes (dad was an alcoholic/abused cocaine).
>
> But I've come to realize that natural rewards and desires, things like romance, sex, success, achievement, fun, hobbies -- I am simply apathetic about. And in response or as substitution, I use the internet far too much. It has affected every corner of my life, including my career.
>
> And after a 3 week suicidal depression after coming off Emsam and switching back to Effexor (Emsam did help with the motivation, gave me more "free will"), I realize that this has to change, and thus, wan tto try some dopaminergic agents.
>
> Hence the mirapex.
>
> Interested in knowing why you think the mirapex didn't work 2nd time around? Do you think it did a down/upregulation? What other DA things did you try?
Hey SatsumasI can't particularly describe how I felt on the Mirapex when it was first working. All I can say is just a feeling of 'normality'. It was like one morning, 'PING' woke up earlyish, after about 5 days of max dosage, not really tired, able to get out of bed easily and start on chores/work etc. The motivation just came out of nowhere, BUT it was nothing like an amphetamine buzz like Ritalin or recreational phet's.
My Doperminergic quest came about from substance abuse a few years back. To be precise, Cocaine. It was the only recreational drug that made me feel 'normal' and totally in control of myself. I don't really feel a high as such; just my baseline mood/depression has just been shunted upwards to an acceptable level. Obviously Cocaine is not a good path to travel down to self medicate, but it did get me researching on the net (I know how you feel about internet abuse! I spend endless hours researching mad and wonderful medications that will hopefully one day cure me..!) For the Doperminergics out there. Mirapex had the most research done on Bipolar so I tried it out!
I looked into the mechanism of the DA's, like what receptor's they hit and what affinity they had to certain other receptors. Mirapex was said to have a D2/D3 agonist mode of action, but with a higher affinity to the D3 receptor, kind of known to be the 'antidepressant' receptor (very armchair psychopharmacology here!). Anyway, my feelings were correct. Had a very, very, understanding Pdoc back then he basically let me take anything I showed evidence for, as he had exhausted all his know avenues!.
The only side effect I ever experienced from the Mirapex was a major urge to smoke! Bad nicotine cravings! I was a very light social smoker before hand and turned into a chain, 20 a dayer smoker! I researched this back then, and there was evidence to show that Dopamine receptors had a connection with nicotine receptors, hence why most schizophrenics on antipsychotics smoke too. I'm hazy on it all now it was so long ago.
As for continuing my Dopamine quest, next up hopefully is Amineptine, the ONLY SDRI ever produced. It was apparently the best AD produced but obviously withdrawn worldwide by the FDA because it made people feel good. Go figure?? Anyway, have found a 'grey market' source so am awaiting the tabs in the next week or so. Apart for that, I am deeply researching D1 agonists, they interest my massively, but there are none commercially available right now...
Opiates are my next option too. Other than the Mirapex the only other remission type effect a med has had was Subutex. Only worked for 4 weeks though and gave me severe constipation, lol, too much to handle! :OS
I've written too much to know where I am so I'll add these last bits before you reply, the other Dopamine med I tried was Abilify, a Dopamine 'stabilizer'. Once again, worked well first time round but I couldn't handle the akathesia, like have insects crawling under my skin with serious RLS.
Lol, I'm lost now, written too much. Have a read if it makes sense and get back to me with feedback?
Gary
Posted by undopaminergic on June 5, 2008, at 16:36:15
In reply to Re: Mirapex sleepyness question, posted by garylee on May 30, 2008, at 4:01:10
>
> Lol, I'm lost now, written too much. Have a read if it makes sense and get back to me with feedback?
>It may be worth trying buprenorphine (Subutex) again, but with methylphenidate (Ritalin or Concerta) and perhaps some dextromethorphan or memantine to prevent or diminish tolerance. Stool-softeners or laxatives may be useful if constipation becomes a problem. Nicotine chewing gum may be a successful substitute for smoking.
Posted by Yasha on June 5, 2008, at 21:10:24
In reply to Mirapex sleepyness question, posted by satsumas on May 29, 2008, at 17:49:24
> Hi, few questions for those of you who are using or who have tried Mirapex, either on its own (did it work for depression?) or as an augmentation therapy (why did you do choose mirapex, and did it have an affect, and at what dose?) -- did the sleepyness that Mirapex can cause ever go away with prolonged use?
>
> I'm at 0.5 in the morning and 0.5 when I go to sleep at night. The 0.5 in the morning feels like im popping a benadryl. Luckily it is fairly responsive to caffeine, but I am still not sure if I'll be able to take it in the long term if the sleepyness doesn't go away, especially since to give this an adequate trial, I'd like to get up to at least 1.0 3x a day.
>
> For the record, I'm trying mirapex as an augmentor to 300mg of Effexor, as Effexor has caused incredible apathy, amotivation, cravings, and emotional flatness, which I'm hoping the mirapex can help allievate.I take .75 mg in evening for RLS and PLMD, the sedative effect is very light, so I also take Lunesta. But, recently the effective seems to have diminished, and the symptoms have begun earlier. I'm not familiar with it's usage in relation to depression. BTW, I take 225mg of Effexor XR for depression. Mirapex was proscribed as a result of a sleep study that revealed PLMD.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.