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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 Jay2112 on February 21, 2022, at 13:49:14
I have posted about my happiness with amphetamines, which have worked well at the same doses for going on 16 years. As well, I have to give a good nod to some tricyclics, mainly nortriptyline.
SRI's...95 percent fail. SNRI...very low dose Effexor. Ritalin...complete fail.
It seems SRI/SNRI's have had a general low success rate. On here, on med review sites like drugs.com, on Facebook groups, the RI's don't seem to make people much happier, or content, and sometimes (often?) cause even much worse behavioural and personal problems. On here...it seems like many of us have learned to get very creative, and maybe that is the key.
The RI's basically *force* the monoamine to hold in the pre-synaptic neuron. I question how healthy this mechanism is..it just seems so aggressive, compared to just making more monoamine available.
I know I am making the case simplistic, but it appears there is at least (maybe?) a grain of truth.
Sorry....just rambling..
Jay
Posted by undopaminergic on February 22, 2022, at 8:21:32
In reply to Reuptake Inhibition causes major probs for me, posted by Jay2112 on February 21, 2022, at 13:49:14
>
> The RI's basically *force* the monoamine to hold in the pre-synaptic neuron.
>They just keep the transporter protein from absorbing the neurotransmitter back into the presynaptic neuron.
> I question how healthy this mechanism is..it just seems so aggressive,
In fact it is a very passive process. So maybe you mean passive-aggressive, haha.
> compared to just making more monoamine available.
Well, possibly if you mean precursors like L-dopa or 5-HTP. But MAOIs would seem approximately equally "aggressive". On the other hand, however, to *force* the neurotransmitters out of their storage vesicles, like amphetamines do, that seems a lot more "aggressive" to me.
-undopaminergic
Posted by Christ_empowered on February 23, 2022, at 11:47:18
In reply to Re: Reuptake Inhibition causes major probs for me, posted by undopaminergic on February 22, 2022, at 8:21:32
the ssri and ssnri drugs are notorious for acting as "emotional novocaine," numbing one's inner life. Thing is...
what frightens me is how shrinks lie about it, while pushing the pills on people. -eek- the effect was noted very early on...as in, early 90s Listening to Prozac era early on (written by a psychiatrist...).
wellbutrin was OK for me, but then again...once I dropped it and went on with life, I noticed...
whoa there; there -had- been a good bit of emotional numbing, just not to the ridiculous extent of, say, Paxil.
Ritalin vs the various amphetamines...I dunno. I did reasonably well with long acting Ritalin in terms of being able to stay on task vs untreated, and I don't think a roughly equivalent dosage of an amphetamine product was superior in that regard, per se, but...
is there a word for being sufficiently stimulated to better stay on task...somewhat improved mood...but also feeling somehow flattened?
not that the amphetamines were better, for me. improved concentration, rather jagged mood boost.
I think...especially when dealing with depression...reuptake inhibition is viewed as less problematic. I read...back in the day, some advocacy group tried to get Ritalin put into Schedule III, not the Schedule II where it lived then (and remains, now). Perhaps -not- surprisingly, some digging revealed the group was funded by companies that produced Ritalin products. And yet...
compared to the amphetamines, ritalin has a reputation for fewer mood problems, less dosage escalation, less psychosis and agitation, and less true addiction...
I also think the cardio profile favors Ritalin? not sure on that one.
Posted by undopaminergic on February 23, 2022, at 13:59:12
In reply to Re: Reuptake Inhibition causes major probs for me, posted by Christ_empowered on February 23, 2022, at 11:47:18
> the ssri and ssnri drugs are notorious for acting as "emotional novocaine," numbing one's inner life. Thing is...
>I noticed they cause a kind of apathy in the sense of caring less. Such as caring less about whether you kill yourself or not. This is probably the effect through which they may reduce suicides. But they can do the opposite, perhaps sometimes for the same reason, ie. caring less about staying alive.
> compared to the amphetamines, ritalin has a reputation for fewer mood problems, less dosage escalation, less psychosis and agitation, and less true addiction...
>The relative lack of dose-escalation is probably due to the flattening of the dose-response curve beyond a certain point. I used to use 108 mg/dose (3x36 mg) of Concerta, beyond which it was pointless to go, because it would produce no added effect.
-undopaminergic
Posted by SLS on February 25, 2022, at 11:22:51
In reply to Re: Reuptake Inhibition causes major probs for me, posted by Christ_empowered on February 23, 2022, at 11:47:18
Prozac might be an exception to the stereotyped SSRI apathy / amotivation characterization of SSRIs.
However, it seems to me that when any SSRI serves to produce a robust antidepressant effect, it has nothing to do with its acting as "emotional novicaine". Even the action of SSRIs to treat true anxiety disorders doesn't depend on its acting as a numbing "emotional novicaine". It is usually a mistake to extrapolate one's own experiences with a drug to generalize its effects on everyone else.
- Scott
Posted by Lamdage22 on February 25, 2022, at 13:29:23
In reply to Re: Reuptake Inhibition causes major probs for me, posted by SLS on February 25, 2022, at 11:22:51
Right. Some feel like a zombie on Neuroleptics. I honestly don't.
This is the end of the thread.
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