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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 linkadge on November 7, 2022, at 15:30:35
Ritalin doesn't do much to speed up my heart rate. Sometimes, it actually slows it down. On the other hand, atomoxetine consistently raises my heart rate to uncomfortable levels.
The idea that ritalin is a "stimulant" and atomoxetine is not, is just semantics in my opinion.
Linkadge
Posted by jay2112 on November 7, 2022, at 19:47:32
In reply to More taychcardia on atomoxetine than Ritalin, posted by linkadge on November 7, 2022, at 15:30:35
> Ritalin doesn't do much to speed up my heart rate. Sometimes, it actually slows it down. On the other hand, atomoxetine consistently raises my heart rate to uncomfortable levels.
>
> The idea that ritalin is a "stimulant" and atomoxetine is not, is just semantics in my opinion.
>
> LinkadgeHave you ever tried a strong dopamine agonist (NOT Wellbutrin)??
Jay
Posted by TriedEveryMedication on November 7, 2022, at 20:37:59
In reply to More taychcardia on atomoxetine than Ritalin, posted by linkadge on November 7, 2022, at 15:30:35
> Ritalin doesn't do much to speed up my heart rate. Sometimes, it actually slows it down. On the other hand, atomoxetine consistently raises my heart rate to uncomfortable levels.
>
> The idea that ritalin is a "stimulant" and atomoxetine is not, is just semantics in my opinion.
>
> LinkadgeI think atomoxetine is not labeled a "stimulant" in the sense that you can't snort it and get euphoria from it. No dopamine action with atomoxetine.
Norepi will certainly raise the heart rate
I found atomoxetine to be pretty dysphoric, actually (no, I didn't snort it).
Posted by linkadge on November 8, 2022, at 6:25:18
In reply to Re: More taychcardia on atomoxetine than Ritalin » linkadge, posted by TriedEveryMedication on November 7, 2022, at 20:37:59
I have not taken any other dopamine agonists besides ritalin and SAMe, both of which had no impact on blood pressure.
When I think of stimulant, I mainly think of something that is going to rev you up. In this sense atomoxetine will certainly "get the ticker going".
Linkadge
Posted by SLS on November 8, 2022, at 9:42:37
In reply to More taychcardia on atomoxetine than Ritalin, posted by linkadge on November 7, 2022, at 15:30:35
> Ritalin doesn't do much to speed up my heart rate. Sometimes, it actually slows it down. On the other hand, atomoxetine consistently raises my heart rate to uncomfortable levels.
>
> The idea that ritalin is a "stimulant" and atomoxetine is not, is just semantics in my opinion.That's an interesting statement. Tachycardia is a side effect of many drugs that do not inhibit the reuptake of any neurotransmitters at all. Some instead block acetylcholine receptors. Anticholinergic drugs produce tachycardia, too. However, as is with methylphenidate (Ritalin), they often confer psychostimulant effects as well.
Your conclusion seems justified.
- Scott
Posted by undopaminergic on November 8, 2022, at 12:34:51
In reply to More taychcardia on atomoxetine than Ritalin, posted by linkadge on November 7, 2022, at 15:30:35
> Ritalin doesn't do much to speed up my heart rate. Sometimes, it actually slows it down. On the other hand, atomoxetine consistently raises my heart rate to uncomfortable levels.
>
> The idea that ritalin is a "stimulant" and atomoxetine is not, is just semantics in my opinion.
>
> LinkadgeI think they used to call such substances "tonics", or more specifically "cardiotonics" with reference to drugs stimulating the heart.
Atomoxetine is not much of a "psychostimulant" or "CNS stimulant", so that's why it is regarded as non-stimulant.
-undopaminergic
Posted by linkadge on November 9, 2022, at 10:16:05
In reply to Re: More taychcardia on atomoxetine than Ritalin, posted by undopaminergic on November 8, 2022, at 12:34:51
But, norepinephrine is a 'stimulating' brain chemical. For example, atomoxetine has been used in chronic fatigue and depression related fatigue with success. This is why drugs like venlafaxine and desipramine are more 'stimulating' than SSRIs. If it's stimulating, then isn't it a stimulant?
Linkadge
Posted by undopaminergic on November 9, 2022, at 11:24:50
In reply to Re: More taychcardia on atomoxetine than Ritalin, posted by linkadge on November 9, 2022, at 10:16:05
> But, norepinephrine is a 'stimulating' brain chemical. For example, atomoxetine has been used in chronic fatigue and depression related fatigue with success. This is why drugs like venlafaxine and desipramine are more 'stimulating' than SSRIs. If it's stimulating, then isn't it a stimulant?
>
> LinkadgeKind of. I guess it is largely arbitrary. Caffeine and nicotine are regarded as stimulants, but the former is sometimes kind of hypnotic for me, and I've used nicotine a lot to calm down and relax when I'm on a "real" stimulant like ethylphenidate. I've also had some help from ephedrine when I was really in need, lacking access to anything else that would help -- I was almost suicidal at the time. And on reboxetine I would wake up earlier.
-undopaminergic
Posted by SLS on November 9, 2022, at 22:13:02
In reply to Re: More taychcardia on atomoxetine than Ritalin, posted by linkadge on November 9, 2022, at 10:16:05
> But, norepinephrine is a 'stimulating' brain chemical. For example, atomoxetine has been used in chronic fatigue and depression related fatigue with success. This is why drugs like venlafaxine and desipramine are more 'stimulating' than SSRIs. If it's stimulating, then isn't it a stimulant?
>
> Linkadge
It might be more accurate to view the amine neurotransmitters as being neuromodulators. Neurons are cables that send messages. Glutamate and aspartate are the stimulatory neurotransmitters. Glycine and GABA are inhibitory. These chemicals either facilitate or they block the messages (action potential) being sent to a destination along a network of circuits. The circuitry is the brain, not the amine modulators (dopamine, norepinephrine, serotonin, trace amines, and myriad other substances). These are not the messengers, but are more like amplifiers and suppressors of the sub-circuits.
- Scott
Posted by linkadge on November 10, 2022, at 14:40:45
In reply to Re: More taychcardia on atomoxetine than Ritalin, posted by SLS on November 9, 2022, at 22:13:02
I'm just wondering what the definition of 'stimulant' is. Atomoxetine's main selling feature is that it is "not a stimulant", but I'd argue that (again) this is semantics. Atomoxetine has been linked to high blood pressure, tachycardia, strokes, sudden death etc. It can apparently also aggravate psychosis. I suppose it is less abuseable, but is that the only definition? Not everything that is abuseable is a stimulant.
Linkadge
Posted by SLS on November 11, 2022, at 9:54:01
In reply to Re: More taychcardia on atomoxetine than Ritalin, posted by linkadge on November 10, 2022, at 14:40:45
> I'm just wondering what the definition of 'stimulant' is. Atomoxetine's main selling feature is that it is "not a stimulant", but I'd argue that (again) this is semantics. Atomoxetine has been linked to high blood pressure, tachycardia, strokes, sudden death etc. It can apparently also aggravate psychosis. I suppose it is less abuseable, but is that the only definition? Not everything that is abuseable is a stimulant.
>
>
> LinkadgeI like your propositions.
- Scott
Posted by linkadge on November 11, 2022, at 14:09:25
In reply to Re: More taychcardia on atomoxetine than Ritalin » linkadge, posted by SLS on November 11, 2022, at 9:54:01
I wanted this medication to help me. Perhaps if it only worked centrally, then I would be able to tolerate it. On pubmed, it is touted as God's gift to ADHD sufferers. It allegedly solves ADHD and accompanying anxiety / depression. I found some of the studies questionable, as they were sponsored by Lilly. The problem is that on patient review sites, it generally only averages a 5 out of 10.
I found atomoxetine to be significantly less tolerable than either wellbutrin or nortriptyline. Interestingly, the antidepressant effect of wellbutrin is (generally) thought to be due to its norepinephrine reuptake inhibition. Yet, even at 300-450mg you are only getting 20-30% occupancy of the norepinephrine transporter. On atomoxetine, 50mg will inhibit 60-80% of the transporter. Yet, despite many trials, atomoxetine has not been found to improve depression. I could not find a single trial that said it worked as monotherapy in depression. The best it could do is augment an SSRI in terms of cognition and energy.
Linkadge
This is the end of the thread.
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