TOT Posted September 17, 2012 Share Posted September 17, 2012 I've done some searching on this forum and on the internet in general, and haven't found much of an answer. As far as i can tell, Wellbutrin is the only antidepressant that works on dopamine that is prescribed in the US. Is this true? My fairly shitty talky shrink said maybe dopamine is my issue, but my druggy shrink (talky shrink = psychologist, druggy shrink = psychiatrist) won't put me on Wellbutrin again because last time i was on it, i had a seizure. It looks like they were working on one in the US up until last year, but stopped. And, well, there's cocaine, but ... yeah.... i don't think Kaiser Permanente will prescribe that. Honestly, i'm at an interesting point - until talky shrink mentioned the possibility of dopamine being my issue, i had no interest in feeling better. A couple of weeks ago i decided i was done with this life, planned out my funeral (there's websites for such things!), got all my affairs in order, yadda yadda yadda. Research into my exit methods of choice left me rather pissed off realizing that there really is no acceptable method for me at this time. So, things are pretty shitty, but for the most part i'm not wanting them to get better, because they'll just get shitty again. I've been doing this dance for most of my life, severely for 13 years. I've been on just about every med, except the MAOIs. And done ECT. So i'm tired. I'd rather just stay down, except now there's possibly a glimmer of something hope-ish in the dopamine world .... which brings me here, because i'm pretty sure that's been squashed, too. Unless you can tell me there are other meds i just can't find for some reason. Thanks. Link to comment Share on other sites More sharing options...
jt07 Posted September 17, 2012 Share Posted September 17, 2012 My pdoc put me on Ritalin to help out with dopamine. Also, Abilify is a D2 receptor agonist (as opposed to antagonist like all the other AAPs), and I believe that is the reason why Abilify has given me back some motivation and interest in life, but I can't prove it. There are the MAOIs which really hit all the neurotransmitters. Finally, there are several drugs which are dopamine agonists and which are used to treat Parkinson's disease. But among the pure antidepressants, the MAOIs are the ones that hit dopamine, but most of these, with the possible exception of Emsam, require strict adherence to a diet and have their own array of side effects. Link to comment Share on other sites More sharing options...
crtclms Posted September 17, 2012 Share Posted September 17, 2012 Here's a list of other SNRIs, although it is from Wikipedia, so take it with a grain of salt. Link to comment Share on other sites More sharing options...
Guest Posted September 17, 2012 Share Posted September 17, 2012 What about an MAOI or a TCA? Are those out of the question? Or maybe Provigil? http://www.medscape....warticle/589934 (If you have trouble with this link you might need a medscape userid. If so, they're free) Link to comment Share on other sites More sharing options...
netsavy006 Posted September 17, 2012 Share Posted September 17, 2012 I can't access the link you gave sylvan. It asks me to log in... ETA: Made account, logged in and was then able to access the link. Link to comment Share on other sites More sharing options...
TOT Posted September 18, 2012 Author Share Posted September 18, 2012 Thanks, all. Hmmm, i've been on Ritalin and Abilify before, neither helped, so maybe dopamine isn't the issue after all. Kaiser isn't big on off label use in my experience, so i'm not sure i'd have much luck asking to try a Parkinson's med, but i can ask. MAOIs are on the no list for me. I am on a TCA. Provigil made a positive difference in my life, but Kaiser flat out refuses to prescribe it for anything but narcolepsy. Been on 2 SNRIs, one made no difference but was the worst experience of my life going off of (Cymbalta), the other (Effexor), made no difference at one dose, and the next half a dose up made me manic, so they won't give it to me anymore. Link to comment Share on other sites More sharing options...
Anodyne Oblivion Posted September 18, 2012 Share Posted September 18, 2012 wellbutrin is the only AD that sort of works for me. Focalin (an ADHD med) made me feel a lot better than wellbutrin alone. i cant taks SSRIs or SNRIs. only NDRI. Of which wellbutrin is the only one apparently ? sorry 4 any typos....on my phone and autocorrect isnt loading. Link to comment Share on other sites More sharing options...
simon_l Posted September 19, 2012 Share Posted September 19, 2012 In Europe there is also Amisulpride, a neuroleptic which - in low doses - increases the dopamine release and is prescribed quite frequently. However, it's not approved in the US and I do not have any experiences with it so far. Link to comment Share on other sites More sharing options...
Guest Posted September 20, 2012 Share Posted September 20, 2012 For what its worth you may as well list cocaine. Its a hell of a drug. Link to comment Share on other sites More sharing options...
TOT Posted September 21, 2012 Author Share Posted September 21, 2012 Notice cocaine is mentioned in the original post Link to comment Share on other sites More sharing options...
Cerberus Posted September 22, 2012 Share Posted September 22, 2012 TOT, my pdoc considers dopamine to be at least part of my issue as well, and prescribes me high-dose Effexor (Venlafaxine) because it acts as a dopanime reuptake inhibitor at the higher dosing range (usually ~300mg-450mg). In addition, he also prescribes me 30mg of Adderall as a dopamine release agent to augment the Effexor. I can't take Wellbutrin, either. It makes me wiggy. Link to comment Share on other sites More sharing options...
Kodos Posted September 22, 2012 Share Posted September 22, 2012 Parkinson's drugs pramipexole (Mirapex) ropinirole (Requip) Others Nicotine amphetamine class drugs Flowering/Japanese Quince (Chaenomeles speciosa) Pipradrol (Meratran) Fencamfamine (Glucoenergan, Reactivan) Link to comment Share on other sites More sharing options...
TOT Posted September 24, 2012 Author Share Posted September 24, 2012 I see my pdoc Wednesday, i'll mention the dopamine thing and see what she thinks... tho i'm still leaning towards just learning to deal with the suck. I'll mention the Parkinsons drugs and Fencamfamine. KP generally doesn't do off label scrips, at least they never will for me. There's no way in hell they'd give me Pipradrol. They won't put me back on Effexor 'cause i was on it last summer - at one dose it did nada, at the next i went pretty damn manic. Hey, i had fun. Thanks all. Link to comment Share on other sites More sharing options...
TOT Posted September 27, 2012 Author Share Posted September 27, 2012 Well, that didn't go all that well. Just deleted a rant about some of it. She said that the Remeron i'm on works on dopamine. And that she's never heard of Fencamfamine, so she's not gonna prescribe it, same with the Parkinson's drugs. She wants me to go do stuff, make goals for myself. I understand the importance of all that, but i've never been this disinterested in EVERYTHING. I get pleasure out of almost nothing. She did say we could try a thyroid med - Liothyronine. Well, it's an avenue i haven't tried. Link to comment Share on other sites More sharing options...
Cetkat Posted September 29, 2012 Share Posted September 29, 2012 I'd suggest getting your thyroid tested rather than just adding the Liothyronine (Cytomel). It has rather slim support at being effective for mood issues. I tried it anyway, mainly from desperation.. (I actually have thyroid issues too, so for me it was also a modification of existing treatment) and the only thing it did was push me hyperthyroid. I was able to confirm that my thyroid has zero bearing on my depression though. Link to comment Share on other sites More sharing options...
TOT Posted September 29, 2012 Author Share Posted September 29, 2012 Did have thyroid tested, but we don't know what is 'normal' for *my* thyroid. She said it's 'normal' but on the low side of normal - but it was just the overall thyroid, not T3/T4. How did you know you were hyperthyroid? Link to comment Share on other sites More sharing options...
Cetkat Posted September 29, 2012 Share Posted September 29, 2012 Did have thyroid tested, but we don't know what is 'normal' for *my* thyroid. She said it's 'normal' but on the low side of normal - but it was just the overall thyroid, not T3/T4. How did you know you were hyperthyroid? Ok, you may have somewhere to go with that then. What was the range your lab used? It went from 0.5 - 5.0 to 0.3 - 3.0 for TSH and not everyone is up to date. A good target range is below 2.5 (or 0.5 - 2.0). Medicating to that makes more sense to me than using thyroid meds as an AD. My T3 never went into the upper-range with normal treatment, so that was my goal with the approach. Basically.. the pure T3 has greater CNS activation and I could feel that. Normally it was a few hours in length after taking the Cytomel, but about 20 days in it suddenly seemed to build rather than dissipate. I started getting more and more anxious and on edge. Then, that night, I became paranoid and new something was really off. I kept looking out the window every minute or two (in spite of trying to watch TV and cook supper) because I had to know if my parent's car was back. I didn't actually care if they were back - the uncertainty of not knowing if they'd pulled up since I'd last looked was just making me really unsettled. By morning I was ok again because the levels had dropped, but I knew better than to take another dose of the Cytomel. I let it wash out of my system for a week or so, then restarted my previous thyroid med (per my GP). I don't know if I'm just used to having a rapid heartbeat and stuff from meds, but it's mainly mental changes that I notice with too high of a dose of thyroid medication. I never got the level from that because I didn't make it the whole month that we were waiting to base an adjustment off of. Link to comment Share on other sites More sharing options...
albertolobat Posted September 30, 2012 Share Posted September 30, 2012 I've heard that Zoloft has some slight dopaminergic action, as well as the usual serotonergic one that is to be expected of SSRI. For me this drug was certainly different from other SSRI, I've noticed almost in the same day like if I were taking some kind of stimulant, I felt invigorated, energized, with lots of motivation. Too bad that I wasn't able to sleep for two straight days and so my pdoc decided that this drug wasn't for me. Link to comment Share on other sites More sharing options...
Velvet Elvis Posted September 30, 2012 Share Posted September 30, 2012 Zoloft's has an effect on DA like Wellbutrin has an effect on Serotonin. Minimal and not enough to be therapeutically useful, just cause side effects. Stimulants such as used for ADD and nicotine are going to be your best bets here. Most of the PS meds have too narrow a focus in terms of the receptors targeted to be useful for depression. Tobacco and speed are pretty much what you're looking at. Link to comment Share on other sites More sharing options...
gizmo Posted September 30, 2012 Share Posted September 30, 2012 I am another person who was put on stimulants to try and overcome lingering symptoms of my bipolar and anxiety and reduce the side effects (all-day fatigue) from my meds. They worked so well on those issues and others I had (quieting of all the thoughts in my head all the time, ability to read and absorb more than three minutes of information at a time) that my pdoc said I'd probably always had ADHD. (Both of my children and my father have it) The big thing I noticed about getting on stimulants was my almost instant calming down of my GAD. I mean, I went from taking my benzo twice a day to taking it once a week or two. My pdoc said it was probably due to the stopping of all the loud anxiety-provoking thoughts running around in my head at the same time, all the time. Link to comment Share on other sites More sharing options...
TOT Posted September 30, 2012 Author Share Posted September 30, 2012 Well, i'm about a 3/4 pack a day smoker, so i got the nicotine... Doc said if the thyroid stuff didn't seem to work, stimulants were our next shot. Link to comment Share on other sites More sharing options...
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