Novel (realistic) Antidepressants

[streetsurfer]

I am borderline PD and I have tried everything. Please, suggestions?

[nuke]

amineptine

[jasoncrest]

I am borderline PD and I have tried everything.

What have you tried?, list them, this is the only way we can tell you what interesting antidepressant you have not taken...

(and what PD means?)

[Helios.]

PD there stands for Personality Disorder.

Willie Nelson advocates the use of marijuana as an antidepressant.
I'm not saying he's wrong or right about that, or that marijuana would be the right antidepressant for everyone, but it's worth looking in to.

[Dr.Heckyll]

Try amisulpride in a low dose (50mg in the morning is standard, up to 2 x 100mg can be taken, but the higher doeses might not work better than the 50mg), this has worked wonders for me and at least on other person who had a chance to try it. It's also completely free of side effects.

[dunwich]

Willie Nelson advocates the use of marijuana as an antidepressant.
I'm not saying he's wrong or right about that, or that marijuana would be the right antidepressant for everyone, but it's worth looking in to.


Worth looking into...perhaps. However, in general, marijuana probably isn't the solution for depressive symptoms. Now, im not saying that it surely wont work, but in these cases it will probably just end up exacerbating everything even if it does help in the beginning. And with something like BPD I would think that pot is really not the answer, but I am not well versed in that subject. Just my 2cents.

[jasoncrest]

Have you tried tetracyclic or tetracyclic-like antidepressants?
They are the only AD that work for me...

Maprotiline
(brand name Ludiomil in the USA and UK)
Used in the treatment of affective disorders. Dosage 75 - 150mg/day. Inhibitor of norepinephrine reuptake. Terminal plasma half-life in healthy subjects about 58 hours. Incidentally seizures reported. Low incidence of anticholinergic or cardiovascular effects. Normaprotiline is a major metabolite. The combination of maprotiline with moclobemide or paroxetine has been suggested for treating therapy-resistant depressions.


Mianserin
(brand names Bolvidon, Tolvon, Lerivon.....)
Antidepressant agent. Distinct pharmacological profile. Insignificant anticholinergic properties, inhibitive effect on 5-HT2 mechanisms. Enhances norepinephrine turnover, presumably by blocking §a§2 adrenergic receptor sites. Maintenance dosage 30 - 60 (90)mg daily. Plasma half-life in healthy subjects 14 to 33 hours; in patients over 60 years 33 ± 15 hours. Major metabolite is normianserin. First dose effect in young subjects reported. Studied as a treatment of sexual dysfunction induced by SSRIs. Proposed in the treatment of alcoholism. It has been reported that low doses of mianserin may be a promising option for the treatment of acute neuroleptic-induced akathisia. It has also been published that mianserin may increase the efficacy of fluoxetine and significantly shorten its onset of action. Beneficial in reversing sexual function caused by SSRIs in women.


Mirtazapine
(brand name Remeron in the USA, Zispin in the UK)
Presynaptic §a§2 adrenoceptor antagonist. Noradrenergic and specific serotoninergic antidepressant (Na SSA), enhances noradrenergic and serontoninergic transmission, probably via its presynaptic §a§2 adrenoceptor blocking effect. Post synaptic 5-HT2/5-HT3 antagonist. Compared with mianserin much weaker inhibition of noradrenaline uptake. Enantioselectivity: antidepressant effects presumably linked to the (R)-enantiomer. Pharmaco-EEG studies. Increased nocturnal melatonin secretion reported. Claimed to be devoid of interaction with cytochrome P450 system. T1/2 (about 20-40h) justifies a once daily prescription. Absolute bioavailability approximately 50%. Steady-state achieved within 3-5 days. Around 100% of the oral dose is excreted via urine and faeces within 4 days. In vitro metabolic pathway: (S)-enantiomer: 8-hydroxylation (catalyzed by CYP 2D(6), (R)-enantiomer. N(2)-demethylation and N(2)-oxidation (catalyzed by CYP3A). Preferred metabolic in vitro route for the (S)-(+)-enantiomer is 8-hydroxylation catalyzed by CYP2D6, and for the (R)-(-)-enantiomer the (N)2-desmethylation and the N(2)-oxidation catalyzed by CYP3A. Some authors advice the precription of mirtazapine and mianserin in nocturnal dosing regimen rather than daytime for avoiding excessive sedation and performance impairment. Initial trial in opioid detoxification. May be linked with the 5-HT2/5-HT3 blocking properties, as typical symptoms of opioid withdrawal can be linked to the stimulation of those receptors. A beneficial effect on sexual functioning has been observed in both sexes. Succesfully studied in the treatment of panis disorder. A pilot study suggests the efficacy of mirtazapine in treating the irritable bowel syndrome.

[jasoncrest]

ATYPICAL ANTIPDESSANTS
(Drugs with an indication other than "depression" but that show antidepressant properties.)

Adinazolam
Anxiolytic
(brand name Deracyn in the USA)
Exists also in sustained release formulation. Antidepressant and anxiolytic agent. Studied in the treatment of depression at a dosage of 10mg/day vs placebo. Dosages of 20mg to 90mg/day also used. Rapid onset of action and minimal anticholinergic side effects. Trials in psychotic disorders foreseen. Phase III clinical trials in panic disorder. It has been reported that the slow-release formulations of adinazolam and alprazolam, prescribed in panic disorder, are better tolerated than clomipramine, but do not offer advantages in terms of efficacy. Halof-life about 2.3 hours.

Amantadine
Antiparkinsonian
(brand name Symmetrel in the USA, Lysovir in the UK...)
Amantadine may work as an antidepressant thought several mechanisms thought to be related to antidepressant activity (dopaminergic, noradrenergic, serotoninergic, MAOAA blocking effect). May work as an antidepressant through several mechanisms thought to be related to antidepressant activity, but the mode of action is still unclear.

Amisulpride
Antipsychotic
(brand name Solian in the USA and UK...)
At lower doses stimulatory effects. Quick onset of action. Elimination half-life about 12 to 19 hours. Clinical trials in dysthymia. Studied as an antidepressant in Europe. This indication is already accepted in ITA and Port.

Clenbuterol
Bronchodilatator
(brand name Spiropent...)
Very potent bronchodilator with selective ß2 adrenergic stimulating activity. Antidepressant effect has been reported, but controlled studies are missing.


Cyproheptadine
Antihistamine
(brand name Periactin in the USA and UK...)
Antihistaminic agent with antidepressant properties. [...] Clinical trials in the management of affective disorders at a dosage of 8mg up to 32mg daily.


Orphenadrine
Muscle-relaxant
(brand name Norflex...)
At doses up to 500mg/day, antidepressant properties reported.



Sibutramine
Antiobesity
(brand name Meridia, Reductil....)
Potential antidepressant with fast onset of action, not affecting cardiovascular functions.




Almost all new-generation antipsychotics can help against depression too: Ziprasidone (Geodon), Aripiprazole (Abilify), Risperdone, etc....

In the list above, I didn't put the Japanese drugs with antidepressant properties, they are commercialized in Japan only:
-indeloxazine
-bifemelane
-flutazolam (another interesting benzo...)
-rilmazafon
-sapropterine
-tandospirone

[rashandreflex]

Orphenadrine
Muscle-relaxant
(brand name Norflex...)


i believe orphenadrine has some pretty strong anticholinergic action, which i would guess would be extremely unpleasant day-to-day (i had a very bad experience with orphenadrine so perhaps i am a bit biased but still...)

two other suggestions:
1) seroquel (quetipiane)...i have known a couple people who have felt that fairly low doses of seroquel lifted their depression
2) ketamine: researchers found that a dose of ketamine seemed to imrpove depressed people's moods for about a week (but then it would need to be re-administered)

[streetsurfer]

Been on
Moclobemide (aurorix) (made me feel detached),
citalopram,(Cipramil)(worked at first then took me years to get off it)
escitalopram(Lexapro)(anxious,weird feeling)
zoloft(Sertraline),(zombie)
Paroxetine(helped but caused anxity attacks),
inipramine(12yo treatment for add, dirty nasty drug),
Atomoxetine (made me want to kill myself)
Mirtazapine (Avanza) Half dose knocked me out for 15 hours!
St johns wart (made anxiety and depression worse)
Prozac, Makes me agressive to the point of rage
selegiline - a really good drug but sedating, seems to lose effectiveness after a while like all the rest
Dexamphetamine - dependence, abuse, mania, erratic behaviour
Ritalin - so buzzy, bad anxity coming down, only last for an hour, abuse, addiction etc

I am on effexor at the moment, I am take a different dose each day by opening the capsules and taking the time release balls a little at a time. I know it will end in tears.
I am also on lamictal 250mg day....undecided how it is working, no side effects except makes my vision blurry...I think.
I also take a b complex and about 12 grams of fish oil a day

Prozac by far makes the biggest difference (for the few days it works for) effexor probably second (such bad constipation and urinary hesitation)


My main problem is social anxiety. I make everyone else nervous I come into contact with. Also while I can be bright and cheery when I am engaged in conversation, the minute I loose that stimulation my thoughts become negitive and repetatative and intrusive.

Thanx for your suggestions, but I have no idea where to begin... I am in Australia, I will have to check the PBS..

[streetsurfer]

PS Ketamine is my number 1 fav drug in the universe. I feel so damn normal on it. Do any of the above drugs have nmda antagonist properties?

[Splatt]

Why don't you try Valpro / Epelim. Ask your doctor about it. It's used to treat epilepsy most of the time but can really balance out moods and is a natural product. Just make sure you eat something with it and are you prone to stomach ulcers? Aspirin is also bad to use with this product. If prozac works i guess try that but I have a thing against prozac.

Just relax your face and eyes, nervous energy can turn bizzarre between people and can cause all sorts of misunderstandings, it comes out naturally and is often misread for people with your disorder.

[jasoncrest]

PS Ketamine is my number 1 fav drug in the universe. I feel so damn normal on it. Do any of the above drugs have nmda antagonist properties?

There are prescription drugs that are NMDA antagonists:
-Amantadine (which I quoted above) is a NMDA antagonist. It's prescribed for Parkinson's disease. As I said above it could have antidepressant properties..
-Memantine is another NMDA antagonist. It's prescribed for Alzheimer. The people who have tried it seem to like it, it has recreational dissociative properties, like Ketamine. But unlike Ketamine, it has neuroprotective properties. It also seems to do wonders against many diseases (surely including depression...)

These 2 drugs are interesting, you should try to convince a doc to prescribe one of them to you, off-label...

[Helios.]

If antidepressants worked there wouldn't be so many of them.

[almost-]

A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression.
Zarate CA Jr, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, Charney DS, Manji HK.
Arch Gen Psychiatry. 2006 Aug;63(8):856-64.

CONTEXT: Existing therapies for major depression have a lag of onset of action of several weeks, resulting in considerable morbidity. Exploring pharmacological strategies that have rapid onset of antidepressant effects within a few days and that are sustained would have an enormous impact on patient care. Converging lines of evidence suggest the role of the glutamatergic system in the pathophysiology and treatment of mood disorders. OBJECTIVE: To determine whether a rapid antidepressant effect can be achieved with an antagonist at the N-methyl-D-aspartate receptor in subjects with major depression. DESIGN: A randomized, placebo-controlled, double-blind crossover study from November 2004 to September 2005. SETTING: Mood Disorders Research Unit at the National Institute of Mental Health.Patients Eighteen subjects with DSM-IV major depression (treatment resistant). INTERVENTIONS: After a 2-week drug-free period, subjects were given an intravenous infusion of either ketamine hydrochloride (0.5 mg/kg) or placebo on 2 test days, a week apart. Subjects were rated at baseline and at 40, 80, 110, and 230 minutes and 1, 2, 3, and 7 days postinfusion.Main Outcome Measure Changes in scores on the primary efficacy measure, the 21-item Hamilton Depression Rating Scale. RESULTS: Subjects receiving ketamine showed significant improvement in depression compared with subjects receiving placebo within 110 minutes after injection, which remained significant throughout the following week. The effect size for the drug difference was very large (d = 1.46 [95% confidence interval, 0.91-2.01]) after 24 hours and moderate to large (d = 0.68 [95% confidence interval, 0.13-1.23]) after 1 week. Of the 17 subjects treated with ketamine, 71% met response and 29% met remission criteria the day following ketamine infusion. Thirty-five percent of subjects maintained response for at least 1 week. CONCLUSIONS: Robust and rapid antidepressant effects resulted from a single intravenous dose of an N-methyl-D-aspartate antagonist; onset occurred within 2 hours postinfusion and continued to remain significant for 1 week.

Full text as pdf: http://www.sendspace.com/file/eguvvi



Future Treatments for Depression, Anxiety, Sleep Disorders, Psychosis, and ADHD:
http://www.neurotransmitter.net/newdrugs.html

[rnd.id.]

Sibutramine
Antiobesity
(brand name Meridia, Reductil....)
Potential antidepressant with fast onset of action, not affecting cardiovascular functions.


Are you sure about that? I remember reading that sibutramine has particularly bad effects on the cardiovascular system. I don't know if that is true, but Wikipedia (http://en.wikipedia.org/wiki/Sibutramine#Safety_concerns) seems to agree somewhat.

Too bad, since otherwise the triple reuptake inhibition would make it interesting as an antidepressant (although the dopamine reuptake inhibition is rather weak according to Wikipedia). I'm quite curious what the triple reuptake inhibitors that are currently being developed will be like.

@almost-:
Funny that they only actually mention ketamine halfway through the abstract. Is this is to let the "shock" sink in gradually? ;)

[lil angel15]

Would Mirtazapine be safe to use during a MDMA/LSD comedown?

[Splatt]

I know someone that mixed Remeron/Avanza with MDMA and survived. Not that that data is enough to make it safe.

[rocknroll714]

I'm probably a few years too late but.. here are some potential options for you:

* Adding dopaminergic reuptake inhibition to your current serotonin and norepinephrine reuptake inhibition. There's a reason why serotonin/norepinephrine reuptake inhibitors are so much less effective than the traditional MAOIs for treating anxiety and depression.. it's because of the lack of additional dopaminergic stimulation. If dopamine reuptake inhibition is added and along with serotonin and norepinephrine all three systems are generally balanaced, I'll bet such a combination would be right on par with an MAOI. Amineptine (maneon, survector), and bupropion (wellbutrin) are currently the only two available drugs that you could do this with. Bupropion is pretty weak so I don't really recommend it but I will say it's not completely useless. Amineptine is a wonderful drug and I'm sure it'd do the trick for you just right if you tried it. Since both bupropion and amineptine are weak on norepinephrine reuptake inhibition I'm pretty sure combining one of them with your effexor would be just fine. If not all you would have to do is switch to an SSRI instead however.

* Getting yourself an irreversible unselective MAOI. Either phenelzine (nardil), tranylcypromine (parnate), or isocarboxazid (marplan) is what you want. I would recommend nardil since you say social anxiety is your primary concern. Nardil is probably the most effective drug there is for social phobia. I went on it for a while myself and it was simply incredible. No shyness, no anxiety, no worries.. whatsoever. Just bliss with me and all my friends and everyone else. With your past drug history I'm sure you would have little difficulty getting a doc to prescribe it.

* Supposedly some guy took a bottle of buspirone (buspar) a day for a few months straight for social anxiolytic and antidepressant purposes. Not sure if I would recommend that or not but could be interesting. Buspirone is a 5-HT1A receptor agonist so it indirectly releases oxytocin and this is believed to cause the social disinhibition. It's theorized that MDMA causes it's empathogenic/entactogenic effects via the very same mechanism of action. So who knows could be worth a try.

* Last but certainly not least.. NMDA antagonist antidepressants. Ketamine works for you? Why not use it! Many people use sub-recreational doses (15 to 30 mg or so I believe) of ketamine every day for anxiety and depression and it works wonders for them. Just keep it on the down low of course. If ketamine isn't an option then I suppose amantadine or memantine off-label (as mentioned above) would be considerable choices instead.

Hope that helps.

[Tsukasa]

What is your diet like? and your day to day activities?

[Pillthrill]

I do to. Was an Wellbutrin XL for a year and then it quit working now I'm on Lamictal Or whatever, as a mood stabilizer

[hugo24]

Duloxetin weakkly blocks the Dopamin Transporter ( 240nm;0.8nm SERT,7.5nm NET) and inhibits DA uptake,maybe its sufficient clinically,at least it appears quite effective (personal experience,but f*** the withdrawal)

http://www.nature.com/npp/journal/v25/n6/full/1395741a.html

Desvenlafaxine (Pristiq) will come to market soon,but it appears more a patent related thing.Venlafaxine is still a bit a mystery to me,not really a SNRI,rather a SSRI, surely more selective than Fluoxetin.Altough in vivo it wins some in selectivity (see same link above).What I'm still missing is the claim for its DRI property in high doses and the alledged "push",maybe its also a metabolite responsible for it?One paper claimed an anti-pain effect,which is antagoniseable with Naloxone,how come that when it doesen't bind to opioid receptors?

[Hammilton]

I think you'll end up with serotonin syndrome before you have valuable DAT inhibition.

[acetylcholine]

Cool list jasoncrest. I have tried Amantadine off-label for depression. It didn't help, but it did make me dizzy.

No one has mentioned Hydroxyzine (Vistaril), an antihistamine that has mild anxyolitic properties. Might be helpful.

[permastoned]

Abilify

[Tsukasa]

Duloxetin weakkly blocks the Dopamin Transporter ( 240nm;0.8nm SERT,7.5nm NET) and inhibits DA uptake,maybe its sufficient clinically,at least it appears quite effective (personal experience,but f*** the withdrawal)

http://www.nature.com/npp/journal/v25/n6/full/1395741a.html

Desvenlafaxine (Pristiq) will come to market soon,but it appears more a patent related thing.Venlafaxine is still a bit a mystery to me,not really a SNRI,rather a SSRI, surely more selective than Fluoxetin.Altough in vivo it wins some in selectivity (see same link above).What I'm still missing is the claim for its DRI property in high doses and the alledged "push",maybe its also a metabolite responsible for it?One paper claimed an anti-pain effect,which is antagoniseable with Naloxone,how come that when it doesen't bind to opioid receptors?

It's anti-nociceptive effect IS mediated by by kappa1- kappa3- and delta-opioid receptor subtypes. Here's some studies:

http://www.ncbi.nlm.nih.gov/pubmed/15157989

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T0G-3XDRYT8-4&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=e6bd783afea9c8e9a32d8444c2434665

A lot of other AD's have some mild opioid effects. Even Trazadone exerts an effect on both mu opioid receptors.

[permastoned]

And look in the future for delta opioid receptor agonists once they fix the seizure issues. Very exciting. As are H3 antagonists. Check them out

[Pillthrill]

Well they had to find novel ones for me because I refuse SSRIs. I have Borderline as well, with a couple other listed disorders.
Wellbutrin worked for a year
then I was moved to a mood stabilizer used to treat sezuires, lamotrigine. It works...as long as I take it. lol.

[hamhurricane]

i have been getting pretty interesting results from the atypical tricyclic AD tianeptine. the first time i took it, it gave me an incredible stupefying euphoria comparable to amphetamine and weed, for the first week of taking it i had to break the pills in half (6.25mg) if i wished to get work done because the euphoria was so distracting. the euphoriant effect is now almost gone at normal doses, but it still exerts a recognizable AD effect. experimentally after sustained use taineptine begins to act more like a classic SSRI...oh well.

[PsychedelicPeptide]

I know it is hard but if you are aware of your problems then why can you not see this as you are doing it and challenge yourself (subconsciously) to omit the unwanted behavior? What is preventing you from trying to work to better your problem without having to take drugs all the time?

[Pillthrill]

Borderline Personality Disorder is a VERY complex disorder to deal with and treat. You often can see what you are doing, after the fact, but you can't seem to help yourself. You don't know what else to do. BPD cannot be treated with medication alone, YEARS of painful therapy is needed and BPD patients are often resistant to change behaviors and view points that have sustained them, although miserably throughout their life. I don't think anyone that doesn't suffer from it can truly understand.
That is about all I will say simply because BPD isn't met with much sympathy or understanding on BL in my personal experience.

[pofacedhoe]

Borderline Personality Disorder is a VERY complex disorder to deal with and treat. You often can see what you are doing, after the fact, but you can't seem to help yourself. You don't know what else to do. BPD cannot be treated with medication alone, YEARS of painful therapy is needed and BPD patients are often resistant to change behaviors and view points that have sustained them, although miserably throughout their life. I don't think anyone that doesn't suffer from it can truly understand.
That is about all I will say simply because BPD isn't met with much sympathy or understanding on BL in my personal experience.

if it was easy to sort out a personality disorder by not doing certain things that would be nice. but most people arent robots who can destroy and replace their personality something more convenient. if it was that obvious for them to see where their logic has gone wrong then they would solve it , but they dont see it

[permastoned]

i have been getting pretty interesting results from the atypical tricyclic AD tianeptine. the first time i took it, it gave me an incredible stupefying euphoria comparable to amphetamine and weed, for the first week of taking it i had to break the pills in half (6.25mg) if i wished to get work done because the euphoria was so distracting. the euphoriant effect is now almost gone at normal doses, but it still exerts a recognizable AD effect. experimentally after sustained use taineptine begins to act more like a classic SSRI...oh well.

I know it's meant to be an SSRE or whatever but try taking a large amount. It feels exactly the same as an opioid, but with a very short duration.

[acetylcholine]

I know it is hard but if you are aware of your problems then why can you not see this as you are doing it and challenge yourself (subconsciously) to omit the unwanted behavior? What is preventing you from trying to work to better your problem without having to take drugs all the time?

We are (thankfully) now in the age of biological psychiatry. Enlightened scientists presently understand that you cannot wish away or think away mental illness. Mild mental distress can be helped by certain kinds of therapy, but the psychological approach is now dated; we are slowly finding out than nearly ever disorder is "organic."

I know the issue is much more complex than that, but that's my assessment.

[Tsukasa]

Behaviors cannot be changed unless ones beliefs are changed.

[melange]

I major in psychology


as someone who suffers from clinical depression, and also being an advanced drug addict/user(lol), I can attest that gabapentin shows promise, at least at higher than usual doses



very little side effects, hard to overdose on - I swear it has been the only thing that has ever worked - I have been on every medicine in the book(exagerration, but at least a dozen antidepressants) I only even know this because I have neuropathy in my legs from a critical methadone overdose, so I was prescribed it - it has a great mood stabalizing(sp?) effect - If I could do a clinical trial right now I would bet money it would fair better than most anti-depressants on the market(most ssri/snri's)

[melange]

also I am not even recommending it by itself - in conjunction with an ssri(in my exp.) the positive effects are even better

[shibireru]

i have been getting pretty interesting results from the atypical tricyclic AD tianeptine. the first time i took it, it gave me an incredible stupefying euphoria comparable to amphetamine and weed, for the first week of taking it i had to break the pills in half (6.25mg) if i wished to get work done because the euphoria was so distracting.

Fuck. That's depressing. What does it say about my basal hedonic tone that I have to take at least 62.5 mg (5 tablets) of Tianeptine to have an experience that were a mere shadow of the ones which you evidently have at 6.25 mg.

P.S. (I am on Clonazepam right now so my I express a far lower degree of diffidence and inhibition than I otherwise would; while sober, even I am not so effrontery as to submit a post that so ran against the grain of a thread as the following does. But I share this now not only because my inhibitions are lowered, but because it treats of an issue that has been eating away at me for years and I want to get it off of my chest.)

At this moment in time I can not well comprehend, on account of the slowness of the declension of my mental health, how much I have lost of the emotional depth and richness of my quondam state of being. Every now and again (twice a year or so) I have an experience characterized by the full restoration of my emotions - in degree and breadth. These experiences last generally a mere fraction of a second, but they are always followed by extreme terror and me screaming at the loudest possible volume out of a keenly painful recognition of how much I have lost and how unlikely it is that there should ever be a long-lasting revivification of my defunct internal life. When I was younger, if I would but close my eyes, suddenly I would observe the coalescence of a vale or tableau from the aether suffused with richness, lucidity, daedal complexity, color, and idyllic otherwordly beauty. This occurred without any real effort on my part at all. Now, when I close my eyes I see and feel only blackness, try as hard as I may to summon forth moving and palatable imagery.

Modern psychiatry, unfortunately, doesn't concern itself with the resolution of problems such as this - instead with bringing the patient to a state somewhere in the vicinity of average health, going no further than that if at all possible. As for me, I am at a total loss as to which receptors need to be agonized, which antagonized, and which brain structures need to be altered and in what way.

Ropinirole enhanced my emotions greatly - but what emotions I experienced were all overwhelmingly dark and dysphoric. And it did nothing to rectify the loss of my faculty of imagination.

[PetersKeys]

I'm probably a few years too late but.. here are some potential options for you:

* Adding dopaminergic reuptake inhibition to your current serotonin and norepinephrine reuptake inhibition. There's a reason why serotonin/norepinephrine reuptake inhibitors are so much less effective than the traditional MAOIs for treating anxiety and depression.. it's because of the lack of additional dopaminergic stimulation. If dopamine reuptake inhibition is added and along with serotonin and norepinephrine all three systems are generally balanaced, I'll bet such a combination would be right on par with an MAOI. Amineptine (maneon, survector), and bupropion (wellbutrin) are currently the only two available drugs that you could do this with. Bupropion is pretty weak so I don't really recommend it but I will say it's not completely useless. Amineptine is a wonderful drug and I'm sure it'd do the trick for you just right if you tried it. Since both bupropion and amineptine are weak on norepinephrine reuptake inhibition I'm pretty sure combining one of them with your effexor would be just fine. If not all you would have to do is switch to an SSRI instead however.

* Getting yourself an irreversible unselective MAOI. Either phenelzine (nardil), tranylcypromine (parnate), or isocarboxazid (marplan) is what you want. I would recommend nardil since you say social anxiety is your primary concern. Nardil is probably the most effective drug there is for social phobia. I went on it for a while myself and it was simply incredible. No shyness, no anxiety, no worries.. whatsoever. Just bliss with me and all my friends and everyone else. With your past drug history I'm sure you would have little difficulty getting a doc to prescribe it.

* Supposedly some guy took a bottle of buspirone (buspar) a day for a few months straight for social anxiolytic and antidepressant purposes. Not sure if I would recommend that or not but could be interesting. Buspirone is a 5-HT1A receptor agonist so it indirectly releases oxytocin and this is believed to cause the social disinhibition. It's theorized that MDMA causes it's empathogenic/entactogenic effects via the very same mechanism of action. So who knows could be worth a try.

* Last but certainly not least.. NMDA antagonist antidepressants. Ketamine works for you? Why not use it! Many people use sub-recreational doses (15 to 30 mg or so I believe) of ketamine every day for anxiety and depression and it works wonders for them. Just keep it on the down low of course. If ketamine isn't an option then I suppose amantadine or memantine off-label (as mentioned above) would be considerable choices instead.

Hope that helps.



Do you think MAOIs like Parnate or Nardil effect dopamine at a greater level than DRIs like Wellbutrin or amineptine?

The only dopamine RE inhibitor thats on the market is bupropion. I don't think think survector is even in the US anymore. Mirapex is a dopamine agonist, but I haven't heard much about its antidepressant effects.

[ZeuZzZ]

Anti depressants cure the symptoms of depression but not always the main cause in my opinion. They do work in the short term for sure (I've used citalopram, and its definately helped)

But if you want to get to the cause of your social anxiety and depression I highly recommend CBT or similar therapies, whether accompanied by anti-dep's or not. Also simple things like running every day and excersising, giving yourself one different goal to achieve every day, eating healthy food and improving your closeness to people and family that you are not too socially anxious around by opening up about things can help wonders in starting to overcome your social phobias that have built up with other certain people (I know this from experience). Also getting a girlfrined/boyfriend and a bit of love in your life is a miracle cure, but I fully appreciate not always easily attainable if your condition is related also to relationship issues (most are)

Hope that helps.

[rocknroll714]

Do you think MAOIs like Parnate or Nardil effect dopamine at a greater level than DRIs like Wellbutrin or amineptine?

The only dopamine RE inhibitor thats on the market is bupropion. I don't think think survector is even in the US anymore. Mirapex is a dopamine agonist, but I haven't heard much about its antidepressant effects.

That's.. complicated. Wellbutrin, yes, since you can only dose it so high due to the norepinephrine and the seizure threshold. Amineptine.. very doubtful. Provided you dosed the MAOI high enough you could still get a very nice boost in dopamine, but nothing comparable to most reuptake inhibitors and releasers. Personally though I think extremely high dose rasagiline would be really sweet.

[PetersKeys]

That's.. complicated. Wellbutrin, yes, since you can only dose it so high due to the norepinephrine and the seizure threshold. Amineptine.. very doubtful. Provided you dosed the MAOI high enough you could still get a very nice boost in dopamine, but nothing comparable to most reuptake inhibitors and releasers. Personally though I think extremely high dose rasagiline would be really sweet.



I wish I could find something that shows the efficacy/affinity of bupropions dopamine effect compared to say, Parnate, Nardil or rasagiline. Rasagiline looks really interesting though apparently patients were able to take it with other antidepressants.

My depression is more dopamine related than seratonin. And since theres only one DNRI on the market(with the exception of MAOIs) for the US it is pretty limited for me. I just wish I could find something that has the antidepressant effect as speed does without the addiction and sides.

Mirapex looks interesting though.

[JahRed24x]

do you guys actually think 'anti-depressants' work? I think they are total and complete BS. The only real anti-depressants are all illegal, lol go figure.

[permastoned]

do you guys actually think 'anti-depressants' work? I think they are total and complete BS. The only real anti-depressants are all illegal, lol go figure.

From what I have noticed, this is a common opinion of many drug users. I have seen them work for non drug users (and a very small amount of drug users). Go figure. For me, they are total and complete BS.

Kobie, you mentioned in another thread that you were once on Nardil and it was bliss. Why did you quit taking it then?

[rocknroll714]

From what I have noticed, this is a common opinion of many drug users. I have seen them work for non drug users (and a very small amount of drug users). Go figure. For me, they are total and complete BS.

Kobie, you mentioned in another thread that you were once on Nardil and it was bliss. Why did you quit taking it then?

I disagree somewhat. A few ADs are really nice.. mirtazapine and phenelzine, for instance. Though it can be certainly said that the SSRIs are total garbage. And yeah, I suppose it is true that most illicit drugs are waaay better to the point of practically being incomparable.. but are they sustainable and affordable? Generally no.

I couldn't afford phenelzine at the time. I got my insurance to cover it though and I'm starting back on it hopefully next week which is gonna be totally sweet!

[permastoned]

^ Interesting, I really only have tried the SSRIS, and selegiline which actually works quite well for me, so I can only assume that phenelzine would top it.

I have to make the decision next week between going on methylphenidate for my ADHD or phenelzine or my depression/anxiety, cause obviously my psych wouldn't put me on both. I have no idea which I should choose at the moment.. bah. Because it has taken me a lot of effort to get the methylphenidate, had to get opinions from 2 psychiatrists because of my past history of drug abuse. What do you recommend?

[rocknroll714]

^ Interesting, I really only have tried the SSRIS, and selegiline which actually works quite well for me, so I can only assume that phenelzine would top it.

I have to make the decision next week between going on methylphenidate for my ADHD or phenelzine or my depression/anxiety, cause obviously my psych wouldn't put me on both. I have no idea which I should choose at the moment.. bah. Because it has taken me a lot of effort to get the methylphenidate, had to get opinions from 2 psychiatrists because of my past history of drug abuse. What do you recommend?

Personally I'd go with the phenelzine, but that's just me. Of course phenelzine can help with ADD/ADHD as well, though not as much as methylphenidate.

[mitragyna]

^ Interesting, I really only have tried the SSRIS, and selegiline which actually works quite well for me, so I can only assume that phenelzine would top it.

I have to make the decision next week between going on methylphenidate for my ADHD or phenelzine or my depression/anxiety, cause obviously my psych wouldn't put me on both. I have no idea which I should choose at the moment.. bah. Because it has taken me a lot of effort to get the methylphenidate, had to get opinions from 2 psychiatrists because of my past history of drug abuse. What do you recommend?
I would most definitely go with the Phenelzine. You will be much better off in the long run.

[Smyth]

Selegiline is not even that good. People see that it elevates dopamine and they automatically think they will like it.

That is just prejudice because if you actually try the stuff you will see how it isnt really good at all.

[permastoned]

^I disagree. Just because it didn't work for you doesn't mean it won't work for everyone. Aight, I'm gonna crank the phenelzine. Cheers guys.