Discussion in 'General Treatment' started by m1she11e, Aug 18, 2012.
Both SSRIs and 5-htp sedate me even at very low doses.
I had the exact same problem with celexa...my doctor wanted to try it because it had the least side effects. I was only taking a 1/4 of the pill and couldn't tolerate it at all. I went to work one day and felt like I was walking on air. A few mornings later I woke up to see my eyes bugging out of my head. I was terribly hungover all the time.
I was only on for 10 days but when I tried to quit I had a headache so bad I thought my head was going to explode so I had to taper even at that low dose.
I have been having great success with Wellbutrin SR. I started low at 150mg in the am and am now on 150mg twice a day. I make sure to take it by 3pm so I don't have any sleep problems. It has worked the best for me and since I have very low serotonin levels it helps with that too...
It has been the only A/D I could tolerate....
Just curious, any reason why you don't take the once-a-day Wellbutrin XL?
I am not really sure....my doctor prescribed the 150mg since that is what I have taken before...I could ask him though and see if that is a better option..thank you! Love the picture!
Maybe I will give the Wellbutrin a try at some point? If you dont mind me asking....Did it help with energy or any physical symptoms or did you take it for depression? Its funny when Doctors ask if I have any depression. I have to think about it because being sick every day of your life does kinda get you down!! I realize most studies dont show anti depressants to be effective in CFS but on occasion it seems to really help people. I guess like everything else.....
Many years ago when I had typical MDD...high anxiety, no appetite, not much sleep...Zoloft helped me more than any others and I took a boatload of them, although had the sexual side effects from it. Now I have the atypical variety, low DA/NE and will be doing Wellbutrin whenever I get it in my head that going the natural supps route is fruitless.
Also, I can't even take a warm to hot shower or bath anymore. Makes my depression worse temporarily till I return to baseline. On the flip side of that, cold showers make me feel better temporarily till I return to baseline. From what I understand, the cold shower releases NE.
It does help with fatigue and energy..which of course could be symptoms of depression. I am not totally sure I am depressed but having just gone through a rough emotional time I figured to give it a try. I never had any side effects from it in the past so I saw no reason not to take it again. . If in a few months I don't feel it is making a difference then I will go off it...
My son is a Yankee fan !
I want to get my hands on a dopaminergic or noradrenergic to increase energy and motivation.
Wellbutrin is not available on prescription in Oz. I have ordered Deprenyl to see how that goes.
Years before getting cfs i took Remeron(mirtazapine). I had more zip than the energizer bunny on amphetamine ice cream.
xks201 posted an interesting link http://www.cfids-cab.org/MESA/Bains.pdf using adrenergic agonists or renin angiotensin system agonists to increase energy production.
I would be worried though that such agonists would put further strain on the HPA axis, considering that noradrenaline may have been a culprit in downgrading the HPA axis response to cortisol in the first place? (Not sure about this).
In other words, will it make it worse in the long run, and what happens when you come off them?
Along with motivation and energy benefits, Remeron come with a truckload of side effects, which is not surprising considering it plays with this many receptors:
Mirtazapine is an antagonist/inverse agonist at the following receptors:
5-HT1A receptor (Ki=18nM; IC50=1,000nM) 
5-HT2A receptor (Ki = 69 nM)
5-HT2B receptor (Ki = ? (~20-fold lower than for 5-HT2A/2C))
5-HT2C receptor (Ki = 39 nM)
5-HT3 receptor (Ki = ? (similar to 5-HT2A/2C (mouse neuroblastoma cell)))
5-HT7 receptor (Ki = 265 nM)
α1-adrenergic receptor (Ki = 608 nM (rat))
α2A-adrenergic receptor (Ki = 20 nM)
α2B-adrenergic receptor (Ki = ? nM (likely similar to α2A/α2B-adrenergic))
α2C-adrenergic receptor (Ki = 18 nM)
H1 receptor (Ki = 5.1 nM) 
mACh receptors (Ki = 794 nM (rat))
Dopamine D1 receptor (Ki=4,167nM) 
Dopamine D2 receptor (Ki=1,460nM) 
Dopamine D3 receptor (Ki=5,723nM) 
Dopamine D4 receptor (Ki=25nM) 
Mirtazapine has also shown affinity towards the norepinephrine transporter and perhaps also (results of test unspecified) the serotonin and dopamine transporter:
Norepinephrine transporter (IC50=260nM) 
Serotonin transporter (IC50=100nM) 
Dopamine transporter (IC50=1,000nM) 
I would be interested to hear if anyone with me/cfs got any clear benefit from noradrenergics or dopaminergics.
I wouldnt touch SSRI's at all.
Not too long ago I online ordered a generic Wellbutrin without a script. Let me know if you want the internet address.
Look into a supp called mucuna pruriens, suppose to contain amino acid l-dopa, but would be careful adding to another dopamine med though.
That Bains study I posted is somewhat oversimplified. Not everyone has an overactive parasympathetic nervous system. I would say most CFS patients are overly sympathetic and would probably have chest palps if given a beta agonist. There are a LOT of possibilities.
I take trazodone for sleep. It works very well if I am sleepy when I go to bed, which is usually at about 2AM. For a while I took rozerem, which worked well to induce sleep, but I'm not taking it right now because of the pain of dealing with the insurance company.
I also take cymbalta for depression. It is the only drug that helps, and I have taken the gamut from A to Z. I don't think it does anything for pain, but I've been taking it for longer than I've had serious CFS, so who knows. The only side effects I have are sexual, which is too bad, but not much of an issue since I'm so tired and achy anyway.
Maybe cold shower thou is helping more blood be getting to your brain as your body focuses the most of keeping your most vital parts warm and the blood to them when a person is cold
Good point. I never thought about that as a possibility. Anyone know the best supp to take to increase blood flow? I've heard some people say Vinpocetine isn't worth a darn. I've tried Ginkgo before. Also, would any of them be safe to take with Wellbutrin?
If you do have an issue with low blood flow.. and have ME.. its probably then related rather to low blood volume which is a very common issue in ME patients.
Low blood volume can sometimes be helped some by salt loading (taking a lot of salt) and drinking a lot water or hydration products. Others of us need drugs such as Florinef to help boost our blood volume. There is also the option of graded medical support stockings to help keep more blood in the brain (helps push it up from the legs better.
Ginkgo.. was no help to me.. (LOTS of water and salt thou did help a wee bit).
You may want to talk to your doctor about adding Wellbutrin XL, then. Wellbutrin XL is known to reduce sexual dysfunction in women: "Reversal of SSRI-induced female sexual dysfunction by adjunctive bupropion in menstruating women: a double-blind, placebo-controlled and randomized study."
Hi Rand, that would be great. Thanks
Broad beans (fava beans) also have l-dopa in them. I might try a plate full of them with a couple of teaspoons of poppyseeds(opioids). Could be a short term recipe for bliss. Or just dinner.
Is there a specific test to detect low blood volume or would a basic CMP show this?
Separate names with a comma.