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Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.
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When the body and its systems are stressed by being forced to metabolize and eliminate a lot of ..... we'll call 'em toxins ... it pulls water from everyplace in your body, leaving your brain til last. But it will cautiously and judiciously pull from that resource, too, if it has to. It just would rather not, for obvious reasons.the kind of dried out I am referring to cannot be rectified by drinking water.
I have found both supplements and drugs to be tricky, in terms of trying to find things which do not make my depression and mental health worse.
Quite a few supplements substantially worsen my depression, usually anything that boosts the immune system (which makes sense, given the latest theories on depression suggest it may be underpinned by inflammation and immune activation in the brain). Echinacea strangely I am fine with.
But the yeast supplement Epicor (Saccharomyces cerevisiae) makes me miserably depressed, and I also get depressed from the immune boosters beta sitosterol, transfer factor and BioBran MGN-3. I am not sure if other people with pre-existing low mood are made further depressed by these supplements, but if depression is a common side effect, perhaps there should be warning labels on the jars. So now I approach any immune booster with caution.
@YippeeKi YOW !!
I really want to use an AD for now. Coping is quite hard. I will try it for 2 weeks and see how it feels. A friend of mine backed out pretty easy. I'm not a fan of consuming a lot of drugs at the same time.
No worries, A read a lot about Abilify (Stanford study as well) and talked to some people in a FB Group. My Psychiatrist is supporting me in a very good way. She doesn't know about the escilatopram (from GP) yet, because she's on holiday, but I will realign with her when she's back. I will take max 2 drugs at a time. Therefore I'm considering to tap off the doxepin for sleep. I already checked contraindications. Lexapro can amplify the effect of Abilify but it is highly unlikely to happen due to the low dose of Abilify. My first priority right now is mood and anxiety (with whatever drug or herb). As soon as I think that I'm in a stable state I will trial Abilify.
I need to work on my grief and give my body time to heal. I'm so short in this and hope that I still have a good window of recovery or remission if I don't overdo things. Trials are secondary to a good state of mind. I got better the last couple of days and hoping to improve more while working on my mood.
Thank you so much for your Input. I really appreciate it
I agree. But using an anti-depressant to suppress that grief can sometimes lead to a lot of issues and potential problems down the road, independent of the rewiring of the brain as well as some neurotransmitters, which can cause some pretty unpleasant, and often hard to undo, problems.Grief is something that does have to be dealt with
Oh, thank God !!!! Lexapro seems to be the new medical go-to, and it can really turn on you in some nasty, nasty ways, so good, good, good .....I stopped Lexapro after 3 days.
I think there can be danger in comparing our condition to others, and then projecting that down the road. We really are all different, with different underlying potentiating issues and different genetic wiring, so dont let all that freak you out. Accept it as input that may or may not have any real bearing on you, personally, and keep looking for your own answers ....Still hoping to recover in the near future, but it seems unlikely from what I‘ve learned about my symptoms compared to stories of others and what science has to offer
Hopefully, it's part of its struggle to restabilize, rebalance, and rewire. It's been thru a lot, and it's not like it can undo all that overnight.My body is acting very weird...
Sure! This place is my refuge these days.Oh, thank God !!!! Lexapro seems to be the new medical go-to, and it can really turn on you in some nasty, nasty ways, so good, good, good .....
Not that it's any of my business ....
Hopefully Abilify will provide what you need, as it seems to for some people, and eliminate the need for a long-term anti-d ....
I think there can be danger in comparing our condition to others, and then projecting that down the road. We really are all different, with different underlying potentiating issues and different genetic wiring, so dont let all that freak you out. Accept it as input that may or may not have any real bearing on you, personally, and keep looking for your own answers ....
Hopefully, it's part of its struggle to restabilize, rebalance, and rewire. It's been thru a lot, and it's not like it can undo all that overnight.
Keep a good thought, keep looking for answers, keep checking in, yes ?
Maybe not immediately, or even as quickly as you'd like, but things do change, and this will, too. And maybe your gf will wait for those changes and maybe she wont. And maybe there's someone even more perfectly attuned to you, hovering just out of sight.But I simply can’t change the situation whatever I do, realizing this helps a little with coping.
@lenora Thanks for your kind words! I‘m pretty young and had many plans turned on hold due to CFS. It‘s been pretty stressful and the grief is real. I just feel it’s too early to be the end of the movie... I was about to marry my gf and have kiddos. I do grieve. A lot. But I simply can’t change the situation whatever I do, realizing this helps a little with coping.
I also do well on MAO inhibitors, in fact even when I was healthy I found the MAO-B inhibitor selegiline (which is famous in cognitive enhancement circles) really great for generating a zesty enthusiastic mood and increased creativity.
Unfortunately I found since getting ME/CFS that selegiline makes my ME/CFS feel worse, and no longer boosted my mood, so I stopped using it. It was a mystery to me why a dry like selegiline which used to make me feel so great stopped working once I was hit with ME/CFS.
Eventually I learnt that selegiline boosts the inflammatory cytokine IL-1beta, which is a major cytokine driving brain inflammation. Since brain inflammation is an issue in ME/CFS to begin with, you would not want to increase IL-1beta and further. So I think this explains why selegiline started making me feel worse.
So then I switched to another MAO inhibitor, moclobemide, which is an MAO-A inhibitor, and I was fine with that.
I like moclobemide because in one study on the sexual side effects of antidepressants, moclobemide came out as having the lowest risk of these side effects (only a 4% chance of getting these side effects, whereas for SSRIs, it's typically around 60%).
we demonstrate that MAO-A, but not MAO-B, mainly contributes to striatal dopamine degradation. In contrast, our whole-cell patch-clamp results demonstrated that MAO-B, but not MAO-A, was responsible for astrocytic GABA-mediated tonic inhibitory currents in the rat striatum. We conclude that, in contrast to the traditional belief, MAO-A and MAO-B have profoundly different roles: MAO-A regulates dopamine levels, whereas MAO-B controls tonic GABA levels.
Redefining differential roles of MAO-A in dopamine degradation and MAO-B in tonic GABA synthesis | Experimental & Molecular Medicine (nature.com)
It was long thought that Selegiline was effective by directly increasing Dopamine, but it may not be right.
As you have difficulties falling asleep, you may have lower GABA now than before your ME, which may explain why Selegiline stopped working.
It may be that Amitriptyline helps you because of it's effect on GABA?These are the antidepressants I take (and these have continued working for me):
Effects kick in within a couple of hours:
- Amitriptyline 10 mg — TCA antidepressant, a reuptake inhibitor of serotonin and norepinephrine
"Additionally, several studies reported increased GABAB receptor binding sites in frontal cortex and hippocampus in rats, after chronic treatment with various antidepressant drugs (ie amitryptyline, imipramine, desipramine, maprotiline, viloxazine, fluoxetine, citalopram),1"
Selegiline does increase dopamine, but selegiline also boosts the inflammatory cytokine IL-1beta.
Increasing IL-1beta may not be an issue in healthy people, but in ME/CFS patients who already have brain inflammation, it will make the brain inflammation worse. My ME/CFS started after a viral brain infection, and I think brain inflammation is part of my ME/CFS.
When I was healthy, I had no problem with selegiline. But once I developed ME/CFS, I found selegiline had adverse effects, like because of the IL-1beta boosting.
I am not sure if the GABA effects would relate to mood boosting.
I found selegiline stopped boosting my mood once I developed ME/CFS. This antidepressant mood boost arises from the dopaminergic effect of selegiline.
I suspect that selegiline may still raise my dopamine, but the benefits may be countered by the increase in brain inflammation from IL-1beta.
I agree Selegiline is dopaminergic, but indirectely.
According to the latest research (the article was released on july 2021), MAO-B does not metabolize dopamine, it is involved in GABA production.
So Selegiline improves the dopamine circuit function by stopping the GABA inhibition on the dopaminergic neurons.
In larger doses (more than 20 mg/day), it loses its specificity for MAO-B and also inhibits MAO-A,
I don't feel the same if i take methylphenidate (dopaminergic)
However, years ago when I was healthy, and regularly took selegiline for its mood and creativity (lateral thinking) boost, I used fairly low doses of 1 or 2 mg daily. Yet this still had a strong dopaminergic feel; so I think low-dose selegiline may still boost dopamine, but by another mechanism.
So maybe as you suggest, selegiline's inhibition of GABA then resulted indirectly in the release of dopamine.
I recently tried the drug rasagiline, which is an MAO-B inhibitor like selegiline. Unlike selegiline, I don't think rasagiline has any pro-inflammatory effect on IL-1beta.
I was hoping rasagiline would give me the same nice mood and creativity boost as selegiline.
However, when I tried a low dose of rasagiline (one eight of a 1 mg tablet), I felt unusually tired all day long. This might have been a coincidence, but I have not yet tried rasagiline again.
Don't you think that if IMAO-B inhibition fails to have dopaminergic effect for you, it could mean you have low GABA?