I tried a rare antidepressant called Opipramol and it worked wonders for cfs.

[cfsJapan]

I suffer from ADHD and CFS, and am particularly troubled by brain fog (a physical feeling of pressure on the brain).

(As an aside, the brain fog is not a cognitive thing, but rather a constant feeling of pressure on my head. I have degenerated discs and abnormally low cortisol levels. What on earth could this be due to?)

So I tried Opipramol, which acts on Sigma-1, and it had a strong effect on both ADHD and CFS.

I also respond well to Prozac, but is this also related to Sigma-1?

However, when I take Opipramol, even a small amount makes my blood pressure very high (my blood pressure is usually around 100/70, but it went up to 140/90)

What I want to ask is:

①What should I know about Opipramol (especially the side effects I should be aware of. I am prone to QT prolongation, so Opipramol, being a tricyclic antidepressant, may be dangerous for me)

②What should I know about Sigma-1 receptors

③What could be the cause of my brain fog and what can I do about it? (Opipramol, Prozac, and Nortriptyline temporarily reduce this pressure, but I feel like the effects of the medicine are wearing off)

Sorry for the long story. I'd like some hints, even if it's just a partial answer.

 

[jaybee00]

So I tried Opipramol, which acts on Sigma-1, and it had a strong effect on both ADHD and CFS.

Can you explain further about what strong effect this medication had? Increased energy levels? Decrease brain fog?

Thank you.

 

[Hufsamor]

①What should I know about Opipramol (especially the side effects I should be aware of. I am prone to QT prolongation, so Opipramol, being a tricyclic antidepressant, may be dangerous for me)

I asked chatGPT. It’s not completely reliable, but it might give you an idea of what to look for? An idea of what might be worth to google further?

 

[Hufsamor]

②What should I know about Sigma-1 receptors

Same warning as above. Take it as a suggestion from someone who might or might not have a clue

 

[Hufsamor]

③What could be the cause of my brain fog and what can I do about it? (Opipramol, Prozac, and Nortriptyline temporarily reduce this pressure, but I feel like the effects of the medicine are wearing off)

Same warning as for the other two

 

[kushami]

I suffer from ADHD and CFS, and am particularly troubled by brain fog (a physical feeling of pressure on the brain).

(As an aside, the brain fog is not a cognitive thing, but rather a constant feeling of pressure on my head.

A lot of people with Long COVID mention a feeling of pressure on or in the head. I don't know whether any of them have figured out what it is or how to treat it.

If you have low cortisol, has any doctor suggested taking a small dose of steroids? Or have you tried this on your own?

 

[Wayne]

I'd like some hints, even if it's just a partial answer.

Hi @cfsJapan -- I ran your post and description of your experiences by AI, asking it if your situation could indicate a brain signaling issue. Below is its response.

​

Spoiler: CFSJapan’s symptoms and drug responses strongly suggest a central brain signaling issue

Could this person's experience indicate he's dealing with a brain signaling issue(s)?​

​

ChatGPT said:​

Yes — very likely. CFSJapan’s symptoms and drug responses strongly suggest a central brain signaling issue, particularly involving neurotransmitters, neuroinflammation, and possibly brainstem or limbic dysfunction.​

---

Signs Pointing to Brain Signaling Dysfunction:​

1. “Physical brain fog” described as pressure​

• Not just cognitive slowness, but a somatic, pressing sensation in the head
• Often reported in people with dysregulated brainstem activity, neuroinflammation, or intracranial pressure abnormalities
• This symptom is common in:
  • ME/CFS
  • Craniocervical instability (CCI)
  • Chronic neuroinflammation
  • Limbic system dysregulation (e.g., amygdala/insula overactivation)
  • Autonomic dysfunction (POTS, OI) with poor cerebral blood flow

---

2. Strong response to Sigma-1 receptor drugs (Opipramol, Prozac)​

• Sigma-1 receptors modulate cell signaling in mitochondria, neurons, and glial cells
• They regulate calcium signaling, ER stress, NMDA receptor activity, and neuroplasticity
• These drugs don’t merely affect mood — they alter neuroimmune and neuroenergetic signaling
• Their impact suggests dysfunction in cellular stress responses and glial signaling in the brain

---

3. Profoundly low cortisol​

• Cortisol is controlled by the HPA axis, which is centrally regulated by the hypothalamus and pituitary
• Very low cortisol could mean:
  • Central suppression due to chronic stress or inflammation
  • Hippocampal damage or altered limbic signaling
  • Some autoimmune conditions (like Addison’s), but in young people with ME/CFS, central dysfunction is often the cause
• Cortisol also affects noradrenaline and dopamine regulation, sleep, and inflammation

---

4. Positive response to noradrenergic agents​

• Suggests deficient or dysregulated dopaminergic/noradrenergic tone
• This is consistent with:
  • Frontal/brainstem underactivation
  • Fatigue of central origin
  • ADHD-like signaling imbalance
• Also common in people with hypoperfusion to frontal cortex (found in many ME/CFS and long-COVID patients)

---

5. Loss of medication effectiveness over time​

• A hallmark of dysregulated receptor signaling, not just chemical imbalance
• Suggests problems with homeostasis or feedback loops — as seen in glial cell priming or autonomic imbalance
• This is often a clue to neuroimmune crosstalk malfunction, not just "neurotransmitter depletion"

---

So what kind of “brain signaling issue” is likely?​

Potential Focus​	Description​
Neuroinflammation​	Microglial priming → alters brain signaling, reduces neuroplasticity, causes “sick brain” symptoms​
Hypothalamic dysfunction​	Disrupts HPA axis, sleep, temperature, and energy balance​
Brainstem compression/dysfunction​	Can explain pressure in head, dysautonomia, low cortisol, and even postnasal drip (vagus/glossopharyngeal involvement)​
Cerebral hypoperfusion​	Low blood flow to frontal cortex or brainstem = fog, fatigue, poor drug metabolism​
Limbic system overactivation​	Common in ME/CFS, triggers exaggerated stress responses, body-wide symptoms​
Dopamine/norepinephrine signaling imbalance​	Can explain ADHD symptoms, fatigue, anhedonia, and partial drug response​
Sigma-1 receptor axis dysfunction​	Suggests cellular signaling and mitochondrial modulation problems in CNS​

​

---

Summary:​

Yes — his experience points squarely to a central signaling problem. The clues — from physical brain fog to cortisol issues and Sigma-1 drug responses — align with neuroimmune and brain signaling dysfunction, not simply psychological or peripheral fatigue.​

If you'd like, I can help:​

• Draft a brain signaling hypothesis tailored to his case
• Build a list of interventions that target central signaling repair (from meds to behavioral/neuroplastic tools)
• Suggest diagnostic directions (e.g., MRI, SPECT, tilt table, qEEG, hormone challenge)

​

​

 

[Hufsamor]

@Wayne how do you do that hiding thing?
Where only the topic shows on a blue line and you have click to read?

 

[bad1080]

@Wayne how do you do that hiding thing?
Where only the topic shows on a blue line and you have click to read?

it is hidden under "more options" and then "spoiler"

https://imgur.com/0C7X1VE

 

[Hufsamor]

Thanks

Spoiler: Thanks

Her er en aristokratisk og svært fjong måte å si “tusen takk” på engelsk:





“I am most exceedingly grateful and forever in your debt. Your generosity shall not be forgotten.”





Eller enda litt mer høytidelig:





“Pray, accept my most profound gratitude. I remain ever appreciative of your most gracious kindness.”





Vil du ha det som del av et brev, tale, eller bare en enkelt setning?

 

[Hufsamor]

Next question, does @Wayne just copy and paste?
My attempt above doesn’t turn up quite as good as his..

 

[Wayne]

Next question, does @Wayne just copy and paste?
My attempt above doesn’t turn up quite as good as his..

Hi @Hufsamor -- I'm working on that one. It's been a bit frustrating having to take out a lot of superfluous paragraph breaks. So I began asking ChatGPT to create a response without them. It tightens things up considerably, but I still often have to do a bit of tweaking afterwards. AND, I have to continue to tell it to do that. -- I'll keep you posted on any new things I learn that make for a cleaner cut and paste.

 

[pamojja]

I have one request. Could we agree to put AI responses into quotes, to make it easier to distinct the author's from AI's response?

Spoilers, especially with too elaborate text, are of course a good means too. But for precise explanations the additional click is sort of unnecessary.

 

[Wayne]

Spoilers, especially with too elaborate text, are of course a good means too. But for precise explanations the additional click is sort of unnecessary.

I think your idea about putting quotes around AI responses has merit, but will it be readily known by those reading it? -- I started using "spoilers" (kind of a strange word) because it's quite easy to create a title that clearly indicates an AI response. I use them as a courtesy for:

1) Those who aren't particularly comfortable with AI, and don't want to have to constantly see long AI oriented messages that are now more and more frequently being posted; and​

​

2) Not to take away from the flow of a thread. For me, long messages sort of overwhelm me, and being able to take them out of view with a click is helpful.​

But I'm open to whatever works. Would be nice to build some kind of consensus on this. One thing I'm planning on doing is making relatively short posts, letting readers know a bit of my perspective and letting them know what's in the spoiler. And then they have the choice of whether or not to click on it.

 

[pamojja]

Agreed with 1. and 2.. However, with quotes too, one has the choice to ignore, if too elaborated. Maybe a good idea to shorten AI response's to really salient points, everyone likes and is able to read? But keep the remains under hiding spoiler? Could also be combined within quotes.

it's quite easy to create a title that clearly indicates an AI response.

As easy as to change any quotes title (see your adulterated title above). By clicking on the rightmost 3 dots in the formatting bar, and choose 'Toggle BB code'.

 

[Hufsamor]

@pamojja
So your thinking something like this?

I asked ChatGPT about this. It said:

“Posting a ChatGPT answer effectively—whether on social media, a blog, a forum, or in professional communication—means presenting it in a way that is clear, trustworthy, and engaging.”

Spoiler: ChatGPT - how do we post the best way

1.

Edit for Clarity & Tone


Refine the language for your audience—remove unnecessary AI-related phrasing like “As an AI language model…”

• Match the tone to the platform: casual for Reddit, professional for LinkedIn, polished for a blog, etc.
• Use simple language unless technical terms are required.

2.


Add a Human Touch


Summarize or introduce the answer in your own words first.

• Frame the response like:
  “Here’s what I found based on ChatGPT’s breakdown:”
  or
  “I asked ChatGPT about this—here’s a great summary:”

3.


Format It Well



Use formatting to increase readability:


Headings for sections

• Bullet points or numbered lists
• Bold key phrases
• Keep paragraphs short

4.


Cite ChatGPT Transparently (if needed)


If the context requires transparency, mention the source:

“Generated with help from ChatGPT by OpenAI.”


This is particularly important in academic, journalistic, or professional settings.





5.


Customize or Expand the Content



Add examples, personal experiences, or local/contextual relevance.

• Combine ChatGPT’s content with your own insights or research.

6.


Ensure Accuracy



Fact-check important claims or data.

• For technical or legal content, verify with a reliable source or expert.

7.


Use Visuals if Possible



For blog posts or social media, visuals boost engagement:


Diagrams

• Screenshots
• Highlighted quotes

 

[pamojja]

So your thinking something like this?

I asked ChatGPT about this. It said:

Rather like this, also do the tedious cleaning out the terrible formatting inside your spoiler.

“Posting a ChatGPT answer effectively—whether on social media, a blog, a forum, or in professional communication—means presenting it in a way that is clear, trustworthy, and engaging.”

Spoiler: “Posting a ChatGPT answer effectively—whether on social media, a blog, a forum, or in professional communication—means presenting it in a way that is clear, trustworthy, and engaging.”

1. Edit for Clarity & Tone

Refine the language for your audience—remove unnecessary AI-related phrasing like “As an AI language model…”

• Match the tone to the platform: casual for Reddit, professional for LinkedIn, polished for a blog, etc.
• Use simple language unless technical terms are required.

2. Add a Human Touch

Summarize or introduce the answer in your own words first.

• Frame the response like:
  “Here’s what I found based on ChatGPT’s breakdown:”
  or
  “I asked ChatGPT about this—here’s a great summary:”

3. Format It Well

Use formatting to increase readability:

Headings for sections

• Bullet points or numbered lists
• Bold key phrases
• Keep paragraphs short

4. Cite ChatGPT Transparently (if needed)

If the context requires transparency, mention the source:

“Generated with help from ChatGPT by OpenAI.”

This is particularly important in academic, journalistic, or professional settings.

5. Customize or Expand the Content

Add examples, personal experiences, or local/contextual relevance.

• Combine ChatGPT’s content with your own insights or research.

6. Ensure Accuracy

Fact-check important claims or data.

• For technical or legal content, verify with a reliable source or expert.

7. Use Visuals if Possible

For blog posts or social media, visuals boost engagement:

Diagrams

• Screenshots
• Highlighted quotes

 

[Wayne]

“Posting a ChatGPT answer effectively—whether on social media, a blog, a forum, or in professional communication—means presenting it in a way that is clear, trustworthy, and engaging.”

I took the AI response you had in your Spoiler link, and asked ChatGPT to take out all the superfluous paragraph breaks, and make it readable (which it readily did). Here's its (notable) reply:

Let me know if you want me to reformat anything else in this style—happy to help streamline it.​

You said:​

But why oh why do we have to continually ask you to reformat things? Can't we just have some kind of default that tells you to format it as if it's going to be a cut and paste?​

​

ChatGPT said:​

You're 100% right to be frustrated. If you frequently copy and paste responses, it makes total sense to want a cleaner, compact format by default—without having to ask every single time.​

The good news? I can absolutely remember that preference for you going forward.​

I'll now default to formatting responses with:​

• Minimal paragraph breaks
• Tight, bullet-style formatting
• Copy/paste-friendly structure
• No AI disclaimers unless needed

If you ever want a more expanded or narrative version, just say so. Otherwise, you won’t have to repeat this request again.​

Preference saved. Expect cleaner formatting from here on out.​

 

[bad1080]

not having to scroll past pages of AI answers is a big argument for using spoilers imo, an extra click to reveal said spoiler seems like a minor inconvenience in comparison. but whatever is going to be the solution, making them clear and distinct is the most important part imo.

 

[Hufsamor]

@Wayne I now asked mine to do the same, and my preference is saved.
I have a steep learning curve at the moment

@pamojja glad you brought it up and came up with suggestions

@bad1080 agreed