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Vortioxetine vs classic SSRI for depression,OCD,GAD

vortioxetine

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#1 mandible

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Posted 21 May 2015 - 07:22 PM


Hello,

anyone who's on vortioxetine or who knows wether vortioxetine is superior to normal SSRIs when it comes to depression,ocd,gad?

 

So far I only tried lexapro 20mg for 4 months and it did nothing and then caused pretty bad withdrawal even though I tapered down.

I just started zoloft a week ago or so. Been to 100mg but now my doc told me to switch to vortioxetine cause it's better and just came out

where I live. I know 7 days is too short to tell if zoloft works or not. I dont know if I should go to 200mg and then see if it works or directly go

to vortioxetine. I only know that the last few days I have been very depressed and anxious and somehow I also link this to zoloft even if it might

have nothing to do with it I still have bad associations now.

 

But I dont know if vortioxetine works for ocd even in theory.

 

Other stuff I tried without any success:

 

stablon 37,5 mg

cymbalta up to 120mg

wellbutrin 300 mg

remeron 30 mg

memantine 20 mg

ritalin 20 mg (for adhd and depression, stacked with lexapro back then, didnt make the lexapro work any better)

Anafranil up to 75mg then had to stop cause of side effects, racing heart. took it for about 3 weeks starting at 10mg and couldnt feel an effect

in this short time

 

Maybe the antidepressants work and it's so weak that I cant tell a differene I dont know.

 


Edited by mandible, 21 May 2015 - 07:23 PM.


#2 mandible

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Posted 22 May 2015 - 05:01 PM

I dont understand something about vortioxetine.

 

I read that 5HT7 is important for cognition. Abilify is a 5HT7 agonist.

But vortioxetine is an antagonist! Does this not mean that it reduces 5HT7?

Would this not be counterproductive?



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#3 Flex

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Posted 23 May 2015 - 05:51 PM

5-ht7 activation causes also anxiety and is afaik prodepressant, so it depends.



#4 mandible

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Posted 26 May 2015 - 01:22 AM

You mean 5-HT7 agonism would cause anxiety?

But then why should they make any drugs which have this effect?



#5 OneScrewLoose

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Posted 27 May 2015 - 07:11 AM

Because it doesn't cause anxiety in everyone, just like SSRIs don't work for everyone.

Also, vortioxetine agonizes 5HT1a, not 5HT7, a completely different receptor. This can increase the release of oxytocin, which may help with social anxiety. Additionally, activation of this receptor seems to reduce the typical SSRI side-effects, like libido issues.


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#6 mandible

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Posted 31 May 2015 - 01:00 AM

I have been taking 5mg so far. Vortio does not seem to have sexual side effects. I can still come pretty easily.

 

However what is REALLY weird is that often times in the morning when I wake up I have the typical SSRI withdrawal symptoms.

How is this possible that I get withdrawal symptoms (brain zaps) when I am ON vortio?

 

To me this indicates that vortio doesn't seem to be very strong otherwise I cant make sense of this.



#7 OneScrewLoose

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Posted 31 May 2015 - 04:52 AM

Because zaps aren't necessarily something that happens just with withdrawal.

 

How long have you been on it? How do you feel overall?



#8 YoungSchizo

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Posted 04 June 2015 - 09:17 PM

What effect does Vortio have mentally (mental processes/energy) is it stimulating or damping?

#9 Ark

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Posted 05 June 2015 - 06:17 AM

ABSTRACT
• In a double-blind, controlled experiment, 62 outpatients with symptoms of depression with anxiety were selected for treatment with phenelzine sulfate, 60 mg daily, phenelzine sulfate, 30 mg daily, or placebo for six weeks. Forty-nine patients (79%) completed the experiment.
Phenelzine sulfate, 60 mg daily, was significantly more effective than placebo in relieving symptoms of both depression and anxiety. Phenelzine sulfate, 30 mg daily, did not differ from the placebo. Only phenelzine sulfate, 60 mg daily, resulted in a median inhibition of platelet monoamine oxidase that exceeded 80%.
The results confirm a previous study that found phenelzine to be effective in the treatment of outpatients with depressive-anxiety states. Drug dosage is an important variable influencing clinical outcome in this patient group.

#10 OneScrewLoose

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Posted 13 June 2015 - 09:46 PM

What effect does Vortio have mentally (mental processes/energy) is it stimulating or damping?

 

I would say neither for most people. It works as an antidepressant and anxiolytic while seeming to avoid these side-effects.


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#11 YoungSchizo

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Posted 13 June 2015 - 10:14 PM


What effect does Vortio have mentally (mental processes/energy) is it stimulating or damping?


I would say neither for most people. It works as an antidepressant and anxiolytic while seeming to avoid these side-effects.

Hmm.. How is it's profile compared to Mirtazapine? I'm actually scared to go off Mirta because it works damping with racing thoughts, on the other hand Mirta seems like it's not working effectively as an antidepressant/anxiolytic anymore.

#12 OneScrewLoose

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Posted 13 June 2015 - 10:16 PM

Completely different drugs. Mirtazapine antagonizes 5HT2a and 5HT2c receptors. Vortioxetine is an SRI and 5HT1a agonist. However, the two are safe to be combined.


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#13 YoungSchizo

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Posted 13 June 2015 - 11:17 PM

Completely different drugs. Mirtazapine antagonizes 5HT2a and 5HT2c receptors. Vortioxetine is an SRI and 5HT1a agonist. However, the two are safe to be combined.


That's good to hear that they can be combined, thanks.

#14 Diego55

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Posted 14 June 2015 - 10:37 PM

Has anyone already tried vortioxetine for any kind of anxiety issues (especially for social anxiety) with any success ?

 

I have tried every single SSRI drug with all family of TCA and MAOI drugs like moclobemide, nardil... and a lot of other drugs and nothing has helped me with these horrible issues. I wonder if this new drug vortioxetine could do some wonders for me ? 



#15 OneScrewLoose

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Posted 14 June 2015 - 11:16 PM

Has anyone already tried vortioxetine for any kind of anxiety issues (especially for social anxiety) with any success ?

 

I have tried every single SSRI drug with all family of TCA and MAOI drugs like moclobemide, nardil... and a lot of other drugs and nothing has helped me with these horrible issues. I wonder if this new drug vortioxetine could do some wonders for me ? 

 

It's known to be more anxiolytic because of its 5HT1a agonism, and it's a near-full agonist. Might be worth a shot.


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#16 YoungSchizo

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Posted 15 June 2015 - 12:34 AM

 

Has anyone already tried vortioxetine for any kind of anxiety issues (especially for social anxiety) with any success ?

 

I have tried every single SSRI drug with all family of TCA and MAOI drugs like moclobemide, nardil... and a lot of other drugs and nothing has helped me with these horrible issues. I wonder if this new drug vortioxetine could do some wonders for me ? 

 

It's known to be more anxiolytic because of its 5HT1a agonism, and it's a near-full agonist. Might be worth a shot.

 

 

Do I recall it correctly, isn't 5HT1a agonism a serious benefit for schizophrenia symptoms?

 

-edit- nevermind, it is: Serotonin 5-HT1A receptors as targets for agents to treat psychiatric disorders: rationale and current status of research.


Edited by YoungSchizo, 15 June 2015 - 12:42 AM.


#17 OneScrewLoose

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Posted 15 June 2015 - 08:53 PM

 

 

Has anyone already tried vortioxetine for any kind of anxiety issues (especially for social anxiety) with any success ?

 

I have tried every single SSRI drug with all family of TCA and MAOI drugs like moclobemide, nardil... and a lot of other drugs and nothing has helped me with these horrible issues. I wonder if this new drug vortioxetine could do some wonders for me ? 

 

It's known to be more anxiolytic because of its 5HT1a agonism, and it's a near-full agonist. Might be worth a shot.

 

 

Do I recall it correctly, isn't 5HT1a agonism a serious benefit for schizophrenia symptoms?

 

-edit- nevermind, it is: Serotonin 5-HT1A receptors as targets for agents to treat psychiatric disorders: rationale and current status of research.

 

All the more reason dude. There there are two of these 'atypical SSRIs', Vilazodone and Vortioxetine. Vilazodone is stronger in the SRI department and a slighter weaker 5HT1a agonist. Vortioxetine is a weaker SRI and a stronger 5HT1a agonist. It just depends on what the patient needs (e.g. if OCD were the issue Vilazodone would be the right choice). I would definitely try the vortioxetine.


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#18 YoungSchizo

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Posted 15 June 2015 - 11:08 PM

Just like with Latuda it's going to be a drama tomorrow at my pdoc's office asking to prescribe me Vortioxetine, but they known me for a while, I'll get what I want in the end :D . Because they are not "familiar" with new medications they are very reluctant in prescribing it.

 

I did some digging on my own, Vortio and Mirtazapine's MOA are completely different, could this mean double anxiolytic/antidepressant effects?

Though, I also compared Latuda and Mirta's MOA and they're somewhat the same, could this mean they also have double effect and/or they interfere with each other and/or make a stronger affinity to some receptors that contribute to some side-effects I'm having trouble with like mental exhaustion (at the gym, even though I'm in top condition), drowsiness, restlessness, agitation and extremely sweating while sleeping? 



#19 Flex

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Posted 16 June 2015 - 07:54 PM

Mirta raises cAMP in the PFC which afaik decreases PFC function, thou I wouldnt guarantee that because of my amateurish knowledge.

I´m taking this allready for 2 Years (45mg) and cant tell what its like to be not on Mirta in terms of cognition & etc.

 

All in one: Personally I think that Latuda blocks allready the receptors to a high extend and Mirta shouldnt cause any of the effects Youre posted, if Youre used to antihistamines.

Otherwise Youre ca. for the first 1-2 weeks drowsy.

Btw: A NE reptuake inhibitor + Mirta "could" be exhausting (called: california rocketfuel)


Edited by Flex, 16 June 2015 - 07:55 PM.

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#20 YoungSchizo

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Posted 17 June 2015 - 12:00 AM

I think I'm not experiencing any of the symptoms I described, I think, I am actually sure Latuda is causing Akathisia. I dropped the dosage back to 37mg (which is the lowest dose), however, any idea's how I can battle this? I just read about NAC can combat this, so popped two of them. I'm afraid if the Akathisia continues on 37mg I'm going to have to drop Latuda as it's driving me crazy.



#21 OneScrewLoose

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Posted 21 June 2015 - 11:30 AM

Sorry I didn't get back to you earlier, been a bit busy.

I recommend Toprol XL for the akathisia. It's a B1 specific antagonist that is time-released and lasts 24 hours in your system. A small dose of 50mg may be all you need.

Although Mirtazapine and Latuda effect fome of the same receptors, they have radically different effects. This leads me to believe that they work in different areas of the brain. Despite mirtazapine's 5HT2a antagonism, it is not in the least bit an antipsychotic.

Brintellix can be combined with both of these. There are little overlapping mechanisms, except for Latuda being a partial 5HT1a agonist (where brintellix is a full agonist). Depending on the strength of Latuda's agonism at 5HT1a, it could competitively antagonize Brintellix's effect on that receptor, have a neutral effect, or even enhance it.

The combination of the 3 would be perfectly safe and may be the right combo for you.


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#22 nowayout

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Posted 21 June 2015 - 02:20 PM

The clinical trial results for vortioxetine seem so underwhelming, and it is apparently ineffective for anxiety plus it has sexual sides.  I'd rather try vilazodone if I were to choose one of the newer atypical ADs - I had no side effects from it except "'roid rage," but that seems to be uncommon.   


Edited by nowayout, 21 June 2015 - 02:21 PM.


#23 YoungSchizo

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Posted 21 June 2015 - 04:19 PM

Sorry I didn't get back to you earlier, been a bit busy.

I recommend Toprol XL for the akathisia. It's a B1 specific antagonist that is time-released and lasts 24 hours in your system. A small dose of 50mg may be all you need.

Although Mirtazapine and Latuda effect fome of the same receptors, they have radically different effects. This leads me to believe that they work in different areas of the brain. Despite mirtazapine's 5HT2a antagonism, it is not in the least bit an antipsychotic.

Brintellix can be combined with both of these. There are little overlapping mechanisms, except for Latuda being a partial 5HT1a agonist (where brintellix is a full agonist). Depending on the strength of Latuda's agonism at 5HT1a, it could competitively antagonize Brintellix's effect on that receptor, have a neutral effect, or even enhance it.

The combination of the 3 would be perfectly safe and may be the right combo for you.

 

NP, Thanks OneScrewLoose, if I were able to give you more ratings I most def would have! :)

 

I was on 74mg Latuda and it was great, made me function above my average (mood, language, socially, cognitive) even though it's primary antipsychotic effect wasn't even fully reached back then. Right now I'm cutting 37mg pills in half and take it 3 times daily, even though it finally reached it's full antipsychotic effect (not miraculously, but way better than Zyprexa) and without side-effects (except being unable to sleep 8-9 hours at night, wake up 4-5 times sweating heavily) it's lost it's other positive effects I had on a one time 74mg dose. 

 

Which of the MaO of Latuda could be the cause of not being able to sleep 8-9 hours? Besides Latuda I was and still am on 45mg Mirtazapine and 0.5/1mg Clonazepam, both should be enough to put me, and keep me sleeping but it isn't anymore.. If it continues like this I feel like I have to change both medications in order to continue with Latuda. (On a side note: Mirtazapine stops racing thoughts which in turn makes me less likely prone to become psychotic if it didn't.)

 

And thanks for recommending Toprol XL I'm going to pursue to get that, but wouldn't that mask akathisia symptoms or is it a cure? (I'm afraid that the akathisia maybe become permanent, I don't want risk and/or end up pacing my days through for the rest of my life.) 

 

As for getting Vortioxetine prescribed next to what I already take, it's going to be tough and take time to persuade the idiot pdocs, but I will eventually.

 

(My sleepless nights are about to show it's effect, I wrote this in a fucking hour haha)



#24 OneScrewLoose

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Posted 29 June 2015 - 07:00 AM

 

Sorry I didn't get back to you earlier, been a bit busy.

I recommend Toprol XL for the akathisia. It's a B1 specific antagonist that is time-released and lasts 24 hours in your system. A small dose of 50mg may be all you need.

Although Mirtazapine and Latuda effect fome of the same receptors, they have radically different effects. This leads me to believe that they work in different areas of the brain. Despite mirtazapine's 5HT2a antagonism, it is not in the least bit an antipsychotic.

Brintellix can be combined with both of these. There are little overlapping mechanisms, except for Latuda being a partial 5HT1a agonist (where brintellix is a full agonist). Depending on the strength of Latuda's agonism at 5HT1a, it could competitively antagonize Brintellix's effect on that receptor, have a neutral effect, or even enhance it.

The combination of the 3 would be perfectly safe and may be the right combo for you.

 

NP, Thanks OneScrewLoose, if I were able to give you more ratings I most def would have! :)

 

I was on 74mg Latuda and it was great, made me function above my average (mood, language, socially, cognitive) even though it's primary antipsychotic effect wasn't even fully reached back then. Right now I'm cutting 37mg pills in half and take it 3 times daily, even though it finally reached it's full antipsychotic effect (not miraculously, but way better than Zyprexa) and without side-effects (except being unable to sleep 8-9 hours at night, wake up 4-5 times sweating heavily) it's lost it's other positive effects I had on a one time 74mg dose. 

 

Which of the MaO of Latuda could be the cause of not being able to sleep 8-9 hours? Besides Latuda I was and still am on 45mg Mirtazapine and 0.5/1mg Clonazepam, both should be enough to put me, and keep me sleeping but it isn't anymore.. If it continues like this I feel like I have to change both medications in order to continue with Latuda. (On a side note: Mirtazapine stops racing thoughts which in turn makes me less likely prone to become psychotic if it didn't.)

 

And thanks for recommending Toprol XL I'm going to pursue to get that, but wouldn't that mask akathisia symptoms or is it a cure? (I'm afraid that the akathisia maybe become permanent, I don't want risk and/or end up pacing my days through for the rest of my life.) 

 

As for getting Vortioxetine prescribed next to what I already take, it's going to be tough and take time to persuade the idiot pdocs, but I will eventually.

 

(My sleepless nights are about to show it's effect, I wrote this in a fucking hour haha)

 

I just looked it up and it appears that Latuda is a potent antagonist at alpha 2 receptors. I did not know this before. This means that it increases the release of norepinephrine. The Toprol should help a lot with this. We can look into other options if it does not.


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#25 YoungSchizo

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Posted 14 July 2015 - 11:59 AM

I just looked it up and it appears that Latuda is a potent antagonist at alpha 2 receptors. I did not know this before. This means that it increases the release of norepinephrine. The Toprol should help a lot with this. We can look into other options if it does not.

 

 

 

a little update:

 

Well, cutting the pills in 20mg and take it 3 times daily eventually backfired too after a week. I stumbled upon akathisia, tremors and heart palpitations, again! I went back to cutting 37mg and take it two times daily, which is effective but by far not as effective as a one time 74mg which demolishes almost all my positive symptoms.  :sad:

 

However, one very positive finding though, I've managed to find a way to restore my sleep and excessive night sweating. I've decreased Mirtazapine from 45 to 30mg and my sleep disturbance went away, turned out that 45mg did the opposite of what 30mg does to me, it stimulated instead of sedated. My pdoc got pissed about this because I did it without her permission and quite frankly I enjoyed making her pissed cause I ain't one of her "slaves".   :dry:

 

As for getting Toprol and/or Popranolol my pdoc is being a senseless bitch about it, she decline to prescribe it unless my heart palpitations showed up on a ECG. Yesterday I had my ECG check-up and it turned out to be just fine which wasn't surprising for me because on this low dosage I don't have any adverse effects. I told the bitch of a pdoc that nothing will show up but she would not listen, I've tried to cheat and took a 74mg pill that day but unfortunately I failed to get me some heart palpitations.  :-D

 

Anyway, one way or another I will force my pdoc eventually to prescribe me a adjunctive for these adverse effects because I really need to find a way to tolerate 74mg and who knows, maybe live happily ever after.  :sleep:



#26 OneScrewLoose

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Posted 14 July 2015 - 01:13 PM

Wow, so you had a moderate dose of Latuda, and a quite high dose of Mirtazapine...both which potently antagonize alpha-2, both which therefore increase the release of Norepinephrine....no wonder you were on edge.

 

I've been looking into it and there is same evidence that SAM-E will help in the turnover of that excess NE, but I couldn't find conclusive evidence. It may be worth a try, but I would start slowly, like at 50mg, because there is also potential that i could make it worse.

 


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#27 YoungSchizo

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Posted 14 July 2015 - 02:48 PM

How bout I lower Mirtazapine to 15mg, theoretically will it help reduce adverse effects of Latuda? (I've been thinking about switching from Mirtazapine to give Vortioxetine a try anyway.)

 

And as for SAM-e, I've researched it quite some time ago and didn't like what I've read/found out about it. And in general, I rather stick to conventional medicine for the time being. First things first, I need to adjust/change the drugs I already take to make it work alongside Latuda, my main goal right now is to get rid of any positive symptoms as I've notice after 10 years it actually IS possible.


Edited by YoungSchizo, 14 July 2015 - 03:04 PM.


#28 OneScrewLoose

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Posted 15 July 2015 - 01:14 AM

Reducing it to 15mg will probably go along way in reducing overall alpha-2 antagonism and reducing NE, and your tension. Try it for a few days and report back.



#29 YoungSchizo

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Posted 23 July 2015 - 04:55 PM

Reducing it to 15mg will probably go along way in reducing overall alpha-2 antagonism and reducing NE, and your tension. Try it for a few days and report back.

 

Well, it's been a week since I lowered the Mirtazapine to 15mg, I took whole dosages of 37mg Latuda which I finally could tolerate. Though I've also have noticed that Latuda started to work differently. Usually I took it when waking up because it was stimulating (because of the excessive NE production of Mirtazapine I assume), now however it was sedating and quite depressing for 1-3 hours so I took it right before sleeping which was a good choice to do. However, I've had a little psychotic break for 1-2 days this past weekend even though I wasn't stressed, could it be caused by lowering Mirtazapine? To counter the psychotic symptoms I upped my Latuda dosage this past Monday to 74mg which helped for psychotic symptoms as for the heart palpitations. Upping the Latuda has not caused any tremor, heart palpitations and/or akathisia to this day but there is a possibility it will after a week (like it did the previous 2 times I was on 74mg).

 

Anyway, I'm struggling with one main issue at the moment, my concentration, longterm-memory and short-term memory are so fucked up at the moment I can't focus on anything than my fucking thoughts, they sort of keep misfiring and keep popping up to the point I'm unable to function properly and am so forgetful like I'm suffering from Alzheimer. Yes, that bad! (I do not experience racing thoughts though, which I was afraid of if I lowered the Mirtazapine). Any thoughts on this? Was/is Mirtazapine a cognitive enhancer? On a side note: even though I do not function properly at all I experience a full remission of depressive symptoms thanks to Latuda and maybe the 15mg Mirtazapine. 

 

I also went to the psychiatrist today, and they and I are kind of puzzled by what causes the heart palpitations, I experience it as both a psychotic symptom (the voices kinda give meaning to why it happens) as a physical reaction (when I'm not psychotic it rarely happens and when it does it's very mild).. Anyone an idea if the heart is able to play a (psychical/mental?) role in schizophrenia?  :|?


Edited by YoungSchizo, 23 July 2015 - 04:59 PM.


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#30 Junk Master

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Posted 23 July 2015 - 06:25 PM

Not to jack it, but great thread.  Excellent advice OneScrewLoose.

 

SAMe is a weird one, isn't it.  I find it useful in combo with Modafinil but only when I'm trying to extend the efficacy of moda over more than three days.  When it works, it also seems to take the edge of large Moda doses (plus 400 mg).

 

Sometimes high doses of SAMe seem to work wonders for my joints and sometimes do nothing but give me the runs.


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