9 replies to this topic

[Tom_]

Hi all, for those of you who don't know me very well, I have moderate excessive day time sleepiness, fatigue, amotivation etc.. caused by multiple and complex sleep disorders (delayed sleep phase syndrome, sleep related breathing disorder) and chronic moderate-severe depression with accompanying severe psychosocial dysfunction and personality pathology. There is also chronic anxiety and

I'm currently on: Agomelatine 50mg and 3mg melatonin. About to start modafinil (I tried briefly once but didn't get much effect, am planning on trying again 'properly', methylphenidate at doses below 80mg had very little stimulating effect. About to start CPAP. And using bight light therapy sporadically, planning on using it properly.

I'm looking either for an adjuctive antidepressant or one to swap with Agomelatine that has strong noradrenaligric re-uptake inhibition without causing undue antihistamine effects/anticholinergic effects. Vanlafaxine is obviously one option but its not very strong noradrenalirgic RI. Wellbutrin is also. Possibly incombo.

Tryacopramide is one option but want to leave it for as long as possible.

Selegeliline is a possibility but it will be hard to get hold of it here.

Traditional stimulants are a no go and don't really have an anti-depressive effect. I'm not really looking for anything like sulbutramine either.

So can you guys give a list of the most stimulating antidepressants.

I am considering something like Vanlafaxine, mirtazapine and bupropion

Thanks

Edited by Tom_, 26 April 2013 - 12:41 AM.

[**DEACTIVATED**]

Bupropion

[Southern_Lights]

Can't say that I have too much to add because it seems your interested in chemicals I have very little knowledge of.
Anecdotally however, Lexapro was very stimulating, for the first couple of weeks it felt like I was on MDMA (Hyper, Want to talk to everyone etc). I have not been able to replicate these effects with Zoloft (only gave me a feeling of a permanent hangover) or any other substance for that matter.
Insurance unfortunately doesn't see the difference, they just focus on the money-makers.

[daouda]

All NRIs, NDRIs, SNDRIs antidepressant should be stimulant shouldnt they?

[nupi]

In my experience, Cymbalta or high doses of Bupropion (both of which can cause anxiety/OCD so be careful) followed by Fluoxetine (much milder though). Venlafaxine is strong on the mood part but comes with the nastiest side effects of them all for me (like massive, rapid weight gain)

Edited by nupi, 26 April 2013 - 06:38 AM.

[1thoughtMaze1]

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[Tom_]

I can't get a hold of protriptyline.

I'm considering: Desipramine, Nortriptyline, Venlafaxine, Bupropion.

I'd hope to be using Venlafaxine and Bupropion in conjunction (I know its not idea; because of antagonistic effects on cytochrome P450 (CYP) 2D6 and venlafaxine dose may need to be reduced a lot). Maybe even Desipramine/Nortriptyline with Bupropion.

[Reformed-Redan]

Any time Bupropion is mentioned the study showing neurotoxicity and Bupropion should be shown. I can't find it but its somewhere around here.

[Dissolvedissolve]

Fluoxetine, especially at low doses, ie 5-10 mg, has some very interesting serotonin antagonist properties that are indirectly pro-dopamine. I believe it is a 5-HT2c antagonist. So it should be stimulating without being anxiogenic. Other than that, bupropion is known for being quite stimulating due to its induction of NE release, although has anxiety as a very common side-effect.

[Tom_]

Other way round mate, the antagonism isn't relevant until about 20mg/day. Unfortunately the noradrenaline dopamine disinhibition doesn't have a very strong effect, thanks anyway.