2 replies to this topic

[Doktor]

Hi all,

Since about February, I have been 100% off of SSRI-based medications (was on lexapro), and have been taking Vyvanse at only 15-20mg daily to help with mood/focus/energy. I have always had a MUCH more significant response to amphetamine-based ADD/ADHD meds as opposed to methylphenidate or strattera, but since I have co-morbid anxiety with my off-and-on depression, the amphetamines do have a noticeable impact on my general level of anxety and stress throughout the day.

Here is what I have learned regarding the vyvanse: for me, I benefit from therapeutic effects at doses as low as 15mg daily (I am prescribed 30mg); at this dose, I hardly notice the actual "amphetamine-style" focus, but do notice that my mood, energy level, and general mental performance is where it should be. However, even at this low dose, I do still notice that I get stressed out quicker, and am slightly more "emotionally volatile" then I am without the stimulation.

In a bid to counteract these side effects, I got some paxil (20mg generic) prescribed by my doctor. The first day I took this medication (only half a pill), I felt like I had not only been given a partial lobotomy, but I had the energy and libido of a 90 year-old... completely unacceptable. Typically I would wait out the start-up effects of a medication before discontinuing, but the effects were so horrificly strong on me that I decided against it.

This brings me to now: today, I took one eighth of my prescribed paxil dose (2.5mg, liquid measured); at this dose, I notice:

1. A reduction in my physical agitation level.
2. Slightly more mellow mood.
3. No side effects.
4. Minimal dampering effect on my vyvanse (as a normal therapeutic dose of paxil will partially cancel out stims competing for CYP2D6

I am interested in microdosing paxil for a few reasons:

1. It is the strongest serotonergic SSRI med avaliable: Seeing as there is an inverse relationship between dopamine and serotonin, I would wager that my serotonin levels are slightly lower then a non-medicated individual due to the vyvanse... if microdoses of paxil can raise my serotonin levels even slightly, then I should experience some benefit in my daily stress levels and anxiety, which I have found reduced while I was taking lexapro.
2. Paxil is a potent inhibitor of CYP2D6... I want to experiment with these microdoses to see if I can slightly extend the duration of my vyvanse (thus smoothing the already-fairly-smooth comedown), while not reducing its overall effect too significantly. I believe this will involve a bit of a juggling act, but could work with the correct dose.

One reason which led me to believe this could be beneficial is that the effects I felt when the initial 10mg dose of paxil was first taking effect (and after I decided to skip my second dose) were quite positive; very relaxing with minimal sides... I postulated at this point that paxil may be beneficial at a lower dose then what is ever prescribed. This could have really been caused by any number of different things, but it gave me a little push to try this out.

Here is an interesting article on microdosed prozac: http://www.theguardi...dose-prozac-pms. Although I don't suffer from PMS (lol), this article does highlight the potential merit of sub-therapeutic doses of SSRI medications... After all, just because a medication is labeled with a given minumum dose of Xmg does not mean that it will have no effect at dosages below Xmg... and besides, I seriously doubt that lower doses then the recommended minimum have been significantly researched in humans.

So anyone experiment with anything similar? Comments? Also... does anyone know if there is any medical literature outlining the threshold dose for both serotonergic and anti-cholinergic effects, respectively? Ideally, I would like to find the lowest dose that exhibits serotonergic effects, while having minimal anticholinergic effects... although seeing as some people (myself included) experience depression from racetams, the anticholinergic effect (with a modest magnitude of effect) may be partially responsible for Paxil's anti-depressive effects... Who knows! So incredibly little is known about how these medications work, and there is (IMO) definitely a lot of potential in exploring micro-doses.

Final note: If this goes well (which so far it is), then I will probably begin exploring micro-doses of various other anti-depressants, including even Parnate (which will require temporary cessation of my vyvanse and a washout period for safety sake). It will be interesting to see if Parnate's contraindications are as applicable with doses below 10mg daily...

 

[Michael Rian]

BUMP!  I am very interested in this, I have a doctors appointment tomorrow and I might talk to him about micro-dosing an antidepressant.  I was on SSRIs/Benzo combo for 4+ years, been off of everything for about 2+ years, but still feeling depersonalized, brain fog, concentration issues, ect ect.  I have been on a very healthy diet and exercise regimen and I sleep fairly well.  I have tried most of the basic supplements and nootropics with little or no effect.  I am getting desperate to feel like myself again so perhaps micro-dosing is the way to go.  Anyways, great thread and good luck with your issues, do you have any updates?  Thank you,  

 

MR 

[blood]

Low-dose prozac seems to be working its magic via increases in allopregnanolone.

Perhaps a pregnenolone supplement would product similar benefits (produces big increases in circulating & brain allopregnanolone)?