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Old 10-01-2013, 06:31 PM   #1 (permalink)
 
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Default What Is Zyprexa's Effect On Dopamine?

I'm looking for a good explination on how Zyprexa and other second generation antipsychotics like Seroquel, etc affect dopamine and other neurotransmitters like serotonin and gaba. (In layman's terms.. I realize a thorough read through google has plenty of explinations but I am honestly confused as to what neurotransmitters get lessened, which get increased and all that haha :P)

And from anyone with experience with them, which dosages worked best for you and in combination with which medications? I've tried so many meds in the past 8-9 months including SSRIs, Amphetamines, MAOIS, Lamotrigine for like a day on a really low dose lol (made me anxious) and Lyrica, that I am beginning to believe bipolar II or something similar like cyclothemia may be causing my depressions and GAD. which is why I am suddenly curious about these meds.. I'm hoping to find a good combo soon. perhaps a low dose atypical antipsychotic along with an SSRI like Lexapro and then Lyrica thrown in might do me good, but im really unsure what my needs are from meds now. my depressions are usually very low energy and i tend to be somewhat dazed/lethargic at least mentally (slower) and i get anger along side it sometimes.. the pdoc at first thought it might be ADD-PI but I used Adderall XR and it really didn't help me focus at any dosages we tried, just increased anxiety and I experienced massive energy, along with anger and bad irritability and crying eventually when it wore off but I realize some of those symptoms were amphetamine come down too. Celexa activated me almost immediately, id say from day 1 or 2 and it made me somewhat hypomanic I think looking back now because I was spending money carefree and didnt care about calling in from work to go have fun, attempted to get with alot of different girls when normally i am an anxious guy etc but then i remember I began to feel depressed again and have bad crying spells, along with i think worsened depression. Nardil didnt help with racing thoughts and depression the way I thought it would and actually kind of made me obsessive thought wise which Im pretty sure is probably another potential indicator of possible bipolar ??.. not to mention the Nardil-induced stupidity and physical sedation
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Old 10-02-2013, 03:13 AM   #2 (permalink)
 
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Dosages range from little dopamine blockade to a lot. For me there is a good synergy between Zoloft and Olanzapine at any dose. From 5-10 mg the dopamine blockade ramps up a fair bit, with 20 quite a lot.
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Dx: Bipolar I
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- Migraine Headaches

Current meds: Lamictal 400mg
(200mg am 200mg pm)

Clonazepam 1mg/day
Propranolol 60mg
Valium 10mg/day
Saphris 10mg
Zoloft 150mg
Zopiclone 7.5-15mg prn
Zyprexa Zydis 5mg

Previous useless meds: Dosulepin 50mg, Lithium 900mg Lexapro 20mg, Lyrica 100mg, Moclobemide 450mg, Prozac 60mg, Sodium Valproate 1500mg, Sumatriptan 50mg, Temazepam 20mg, Topamax 100-150mg,
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Old 10-02-2013, 05:32 AM   #3 (permalink)
 
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You mean your Zoloft increases your dopamine and the Zyprexa decreases it? Does Zyprexa help you alot? Make you really drowsy or dumb lol?
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Old 10-02-2013, 05:54 AM   #4 (permalink)
 
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Quote:
Originally Posted by hworth View Post
You mean your Zoloft increases your dopamine and the Zyprexa decreases it? Does Zyprexa help you alot? Make you really drowsy or dumb lol?
I'm not sure if zoloft increases dopamine, however i know that zoloft+Olanz works really well for me.

I don't feel drowsy even at the max dose of Olanz (20mg).
However, I'm a high functioning bipolar 1
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Dx: Bipolar I
- GAD + Panic attacks
- Insomnia
- Migraine Headaches

Current meds: Lamictal 400mg
(200mg am 200mg pm)

Clonazepam 1mg/day
Propranolol 60mg
Valium 10mg/day
Saphris 10mg
Zoloft 150mg
Zopiclone 7.5-15mg prn
Zyprexa Zydis 5mg

Previous useless meds: Dosulepin 50mg, Lithium 900mg Lexapro 20mg, Lyrica 100mg, Moclobemide 450mg, Prozac 60mg, Sodium Valproate 1500mg, Sumatriptan 50mg, Temazepam 20mg, Topamax 100-150mg,
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Old 10-02-2013, 06:04 AM   #5 (permalink)
 
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Typically lower doses 2.5-5mg increases dopamine in the prefrontal cortex. Once you go 10+ then start dropping dopamine in the mesolimbic pathway among other areas. That is even lower doses still have some effect on these areas but just not great enough to be considered therapeutic.
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Old 10-02-2013, 08:48 AM   #6 (permalink)
 
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Quote:
Originally Posted by A Sense of Purpose View Post
I'm not sure if zoloft increases dopamine, however i know that zoloft+Olanz works really well for me.

I don't feel drowsy even at the max dose of Olanz (20mg).
However, I'm a high functioning bipolar 1
Actually, believe it or not, there's evidence to suggest that Sertraline does indeed increase dopaminergic activity.

Here, for example: http://www.psychotropical.com/index....upropion-zyban

This doctor pretty much slams the science behind Bupropion's marketing.

Back to the OP's post

It really sounds that you have a good case for an unstable mood disorder. Perhaps Borderline Personality Disorder (or the more accurate Emotionally Unstable Personality Disorder). I don't know your symptoms, so I really can't judge. But you might want to look into them.

As for medications, a combination of Olanzapine and an SSRI has pretty good evidence. Olanzapine doesn't seem to be doing anything for me, but that doesn't mean it won't work for you. It's probably got some of the best evidence around for use in bipolar depression. Just be wary of weight gain.

FWIW, I would avoid Risperidone and Aripiprazole. Last psychiatrist said they really didn't help with anxiety, and Risperidone is not good for young men, for sexual side effects

Lyrica is a good drug for anxiety, and anxiety may very well "kindle" your depression. Problem is, the side effect profile. It CAN (but doesn't always) make you very dopey. If you're not used to sedating drugs, it may also make you quite tired.

Bear in mind with Lyrica: a) it's hella expensive; b) the maximum dose for anxiety (600mg) is significantly lower than its usage for pain disorders. Or so said my previous psychiatrist, who seemed to know his stuff.
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Dx: MDD, EUPD/BPD, occasional mania, strong anxiety

Daily Rx:
  1. Pregabalin, 600mg
  2. Lamotrigine, 300mg (currently titrating to 400mg/600mg. Hopefully)
  3. Metformin - 2g
  4. Clomipramine, 150mg
  5. Olanzapine, 20mg (discontinued - unofficially)
  6. Chlorpromazine, 100mg (aiming to replace Olanzapine with this)
  7. Flupenthixol, 3mg (aiming to restart this soon)
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Old 10-02-2013, 09:11 AM   #7 (permalink)
 
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Quote:
I've tried so many meds in the past 8-9 months including SSRIs, Amphetamines, MAOIS, Lamotrigine for like a day on a really low dose lol (made me anxious) and Lyrica, that I am beginning to believe bipolar II or something similar like cyclothemia may be causing my depressions and GAD. which is why I am suddenly curious about these meds


I agree with the poster above me. Your symptoms seem to be more along bipolar disorder, than Generalized Anxiety Disorder. I am diagnosed with GAD, more specifically PD (Panic Disorder) and I take a SSRI, which helps significantly; however the SSRI I take, Setraline, is approved by the FDA to handle anxiety disorders such as PD.

I once tried Zyprexa, an antipsychotic, which didn't work. But based on what I've researched, antipsychotics are not approved by the FDA for anxiety disorders, but for bipolar disorder and schizophrenia.

So if your symptoms are more about bipolar disorder - an antipsychotic like Zyprexa may be of help to you.
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Old 10-02-2013, 07:55 PM   #8 (permalink)
 
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Quote:
Originally Posted by VERBW View Post
Actually, believe it or not, there's evidence to suggest that Sertraline does indeed increase dopaminergic activity.

Here, for example: http://www.psychotropical.com/index....upropion-zyban

This doctor pretty much slams the science behind Bupropion's marketing.

Back to the OP's post

It really sounds that you have a good case for an unstable mood disorder. Perhaps Borderline Personality Disorder (or the more accurate Emotionally Unstable Personality Disorder). I don't know your symptoms, so I really can't judge. But you might want to look into them.

As for medications, a combination of Olanzapine and an SSRI has pretty good evidence. Olanzapine doesn't seem to be doing anything for me, but that doesn't mean it won't work for you. It's probably got some of the best evidence around for use in bipolar depression. Just be wary of weight gain.

FWIW, I would avoid Risperidone and Aripiprazole. Last psychiatrist said they really didn't help with anxiety, and Risperidone is not good for young men, for sexual side effects

Lyrica is a good drug for anxiety, and anxiety may very well "kindle" your depression. Problem is, the side effect profile. It CAN (but doesn't always) make you very dopey. If you're not used to sedating drugs, it may also make you quite tired.

Bear in mind with Lyrica: a) it's hella expensive; b) the maximum dose for anxiety (600mg) is significantly lower than its usage for pain disorders. Or so said my previous psychiatrist, who seemed to know his stuff.
It's good to hear this response and the others along with it in this thread, makes me feel like I'm on the right line of thinking here with possible Bipolar. or borderline/something similar (i believe similar meds are used since BPD is sometimes considered bipolar-ish? lol)

I'm set to see a psychiatrist for the first time on October 17th, and in the meantime I saw my pdoc today to discuss the results of my trial with Lyrica as an anxiolytic. I told him the truth: made me feel less anxious but also made me tired and more depressed, so we decided maybe Wellbutrin in combo with Lyrica would be good (would theoretically stop the depression and the anxiety!) but ill watch myself for signs of mania/hypomania/weird moods since I'm on the alert about possibly being bipolar.. altho i guess Wellbutrin is sometimes used for BP depression, but im sure its with a mood stabilizer alongside it which I'm not currently on.

Thanks for the advice about avoiding Risperidone and Abilify for now, good to know. If I mention my thoughts to the psych I'll tell her I've heard about the Zyprexa + SSRI combo and see what she thinks.

I know from a couple reports on here at Social Anxiety Forum that Wellbutrin + Lyrica is really good for S.A.D. but does anyone know if it would be bad for someone with bipolar?
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Old 10-03-2013, 04:39 AM   #9 (permalink)
 
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Quote:
Originally Posted by VERBW View Post
Actually, believe it or not, there's evidence to suggest that Sertraline does indeed increase dopaminergic activity.

Here, for example: http://www.psychotropical.com/index....upropion-zyban
To be honest, its only at high dosages of =/> 200mg. Even then its questionable whether it its effective enough and has a high enough affinity to be a DRI
__________________
Dx: Bipolar I
- GAD + Panic attacks
- Insomnia
- Migraine Headaches

Current meds: Lamictal 400mg
(200mg am 200mg pm)

Clonazepam 1mg/day
Propranolol 60mg
Valium 10mg/day
Saphris 10mg
Zoloft 150mg
Zopiclone 7.5-15mg prn
Zyprexa Zydis 5mg

Previous useless meds: Dosulepin 50mg, Lithium 900mg Lexapro 20mg, Lyrica 100mg, Moclobemide 450mg, Prozac 60mg, Sodium Valproate 1500mg, Sumatriptan 50mg, Temazepam 20mg, Topamax 100-150mg,
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Old 10-03-2013, 04:57 AM   #10 (permalink)
 
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Quote:
Originally Posted by A Sense of Purpose View Post
To be honest, its only at high dosages of =/> 200mg. Even then its questionable whether it its effective enough and has a high enough affinity to be a DRI
Fair point, well made.
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Dx: MDD, EUPD/BPD, occasional mania, strong anxiety

Daily Rx:
  1. Pregabalin, 600mg
  2. Lamotrigine, 300mg (currently titrating to 400mg/600mg. Hopefully)
  3. Metformin - 2g
  4. Clomipramine, 150mg
  5. Olanzapine, 20mg (discontinued - unofficially)
  6. Chlorpromazine, 100mg (aiming to replace Olanzapine with this)
  7. Flupenthixol, 3mg (aiming to restart this soon)
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Old 10-03-2013, 06:18 PM   #11 (permalink)
 
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If Lyrica even on low doses made me a totally spacey idiot, is it more than likely that other anticonvulsants like Sodium Valproate and even something like Lithium will be bad for me?

Like VERBW mentioned, and I've been reading, it seems like Olanzapine would probably be a good fit? With all the anxiousness I have and etc, plus I see it's a thienobenzodiazepene so makes sense to me on why it would be effective in that regard. I'm just worried about the side effects (cognitive dulling, extreme lethargy, potential personality change for the worst) but that's probably just my GAD speaking. I've given up on the Lyrica for good as it keeps making me extremely dopey and unfocused even at low dosages.
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