# Ssri/ndri



## chocp (May 24, 2010)

Hi I wanted to get some opnin from people who have tried SSRI+NDRI combination like Prozac+Zyban. Has it helped?

Does Prozac eliminate or lowers social anxiety? Or is it useless?

Can we not mimick the good effect oc cocaine/ecstacy/meth? using prescription drug combos?

Has anyone tried this?


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## hensley258 (Apr 24, 2010)

chocp said:


> Hi I wanted to get some opnin from people who have tried SSRI+NDRI combination like Prozac+Zyban. Has it helped?
> 
> Does Prozac eliminate or lowers social anxiety? Or is it useless?
> 
> ...


Wow! I havent heard anyone call Buproprian Zyban since 94. I didn't even know the name brand Zyban was still for sale. I remember when it was used to help people stop smoking. LOL! What a joke that was! It did nothing to curb the smoking habbit and most people thru it in the garbage.

It's just Welbutrin and it makes a good antidepressant. Prozac + Welbutrin, yea I would say you have a pretty energizing combo there, but that's nothing compared to other antidepressant combinations that, yes can in some ways Mimiick Cocaine - Meth to a degree.

Parnate is supposed to be very energizing. I don't start it until Friday so I will let you know. Like you I also prefer more energizing antidepressants.
(Who wants to sleep all day anyway)

I once talked to a guy that combined (with his doctors approval) Parnate and Amphetimine! Holy crap! That would scare me, but he is doing ok on it.

I say that because usually mixing those two drugs is like asking for a hypertensive reaction and stroke. Guess it depends on the person mostly.

I bet his house stays clean! LOL!


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## chocp (May 24, 2010)

Hensley, sorry but my knowledge is limited. by parnate you mean a anti-depressant of MAOI class ? Arent they suppose to have a dietry restriction? also do doctors prescribe that easily?


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## chocp (May 24, 2010)

is there anything called Selective Dopamine Reuptake Inhibitor? (wishful thinking)
If there is then what about the combo - SSRI+SNRI (Selective NE)+SDRI (Selective DA) 

is irreversible MAOI the only thing which can compete with cocoaine/meth type feeling? Is there nothing else which can help? I dont think MAOI are easy to get are they? Doctors keep prescribing SSRIs.


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## crayzyMed (Nov 2, 2006)

The only thing that you can get prescribed thats the closest to meth/cocaine is amphetamine, while amphetamine on its own could cause a rapid tolerance, a few ppl here have found succes by combining it with memantine. As long your not chasing the euphoria of meth, abusing your script wouldnt work out.


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## hensley258 (Apr 24, 2010)

chocp said:


> Hensley, sorry but my knowledge is limited. by parnate you mean a anti-depressant of MAOI class ? Arent they suppose to have a dietry restriction? also do doctors prescribe that easily?


Yea Parnate is an Irriversable MAOI and yes the dietary restriction can be a bit long, but some "I hear" later find they can eat most things with no problem.

I wouldn't say that it has an amthtimine like effect, but am told it can be pretty energizing if your depression causes you a lot of lathargy.

As for a Selective Dopamine Reuptake Inhibitor... I guess you could in a way look at Welbutrin (Zyban) as being close to one. Jim Morrison here seems to know loads about Welbutrin so he would be the guy to ask.

MAOI is pretty easy to get prescribed in the UK and AU, but in the states most Psychiatrist would rather eat a S**t sandwich before writing a script for it. Took me a very long time and many Psychiatrists to get it written and even then they wouldm't have done it if I had not already failed on 32 plus medications prior.

Some folks in the states get lucky and just happen to have a doc that say's sure lets try it with no problem, but that is rare. Just like my neighbor who's Doc prescribes her 600Mgs a month of Xanax. How in the world she pulled that off I have no clue.


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## pascal (Nov 15, 2008)

I did try wellbutrin and prozac.

This can be a pretty good combo. In m case, the combo boosted me up for a few day. After that I went back to my usual self with a little bit more energy.

Keep in mind that I am strongly treatment resistant and the combo managed to help a little.


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## jim_morrison (Aug 17, 2008)

hensley258 said:


> Wow! I havent heard anyone call Buproprian Zyban since 94. I didn't even know the name brand Zyban was still for sale. I remember when it was used to help people stop smoking. LOL! What a joke that was! It did nothing to curb the smoking habbit and most people thru it in the garbage.


Lol, here in Aus it's only available as Zyban, and it's only approved for smoking cessation, not for depression. Weird huh?


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## hensley258 (Apr 24, 2010)

jim_morrison said:


> Lol, here in Aus it's only available as Zyban, and it's only approved for smoking cessation, not for depression. Weird huh?


LOL dude that is funny. It's been so long since Zyban has been marketed as a stop smoking aid here in the states. I took Zyban - Welbutrin (whatever you care to call it for depression many moons ago.) I have smoked like a chimny since 20 and that stuff, while it did give me a small lift in my depression, never did a bit of help with my smoking.

Here they have Chantix which is supposed to be the real deal for quitting the smoke habbit. People say it works ok and many quit on it. It's a new drug. I would rather keep smoking than toss another chemical altering substance in my already abused brain.


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## Under17 (May 4, 2010)

hensley258 said:


> LOL dude that is funny. It's been so long since Zyban has been marketed as a stop smoking aid here in the states. I took Zyban - Welbutrin (whatever you care to call it for depression many moons ago.) I have smoked like a chimny since 20 and that stuff, while it did give me a small lift in my depression, never did a bit of help with my smoking.
> 
> Here they have Chantix which is supposed to be the real deal for quitting the smoke habbit. People say it works ok and many quit on it. It's a new drug. I would rather keep smoking than toss another chemical altering substance in my already abused brain.


My grandmother quit smoking cold turkey after 50+ years of smoking 6 packs a day. Man up lol.


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## hensley258 (Apr 24, 2010)

Under17 said:


> My grandmother quit smoking cold turkey after 50+ years of smoking 6 packs a day. Man up lol.


LOL! he's a tough grinder is all I can say. Not making excuses, but I seriously think that if I did not suffer severe anxiety and depressive dissorder that I could stop smoking.

I honestly just don't really care about my life because I am so sick, thus the prospect of getting lung Cancer honestly does not scare me. I figure it saves me from having to wack myself in a few years.

I know that sounds sick, but that's my brain and how it thinks all the time. I stay alive for my little girl. No other reason because I don't care about my fate. Hey I made it 40 years so far with this illness! How many can say that without a bullet in the head?:clap


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## chocp (May 24, 2010)

Ok ok gys lets say on track. This discussion wasnt about smoking scessation aid. 

What 'm suprised to hear is that MAOIs are easily precribed in UK? Because I live in London. I hav only been to doctor twice. First I was on Citalopram (40mg) which I think effective but the side effects were a nightmare.

Then I tried fluoxetine (20 mg). been on it for 16 days. The side effects are ok not as bad as Citalopram. I used to smoke like 15 a day. I have stopped just 5 days back with the help of nicotene pacthes and lozenges. wanted to go to my NHS doctor and see him for my smoking habit and ask for Zyban. Is Zyban and Wellbutrin the same thing? because whenever I read about Zyban I always seesmoking cessation aid and nothing about anti-deprassant properties. So if I do get Zyban will it affect my NE and DA reuptake?

Thanks for all who have replied. After reading what I have, I'm not 100% convinced that Fluoxetine+Zyban is going to give me the invicbility feeling in social settings.


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## chocp (May 24, 2010)

hensley258 said:


> I wouldn't say that it has an amthtimine like effect, but am told it can be pretty energizing if your depression causes you a lot of lathargy.


 Yeah fluoxteine makes me little drowsy throughout the day although I'm on low dose (20mg). Its no way near as a bad as citalopram where I was yawning like 40% of my day time. lol.I do think I can use something which gives me a lot of energy and positivity and makes me feel more social and less inhibited in social settings. You are saying mAOIs can do the trick?



hensley258 said:


> As for a Selective Dopamine Reuptake Inhibitor... I guess you could in a way look at Welbutrin (Zyban) as being close to one. Jim Morrison here seems to know loads about Welbutrin so he would be the guy to ask.


Thanks 



hensley258 said:


> MAOI is pretty easy to get prescribed in the UK and AU, but in the states most Psychiatrist would rather eat a S**t sandwich before writing a script for it. Took me a very long time and many Psychiatrists to get it written and even then they wouldm't have done it if I had not already failed on 32 plus medications prior.


Do you think I can go to my UK NHS doctor and just say I need mAOIs? he refused when I asked for alprax as a sleeping aid with fluoxetine


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## hensley258 (Apr 24, 2010)

chocp said:


> Ok ok gys lets say on track. This discussion wasnt about smoking scessation aid.
> 
> What 'm suprised to hear is that MAOIs are easily precribed in UK? Because I live in London. I hav only been to doctor twice. First I was on Citalopram (40mg) which I think effective but the side effects were a nightmare.
> 
> ...


Yea, Zyban and Welbutrin are both Bupropion. Same exact to the tee drug.
Not even a tweek of difference.


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## jim_morrison (Aug 17, 2008)

chocp said:


> Is Zyban and Wellbutrin the same thing? because whenever I read about Zyban I always seesmoking cessation aid and nothing about anti-deprassant properties.


Yep, same stuff different packaging. Both are bupropion.


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## hensley258 (Apr 24, 2010)

chocp said:


> Yeah fluoxteine makes me little drowsy throughout the day although I'm on low dose (20mg). Its no way near as a bad as citalopram where I was yawning like 40% of my day time. lol.I do think I can use something which gives me a lot of energy and positivity and makes me feel more social and less inhibited in social settings. You are saying mAOIs can do the trick?
> 
> Thanks
> 
> Do you think I can go to my UK NHS doctor and just say I need mAOIs? he refused when I asked for alprax as a sleeping aid with fluoxetine


Hard to say because every doc is different. Even in the UK they like to see a few years of effort with many safe combinations before going the MAOI route with you.

Not only that I honestly think you owe it to yourself to give a few more med cobos a good long shot before throwing in the MAOI towel. (That's just me because I think they should be used only if several other things have tried and failed, as in many other things.)

Not sure in the UK if a regular family doctor would prescribe an MAOI ever, but I know the Psychiatrists in the UK are more easy with prescribing them.

Can't give you much first hand info on MAOI Parnate yet. I don't start it until Friday. I hear some normal and weird things from people that use it. Some say it makes them feel uporic, others say no it doesn't. Most do say it works and that is why I was interested in it, but In two decades I have tried more meds than a Lab Monkey so you can understand why it's reached this point of MAOI.


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## chocp (May 24, 2010)

hensley, thanks for your info. I'm going to do to the doctor and ask me to refer to a psychiatrist. lets see.

So what are some good combos you will recommend which helps in elevating mood, make you social and decreases anxiety of talking to people (especially girls)

SSRI+ NDRI
SSRI + Mirtazapine 
NDRI alone
SSrI+ Adderall
SSRI+Opiods?
MAOIs
SSRI+Benzodiazapines
NDRI+Benzodiazipines

Any other you reckon? or anyone have experience of the above?


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## hensley258 (Apr 24, 2010)

chocp said:


> hensley, thanks for your info. I'm going to do to the doctor and ask me to refer to a psychiatrist. lets see.
> 
> So what are some good combos you will recommend which helps in elevating mood, make you social and decreases anxiety of talking to people (especially girls)
> 
> ...


Maybe try (California Rocket Fuel) Effexor XR high dosage plus Remeron and maybe your favorite Benzo before going out. (remember Effexor XR is a great SNRI, but will not produce the NRI effect below 187.5Mgs. Under that dosage and Effexor is just another SSRI)

Remeron taken before bed because it's a weird drug. It's first few hours after dosage make you sleepy, but by morning it turns into a lifting antidepressant.

The Effexor XR in morning. Benzo when you need it just keep dose low and maybe take before your going out.

A couple guys here say next to an MAOi that California Rocket Fuel is a very effective combination. (That's just a slang for the combo, but I find it funny)

I used to take Effexor at 300Mgs a day and used to take Remeron, but never both at the same time. I'm told combined they are a beefy combo.

As for getting a Psychiatrist....Oh yea dude for sure. You don't want a GP prescribing your meds. That's like asking a pediatrist to perform spinal surgury on you. P-docs have the training in this, GP have almost none.

You know what most GP's do? "here's a usless SSRI because it's all I feel safe giving." Forget that crap. I would sooner shave my head with a cheese grater before allowing a GP to prescribe my Psychiatric meds.


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## euphoria (Jan 21, 2009)

I was told by my psychiatrist MAOIs are not licensed for use here in the UK. She said she can prescribe off-label drugs (and has done several times for me), but not drugs that aren't licensed. Anyone on MAOIs from the UK?

Bupropion (Wellbutrin, or Zyban in the UK) is only used for smoking cessation here, but I think I would have a lot more luck getting it prescribed off-label than asking for an MAOI (for which I received a categorical "no chance").

As for the suggestion of opioids for mental health, that's a recipe for disaster unless you know exactly how to prevent/slow tolerance, and even then it might not be the best of ideas. For a lot of rewarding drugs you need some plan for tolerance prevention if you want to sustain the hedonic effects for a long period of time.


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## hensley258 (Apr 24, 2010)

euphoria said:


> I was told by my psychiatrist MAOIs are not licensed for use here in the UK. She said she can prescribe off-label drugs (and has done several times for me), but not drugs that aren't licensed. Anyone on MAOIs from the UK?
> 
> Bupropion (Wellbutrin, or Zyban in the UK) is only used for smoking cessation here, but I think I would have a lot more luck getting it prescribed off-label than asking for an MAOI (for which I received a categorical "no chance").
> 
> As for the suggestion of opioids for mental health, that's a recipe for disaster unless you know exactly how to prevent/slow tolerance, and even then it might not be the best of ideas. For a lot of rewarding drugs you need some plan for tolerance prevention if you want to sustain the hedonic effects for a long period of time.


Maybe I was wrong about MAOI in the UK. Just that I saw so many people post from the UK that said they were taking MAOI I made the false assumption it was an easy AD to accuire in the UK. My bad.

They must be getting it from somewhere.
I had my turn with Opioids for depression a couple years ago when I got tired of AD's not working good enough. I met a couple guys that were using Tramadol for their depression. (I may be wrong but Tram is like a synthtic Opioid, but it's still addictive and tolerance build up is still a problem.)

The guys found a way to trick the Tolerance build up buy doing some weird schedule of taper breaks every few weeks. I gave it a shot, and found it had great antidepressant properties, but didn't work right with my anxiety which the other guys didn't have.

Tramadol will give a fast antidepressant lift though. Then again so will Vicotin and Oxy. It's just not a good long term solution and even people using Tramadol got in a worse lot many months down the road.


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## chocp (May 24, 2010)

Yeah I have read that with MAOIs if you take tyramine (found in cheese) it can kill you. Also it can interact with over the counter drugs. So I'm not suprised that it is not easily given and I may have to wait 10+ ****ing years to get my hands on it.

I have heard about Adderall and Ritalin also giving a europhoric feeling and antianxiety effect? Has anyone got experience of using it? Does it also become addictive like xanax does? Can I get Adderall for social anxiety/fobia disorder? or I will have to be diagnosed for ADHD only? 

SSRIs make me sleepy (I yawn a lot during day time) What can I use to stay alert and focussed and talkitive? Zyban? or Adderall? any other thing?


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## hensley258 (Apr 24, 2010)

chocp said:


> Yeah I have read that with MAOIs if you take tyramine (found in cheese) it can kill you. Also it can interact with over the counter drugs. So I'm not suprised that it is not easily given and I may have to wait 10+ ****ing years to get my hands on it.
> 
> I have heard about Adderall and Ritalin also giving a europhoric feeling and antianxiety effect? Has anyone got experience of using it? Does it also become addictive like xanax does? Can I get Adderall for social anxiety/fobia disorder? or I will have to be diagnosed for ADHD only?
> 
> SSRIs make me sleepy (I yawn a lot during day time) What can I use to stay alert and focussed and talkitive? Zyban? or Adderall? any other thing?


The main concern with MAOI is just fermented and aged foods. You can eat most cheese just not aged cheese like sharp chedder and some others. The cheese on your big mack is fine. You can even eat mild cheddars as they are not so aged. No pepperoini though, that sucks and no beef jerky or sticks.

Really the only thing I will miss a lot is Dry aged prime rib steak, but they are so expensive I can't afford it often anyway. Find a good butcher that does dry aged prime steaks. They cut with a fork and melt in your mouth.

SSRI's make me sleepy also. To combat this you could always add Welbutrin. It might help a bit.


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## Ash09 (Apr 27, 2009)

euphoria said:


> I was told by my psychiatrist MAOIs are not licensed for use here in the UK. She said she can prescribe off-label drugs (and has done several times for me), but not drugs that aren't licensed. Anyone on MAOIs from the UK?


If you look on the BNF website it shows that Tranylcypromine, Phenelzine and Isocarboxazid are indicated for depression, and Moclobemide is also indicated for social anxiety disorder. Also selegiline and rasagiline are indicated for parkinsons. I think it is likely that your psychiatrist is lying because she doesn't feel comfortable prescribing them.

http://bnf.org/bnf/bnf/59/3341.htm



> Monoamine-oxidase inhibitors are used much less frequently than tricyclic and related antidepressants, or SSRIs and related antidepressants because of the dangers of dietary and drug interactions and the fact that it is easier to prescribe MAOIs when tricyclic antidepressants have been unsuccessful than vice versa. *Tranylcypromine* is the most *hazardous* of the MAOIs because of its stimulant action. The drugs of choice are *phenelzine* or *isocarboxazid* which are less stimulant and therefore safer.
> Phobic patients and depressed patients with atypical, hypochondriacal, or hysterical features are said to respond best to MAOIs. However, MAOIs should be tried in any patients who are refractory to treatment with other antidepressants as there is occasionally a dramatic response. Response to treatment may be delayed for 3 weeks or more and may take an additional 1 or 2 weeks to become maximal.
> 
> *Moclobemide* is indicated for major depression and social anxiety disorder; it is reported to act by reversible inhibition of monoamine oxidase type A (it is therefore termed a RIMA). It should be reserved as a second-line treatment.
> ...


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## jim_morrison (Aug 17, 2008)

chocp said:


> So what are some good combos you will recommend which helps in elevating mood, make you social and decreases anxiety of talking to people (especially girls)
> 
> SSRI+ NDRI
> SSRI + Mirtazapine
> ...


Well theres no need to jump straight in the deep end. If you havn't tried meds before then I'd suggest starting with just either Prozac or Effexor and adding a benzo as needed for social situations and see how that goes first. If your not responding after an adequate trial of this then that's when it's possibly time to consider some of the heavier stuff such as adding augmenters, or switching to an MAOI.

I have to agree with the other posters though that opioids are a bad idea, I'd stay away from that one.


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## hensley258 (Apr 24, 2010)

I'm kind of on the same page. even if you have tried one or two meds and didn't get full relief, don't pull out the Elephant gun right away.

The goal is if you can find a mild combo to do the trick because the time will come when maybe a few years later you will need to step it up a notch. If you start with a super heavy duty combo then if that fails years later your options are less.

I started mild to give plenty of head room and options if needed later.


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## jim_morrison (Aug 17, 2008)

Yup, I think prozac and effexor in particular are good first options because they are single meds capable of boosting serotonin, norepinephrine and dopamine, which is why I suggested them.


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## chocp (May 24, 2010)

jim_morrison said:


> Yup, I think prozac and effexor in particular are good first options because they are single meds capable of boosting serotonin, norepinephrine and dopamine, which is why I suggested them.


I thought Prozac was an SSRI and it only sleectively booasts seretonin. Effexor I've heard is an SNRI. not sure if it booasts dopamine. but thanks guys this is quite valuable advise and I will try some of what you have recommended before jumping for MAOIs.


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## chocp (May 24, 2010)

Aha got my Benzos today (Alprax). Will try that and see if it helps


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## jim_morrison (Aug 17, 2008)

chocp said:


> I thought Prozac was an SSRI and it only sleectively booasts seretonin. Effexor I've heard is an SNRI. not sure if it booasts dopamine. but thanks guys this is quite valuable advise and I will try some of what you have recommended before jumping for MAOIs.


Prozac is additionally a 5ht2c antagonist (which releases dopamine and norepinephrine) and SNRI's inhibit the reuptake of dopamine in the prefrontal cortex of the brain, also Effexor acts as an SNDRI at high doses. So I think that these meds might indeed boost dopamine somewhat, though not as strongly as MAOI's.


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## chocp (May 24, 2010)

Thanks JM. Since I'm already takeing Prozac and feel little drowsy sometimes, what would you recmmend as first line to counter that effect.

benzos
Bupropion
Effexot
any other?

Also is there any med whihc can reduce the sexual side effect of prozac when taken in combo with prozac


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## jim_morrison (Aug 17, 2008)

chocp said:


> Thanks JM. Since I'm already takeing Prozac and feel little drowsy sometimes, what would you recmmend as first line to counter that effect.
> 
> benzos
> Bupropion
> ...


What dosage of prozac are you taking and how long have you been taking it? also are you also taking any other meds at the moment?


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## chocp (May 24, 2010)

jim_morrison said:


> What dosage of prozac are you taking and how long have you been taking it? also are you also taking any other meds at the moment?


 Hi JM, I'm on 20 mg Fluoxetine. I ahve been takeing it for 17 days so far. I'm not on any other medication as of now. I have alprax (which my father sent to me by post from India). I havent taken it yet. but reading about withdrawal symptoms and the way it effects GABA, I'm doubting its going to make me energetic. I think its going to make me even more sleepy.

I stopped smoking a week back and using nicotene patches. I can go to the doctor and ask for Zyban but I can do without it as well. I wanted to feel alert, energetic and can concentrate on things and tasks and also be in very social talktitive mood.

Any suggestions?


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## jim_morrison (Aug 17, 2008)

chocp said:


> Hi JM, I'm on 20 mg Fluoxetine. I ahve been takeing it for 17 days so far. I'm not on any other medication as of now. I have alprax (which my father sent to me by post from India). I havent taken it yet. but reading about withdrawal symptoms and the way it effects GABA, I'm doubting its going to make me energetic. I think its going to make me even more sleepy.
> 
> I stopped smoking a week back and using nicotene patches. I can go to the doctor and ask for Zyban but I can do without it as well. I wanted to feel alert, energetic and can concentrate on things and tasks and also be in very social talktitive mood.
> 
> Any suggestions?


Yes I agree that alprax will most likely only make you more tired, so maybe not that one. You could try adding Zyban yes, this might improve your energy and alertness, and also should reduce the sexual dysfunction from prozac.

Also remember that prozac takes 1 to 2 months to fully kick in so you might not be feeling it's full effects yet.


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## chocp (May 24, 2010)

jim_morrison said:


> Yes I agree that alprax will most likely only make you more tired, so maybe not that one. You could try adding Zyban yes, this might improve your energy and alertness, and also should reduce the sexual dysfunction from prozac.
> 
> Also remember that prozac takes 1 to 2 months to fully kick in so you might not be feeling it's full effects yet.


JM,
yes you are correct. with these one has to be patient enough. yeah true. thanks. I will ask doctor for buproprion next and see if that helps.
I will take Alprax today and see if that makes any differentce


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## crayzyMed (Nov 2, 2006)

jim_morrison said:


> Yup, I think prozac and effexor in particular are good first options because they are single meds capable of boosting serotonin, norepinephrine and dopamine, which is why I suggested them.


I'm a bit skeptical about that tough, has prozac been shown to be better then the other SSRI's? While it may be a 5HT2C antagonist, this action may be insignificant at the doses for reuptake inhibition.


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## euphoria (Jan 21, 2009)

Prozac is generally though of as not the one to use for social anxiety, compared to other SSRIs.


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## chocp (May 24, 2010)

euphoria said:


> Prozac is generally though of as not the one to use for social anxiety, compared to other SSRIs.


My doc told me fluoxetine is what is used to treat SAD and he gave me a 6 month prescription. I was also suprised as from what I have read, I thought he was going to give Mirtazapine or something.


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## jim_morrison (Aug 17, 2008)

crayzyMed said:


> I'm a bit skeptical about that tough, has prozac been shown to be better then the other SSRI's? While it may be a 5HT2C antagonist, this action may be insignificant at the doses for reuptake inhibition.


It seems to be atypical and more energizing than the other SSRI's and it is shown to increase plasma catecholamine levels so I would say that it plays a role.

http://www.ncbi.nlm.nih.gov/pubmed/15741747

"Twelve patients affected by major depression received a single oral dose of fluoxetine in the morning, 5 mg in the first 5 days, 10 mg from the 6th to the 10th day and 20 mg from the 11th to the 40th day. Twelve healthy subjects received a placebo under identical testing procedures. Blood samples were collected at baseline and 7, 10 and 24 h after drug administration on the 1st day of fluoxetine administration at a dose of 5 mg, and on the 1st and the 30th day of fluoxetine administration at a dose of 20 mg (days 11 and 40 of treatment, respectively). *We found that plasma norepinephrine, epinephrine and dopamine levels significantly increased after acute and chronic treatment* (p < 0.001), reaching the highest concentrations on the last day. No significant changes of these parameters were observed in control patients."

http://www.ncbi.nlm.nih.gov/pubmed/15741747


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## crayzyMed (Nov 2, 2006)

Then prozac should be the best SSRI for social anxiety, as dopamine increase is VERY important to treat our disorder.


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## crayzyMed (Nov 2, 2006)

5HT2A also plays a role in prozac's dopamine increase:



> In another study, injections of M100907 attenuated fluoxetine-induced
> increases in cortical DA (Zhang et al., 2000). Thus, selective antagonism of 5-HT2A receptors
> attenuates mesocortical DA release.


Comes from this paper:
http://pubget.com/search?q=pharmaco...gulation+of+dopamine+neurotransmission.&asesp[1]=AND&asesp[2]=AND&asesp[3]=AND&institution=

Besides, some interesting facts about 5HT2A:

------------------

Atypical, but not typical, antipsychotic drugs robustly increase DA release in the PFC. A
common property of these drugs that distinguishes them from the typical agents is high affinity
for the 5-HT2A receptor. Thus, a plausible hypothesis was that 5-HT2A receptor antagonism
increases cortical DA efflux. Earlier studies demonstrated that administration of the nonselective
5-HT2 receptor antagonist ritanserin increased nigrostriatal and mesocorticolimbic
DA efflux (Devaud et al., 1992; Pehek, 1996; Pehek and Bi, 1997). However, subsequent work
has shown that ritanserin may facilitate DA cell activity by antagonizing D2 receptors (Shi et
al., 1995). Multiple subsequent studies have since been performed with the selective 5-HT2A
receptor antagonist M100907 and demonstrate that systemic or intracortical administration
Alex and Pehek Page 11
Pharmacol Ther. Author manuscript; available in PMC 2008 October 7.
NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript
blocks DA release evoked by treatment with the 5-HT2 receptor agonist DOI (Gobert and
Millan, 1999; Pehek et al., 2001).

------------------------

In contrast to studies employing the administration of 5-HT2A receptor antagonists alone, the
combined, systemic administration of D2 and 5-HT2A receptor antagonists results in a
potentiation of cortical DA release (Westerink et al., 2001; Liegeois et al., 2002). Evidence
has been provided that this effect may be mediated by actions of released 5-HT interacting
with 5-HT1A receptors (Bonaccorso et al., 2002). In addition, this potentiation may result from
actions of drugs on DA cells in the VTA. It is clear that, as a class, atypical antipsychotic drugs
enhance DA release in the PFC. It is also clear that this effect is not mimicked by selective
antagonism of 5-HT2A receptors. Rather, it may result from a combination of receptor binding
properties including blockade of 5-HT2C receptors (see below).

------------------------------

We have
demonstrated that intracortical infusions of the 5-HT2A receptor antagonists M100907 or MDL
11,939 blocked the increases in cortical DA produced by the systemic administration of the 5-
HT2 receptor agonist DOI (Pehek et al., 2001; Pehek et al., 2006).

------------------------------

Recent behavioral studies demonstrate that selective 5-HT2A receptor blockade attenuates
DA-mediated behaviors. Administration of the 5-HT2A antagonist SR 46349B (1.0 mg/kg or
less) attenuates hyperactivity induced by either the acute or repeated administration of cocaine
(Filip et al., 2004). Treatment with M100907 reversed behavioral deficits in locomotor activity
and prepulse inhibition of acoustic startle in DAT knockout mice (Barr et al., 2004). In addition
to behavioral abnormalities, these mice display elevated synaptic levels of DA (Gainetdinov
et al., 1999). The authors suggest that 5-HT2A antagonists may be useful in the treatment of
conditions characterized by chronic, elevated dopaminergic tone.

------------------------------

Summary
Activation of 5-HT2A receptors stimulates dopaminergic activity in all three pathways
although most work has been performed in the mesocortical system. Investigations into the
circuitry of this regulation indicate that 5-HT2A receptors on corticotegmental projections
regulate DA cellular activity. A functional role for 5-HT2A receptors localized on VTA DA
neurons remains to be determined.

5HT2A antagonism on its own doesnt increase cortical dopamine at all, instead it appears that agonism actually increases dopamine in several brain area's. Ive never really jumped on the anti 5HT2A bandwagon, but many ppl still think that 5HT2A antagonism is a good thing, i have to disagree with that.


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## trayhawk (May 26, 2010)

Although, it is quoted as being "modest" in regards to its effect as A DRI, Modafinil has been shown to acheive this.

From Wikipedia
Recently, modafinil was screened at a large panel of receptors and transporters in an attempt to elucidate its pharmacology.[85] Of the sites tested, it was found to significantly act only on the dopamine transporter (DAT), inhibiting the reuptake of dopamine with an IC50 value of 4 μM.[85] Accordingly, it produces locomotor activity and extracellular dopamine concentrations in a manner similar to the selective dopamine reuptake inhibitor (DRI) vanoxerine, and also blocks methamphetamine-induced dopamine release.[85] As a result, it appears that modafinil exerts its effects by acting as a weak DRI, though it cannot be ruled out that other mechanisms may also be at play.[85] On account of its action as a DRI and lack of abuse potential, modafinil was suggested as a treatment for methamphetamine addiction by the authors of the study.[85]
The (_S_)-enantiomer of modafinil has also recently been found to act as a D2 receptor partial agonist, with a Ki of 16 nM, an intrinsic activity of 48%, and an EC50 of 120 nM, in rat striatal tissue.[86] The (_R_)-enantiomer is inactive (Ki > 10,000).[86]


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## Edwin (Jun 19, 2008)

crayzyMed said:


> Then prozac should be the best SSRI for social anxiety, as dopamine increase is VERY important to treat our disorder.


I have tried it, but couldn't tolerate it. It made my social anxiety worse, probably because the initial dopamine boost seemed to make way for a higher norepinephrine boost after 2 weeks, which made me very paranoid and restless.


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## firestarter8779 (Sep 30, 2010)

hensley258 said:


> LOL dude that is funny. It's been so long since Zyban has been marketed as a stop smoking aid here in the states. I took Zyban - Welbutrin (whatever you care to call it for depression many moons ago.) I have smoked like a chimny since 20 and that stuff, while it did give me a small lift in my depression, never did a bit of help with my smoking.
> 
> Here they have Chantix which is supposed to be the real deal for quitting the smoke habbit. People say it works ok and many quit on it. It's a new drug. I would rather keep smoking than toss another chemical altering substance in my already abused brain.


As far as the Wellbutrin being used for smoking cessation personally, I didnt even want to quit smoking, it was my last vice but when I started taking Wellbutrin, in less than two months I noticed I had been smoking A LOT less. I even tried to continue smoking but after about two drags I couldnt stand it anymore and had to put the cigarette out. I was not happy about this but despite my desire to keep smoking after a few months of being on Wellbutrin I stopped smoking. Very strange that it doesn't seem to be helping people who actually WANT to quit...I didn't realize that.

On another note I have been diagnosed with ADD as well as Major Depression and Anxiety Disorder. I noticed that when I had taken Adderall in the past it also seemed to help me "feel" better in all the other areas (depression, motivation, will power, etc) Since they have put me on the Wellbutrin I have not been on Adderall (just a coincidence). Today I decided to go online and research what Adderall did in the brain chemically to see if it had anything in common with Wellbutrin the NDRI I am currently on. Adderall (amphetamine-dextroamphetamine) stimulates the central nervous system by increasing the amount of certain chemicals, such as dopamine and norepinephrine. Wellbutrin, being an NDRI also works to achieve the same goal (basically). As a result of the above information I am wondering if combining the two medications together would achieve a desired result of being able to function, which currently I am unable to do and have been like this for over a year. Has anyone tried this and does it make sense to anyone else? Of course I'll be discussing it with my doctor but I was curious if it had been done before and worked for anyone else or if it at least seemed logical?


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## firestarter8779 (Sep 30, 2010)

chocp said:


> Yeah I have read that with MAOIs if you take tyramine (found in cheese) it can kill you. Also it can interact with over the counter drugs. So I'm not suprised that it is not easily given and I may have to wait 10+ ****ing years to get my hands on it.
> 
> I have heard about Adderall and Ritalin also giving a europhoric feeling and antianxiety effect? Has anyone got experience of using it? Does it also become addictive like xanax does? Can I get Adderall for social anxiety/fobia disorder? or I will have to be diagnosed for ADHD only?
> 
> SSRIs make me sleepy (I yawn a lot during day time) What can I use to stay alert and focussed and talkitive? Zyban? or Adderall? any other thing?


I apologize ahead of time, Im new here and the layout is confusing me and I'm not even sure of what thread Im on anymore BUT ANYWAY...as far as the effect Adderall has in the system of a person diagnosed with depression and anxiety disorders I personally can attest to the fact that it definitely did seem to help me in many areas. It helped primarily in the areas of motivation and the ability to "get up and go" as well as the depression. Chemically it stimulates the central nervous system by increasing the amount of certain chemicals, such as dopamine and norepinephrine. However, also having anxiety problems I noticed that if I wasn't very busy while I was taking it, if I was just sitting around it seemed to increase my anxiety so just be aware. And yes, it can be addictive but what medication can't be when you're messing with the chemicals in your brain. It will for sure make you "talkative" as it acts like "speed" basically but compared to ALL the other medications I have been on, such as Effexor, Prozac, Zoloft, Celexa, Luvox, Paxil, Cymbalta, etc. that made me sleepy and lethargic, Adderall is worth the anxiety risks. I just kept Xanax around just in case (I dont recommend combining those 2 medications though, but if in a full blown anxiety attack it seemed to be ok for me) I took Ritalin for a few years and hated it so I can't recommend it based on my own experiences but everyone's different. When it wore off at the end of the day I was in a horrible mood for about 3 hours until it was out of my system. Adderall does not have this effect on me, it just wears off with no "coming down" effects. I just added a post asking about this in other people (I believe on this same thread so if you see it please respond)

I have been diagnosed with ADD however but not a severe case of it, I have it without hyperactivity. I have taken Adderall on and off for years but it seems to help in all the areas I need help in. For more information on this read the post I added about this same topic a few minutes ago. I dont want to bore anyone by repeating myself anymore than I already have.


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## brucegoose (Nov 25, 2010)

jim_morrison said:


> Lol, here in Aus it's only available as Zyban, and it's only approved for smoking cessation, not for depression. Weird huh?


You should be able to get it 'off label' from a willing GP who will work with you.

My GP has prescribed it as Augmentation to Duloxetine 60mg. So far on this new regime I'm on 30mg Duloxetine and 300mg Prolonged Release Buproprion or Zyban as it's more commonly called here in Ireland/UK.

I want a better deal for anxiety and depressive spells. Also I need my sex drive back.

I was even off my meds for 2 months and it didn't come back as I now think I'm low on dopamine.

Any opinions/feedback appreciated.


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