# Stay away from Dopamine Agonists!



## Guide 4 Dummies (Nov 2, 2009)

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## Ehsan (Mar 21, 2009)

i think dopamine agonists may worsen SAD after quitting.


> NEW YORK (Reuters Health) - Just like cocaine and other drugs that increase brain dopamine levels, the dopamine agonists used to treat Parkinson disease can also produce a withdrawal syndrome after prolonged use, according to a report in the January issue of the Archives of Neurology.
> 
> Symptoms of dopamine agonist withdrawal syndrome (DAWS) are similar to those of other withdrawal syndromes and include anxiety, panic attacks, depression, agoraphobia, dysphoria, diaphoresis, fatigue, pain, orthostatic hypotension, and drug cravings. DAWS seems to occur predominantly in patients with a dopamine agonist-related impulse control disorder, the report indicates.
> 
> ...


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## crayzyMed (Nov 2, 2006)

Other dopaminergics are a much better option as you can take a day off regurally and prevent withdrawal, but there arent many options.

Ritalin doesnt seem to work good thats why i think amphetamine is the best treatment for social anxiety. Some ppl dont want to take it because they are scared of neurotoxiticy but i have enough reason to beleive it isnt that bad, i will make a post with all my arguments soon in the amphetamine toxiticy thread.

Other options are AMT and desoxy but those are research chemicals and have risk, but they have both been in clinical use for a while so there is atleast some safety data.


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## euphoria (Jan 21, 2009)

Dopamine agonists having very unpleasant withdrawal effects is to be expected. Dopamine is rewarding and greatly improves mood; the rebound/withdrawal would logically be terrible. Opiates make you feel good -> withdrawals make you feel like crap. It's not any sort of evidence that people shouldn't use them; it's just evidence for the role of dopamine in mood and reward. Tweaking your reward system isn't something to be taken lightly, but for some it is necessary. I'm sure I'll be able to find a memantine dose high enough to prevent tolerance.

If dopamine agonists work for me, Dexedrine isn't something I'd choose over them. The stimulation/agitation/anxiety/crash of stimulants is something I totally do not want; just a clean mood-lifting dopamine effect.

Amphetamine withdrawal effects (from Wiki):



> Withdrawal from chronic use of amphetamine can include anxiety, depression, agitation, fatigue, excessive sleeping, increased appetite, short temper, psychosis and suicidal thoughts.


Hmm, remarkably similar to prami withdrawals. I guess we should stay away from that too... and pretty much anything that treats anhedonia.


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## Ehsan (Mar 21, 2009)

i think MAOIs(long-term) and stimulants(short-term) are the best options to improve dopamine neurotransmission.
i wanna investigate using short-acting dopamine antagonists over nights to reinforce dopamine system in long-run. antipsychotics are used to treat ADHD in children.


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## crayzyMed (Nov 2, 2006)

Amphetamine withdrawal lasts 2 weeks or something and then its over, its not to be compared with benzo or dopamine agonist withdrawal.


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## euphoria (Jan 21, 2009)

Ehsan said:


> i think MAOIs(long-term) and stimulants(short-term) are the best options to improve dopamine neurotransmission.
> i wanna investigate using short-acting dopamine antagonists over nights to reinforce dopamine system in long-run. antipsychotics are used to treat ADHD in children.


That's basically making half your day unpleasant and the other good. Nothing is really gained overall.



crayzyMed said:


> Amphetamine withdrawal lasts 2 weeks or something and then its over, its not to be compared with benzo or dopamine agonist withdrawal.


I've read that acute dopamine agonist withdrawal lasts roughly the same time as other dopaminergics. Benzo withdrawal obviously lasts longer. They should all be tapered rather than cold-turkeyed. Where are you getting your information that DA agonist withdrawal lasts longer



> Pretty much something like: Dopamine agonist makes you feel like crap -> withdrawal makes you feel even more crappier.


That's not the case with everyone though, and prami must've had some effect on something (even if it induced anhedonia) or there'd be nothing to withdraw from. Many people take them and get great effects on mood.



> I tried Memantine 20-30 mg /day with Pramipexole 1.5 mg/day. Memantine reset the adaptation period after I was fully adapted, and I was pretty much stuck with the adaptation symptoms daily. It didn't have any effect on withdrawals though.


Wes told me you added memantine in after you'd been on prami a while, then only took it a few days before giving up. Is that true?


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## euphoria (Jan 21, 2009)

In what way didn't it work well with prami?


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## euphoria (Jan 21, 2009)

Hmm, well thanks for the info, I guess I'll find out whether the two work together soon enough.


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## crayzyMed (Nov 2, 2006)

> I've read that acute dopamine agonist withdrawal lasts roughly the same time as other dopaminergics. Benzo withdrawal obviously lasts longer. They should all be tapered rather than cold-turkeyed. Where are you getting your information that DA agonist withdrawal lasts longer


The pletoria of anecdotal reports for example on ADD forums, ive never read a withdrawal simular to those of dopamine agonists or benzo's.

And G4D here is saying that he's prami withdrawal is worse then benzo withdrawal.


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## euphoria (Jan 21, 2009)

I've read on Parkinson's forums that withdrawal lasts roughly 2 weeks. I don't really care if the withdrawals are severe, they tend to be for dopaminergics and I'd expect nothing less of direct dopamine agonists. I have plans to manage it (i.e. memantine), and if that doesn't work with ropi, then I'll switch to something it does work with.

N.B. I plan to stay on dopaminergics indefinitely unless something changes (or better drugs are made), so withdrawal isn't something I'm concerned with.


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## Vini Vidi Vici (Jul 4, 2009)

Ropinirole has helped me alot, I was taking .5mg 4x/day. but then i ran out, And I did get noticeable bad withdrawal symptoms, my Depression became much worse, Anxiety and OCD got much worse, more RLS-ish-ness, and ADD so bad even Watching a Movie or TV show is Impossible ( because of Anhedonia ) 

The only thing that worries me, is the potential to Run out accidentally/forget to refill prescription , for Dopamine agonist like Requip, cuz It has such a Short half-life. 

not sure why im posting this, but i just felt like contributing, im feeling lonely and uninvolved lol. I wanna my Requip its very frustraattingg to run out,


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## Noca (Jun 24, 2005)

Adderall XR withdrawal was hell for me, though it only lasted 3 days. I just wanted to die the entire time.


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## euphoria (Jan 21, 2009)

Vini Vidi Vici said:


> Ropinirole has helped me alot, I was taking .5mg 4x/day. but then i ran out, And I did get noticeable bad withdrawal symptoms, my Depression became much worse, Anxiety and OCD got much worse, more RLS-ish-ness, and ADD so bad even Watching a Movie or TV show is Impossible ( because of Anhedonia )
> 
> The only thing that worries me, is the potential to Run out accidentally/forget to refill prescription , for Dopamine agonist like Requip, cuz It has such a Short half-life.
> 
> not sure why im posting this, but i just felt like contributing, im feeling lonely and uninvolved lol. I wanna my Requip its very frustraattingg to run out,


Do you have more on order?


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## euphoria (Jan 21, 2009)

Guide 4 Dummies said:


> I agree on MAOIs. AMT seems interesting because there is no crash nor tolerance according to crayzymeds and karoloydi, but it's a research chemical that comes with unknown risks.


According to several people, AMT was used for a long time in Russia under the name Indopan as an antidepressant, but was discontinued due to abuse potential. No significant toxicity AFAIK, and it was used long enough to know these things.


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## Ehsan (Mar 21, 2009)

Guide 4 Dummies said:


> By the way, can you tell us more about your experience with ldopa/selegiline withdrawal? How long did it last, and did the symptoms gradually decreased in severity? How bad was it compared to dopamine agonist withdrawal? and do you think you have completely recovered or are there still lingering symptoms / permanent damage? When did you quit taking that combo?


i quitted that combo cold-turkey because i wanted to try memantine.
before starting selegiline/l-dopa i had tried gabapentin and clomipramine and i had some success with them.
when i started selegiline/l-dopa my SAD improved significantly at first but when i quitted the combo and started memantine a bad depression, anhedonia and fatigue returned.
the only thing that annoys me is that all the improvements which i had made before trying selegiline/l-dopa dissapeared and this was a permanent effect.
in fact i think trying selegiline/l-dopa worsened my SAD at the end.


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## Ehsan (Mar 21, 2009)

*i believe it's not rational to continue NMDA antagonists(like memantine) while you are quitting addictive meds.*
nmda antagonists decrease the speed of adjustment to changes so it's rational to take them to prevent tolerance but when you wanna quit meds you should increase the adjustment speed of your body to changes.
we have made similar mistakes:
i started memantine right after selegiline/l-dopa discontinution.
yoo are using memantine while you are quitting prami.


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## Ehsan (Mar 21, 2009)

Guide 4 Dummies said:


> No, I'm not. I quit Memantine before going cold-turkey in both times.
> 
> However, I think Memantine would be helpful in dopamine agonist withdrawal since it reset the adaptation period, which means it caused at least the presynaptic receptors to upregulate. Actually, I'm thinking maybe Memantine was the reason it was very easy to go from 1.5mg to 0.375mg, either that or I'm merely dependent on 0.375mg.


i can't accept it.
when you wanna maintain or increase your dose you use memantine to slow adaption speed. however the adaption occurs gradually.
so when you want to decrease dose or quit you should increase adaption speed to new conditions.
if you continue memantine it's possible that you never return to normal conditions.
however it's only a hypothesis.


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## crayzyMed (Nov 2, 2006)

Memantine accelerates recovery.

Memantine does not block homeostasis, NMDA antagonism just upregulates some receptors that are connected with NMDA. For example amphetamine withdrawal will go away sooner when you cantinue to take memantine then without it.


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## karoloydi (Feb 18, 2010)

Ehsan said:


> i can't accept it.
> when you wanna maintain or increase your dose you use memantine to slow adaption speed. however the adaption occurs gradually.
> so when you want to decrease dose or quit you should increase adaption speed to new conditions.
> if you continue memantine it's possible that you never return to normal conditions.
> however it's only a hypothesis.


Yeah. This is also possible. Maybe memantine extends the withdrawal symptoms. Better stop taking memantine just in case.
Who was the one that was taking memantine and couldnt adapt to pramipexole because of this? Maybe the reverse is also possible.


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## crayzyMed (Nov 2, 2006)

Its not possible that memantine extends withdrawal symptons, thats not the way it works.

Memantine upregulates several dopamine receptors wich is why it prevent tolerance, it also speeds up withdrawal because receptors upregulate faster (based on anecdotal reports and my own experience).


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## euphoria (Jan 21, 2009)

I don't think memantine slows withdrawal, I hear it actually helps it.


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## crayzyMed (Nov 2, 2006)

...



> J Neural Transm Park Dis Dement Sect. 1993;6(1):63-72.
> Glutamate receptor antagonists for neuroleptic malignant syndrome and akinetic hyperthermic parkinsonian crisis.
> Kornhuber J, Weller M, Riederer P.
> 
> ...





> A Pilot Study of Memantine Effects on Protracted Withdrawal (Syndrome of Anhedonia) in Heroin Addicts
> Krupitsky, E. M. MD, PhD; Masalov, D. V.; Burakov, A. M. MD; Didenko, T. Y. MD; Romanova, T. N. MD; Bespalov, A. Y.; Neznanova, O. N.; Grinenko, N. I. MD; Grinenko, A. Y. MD; Slavina, T. Y. MD; Tcheremissine, O. V. MD; Zvartau, E. E.
> Abstract
> Objectives: There is a growing body of evidence suggesting that N-methyl-D-aspartate (NMDA) receptor antagonists effectively counteract somatic and behavioral symptoms of the opioid withdrawal syndrome in humans and in laboratory animals. NMDA receptor blockade also reduces the development and expression of drug-conditioned behaviors. At present, there is only one NMDA receptor antagonist, memantine, registered for clinical use in Russia. Memantine is used in Europe for the treatment of Parkinson's disease and senile dementias. Most of heroin addicts soon after the termination of withdrawal syndrome are suffering from protracted withdrawal (syndrome of anhedonia [SA]), which includes affective disorders (depression and anxiety) and craving for heroin. SA is viewed as a major factor contributing to the relapse to heroin use.
> ...


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## crayzyMed (Nov 2, 2006)

Thats good news, good luck with it mate!


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## Vini Vidi Vici (Jul 4, 2009)

euphoria said:


> Do you have more on order?


oh yeah, Im good, Gonna get it Tomorrow, - - but either way, It will be ok because I took .25mg Cabergoline and awesomely it is Working, .... for some reason I don't feel bad, I feel better than i did before I took the Cabergoline. But what worries me tho, is that I have been getting hand tremors for a couple months, and today my muscles felt really weak, super depressed, horrible, I took the Cabergoline and felt better within bout an Hour, so Im actually not worried anymore


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## crayzyMed (Nov 2, 2006)

> I should quit Memantine, get on a high dose of Pramipexole, fully adapt to it, and then taper off very slowly, but that could be shooting in the dark."


That doesnt make much sense.

I would completely stop memantine and then take a low dose of prami wich only agonizes the autoreceptors so they downregulate, after they downregulate stop prami.

Right now your upregulating your autoreceptors wich sulpiride by blocking them.


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## crayzyMed (Nov 2, 2006)

Guide 4 Dummies said:


> I'm thinking of 0.75 mg or 0.5 mg twice daily, I don't know what is the optimal dose for selective presynaptic agonism.
> 
> Either that, or I can take Sulpiride until the presynaptic receptors upregulate too much, and then abruptly discontinue taking it, this way there would be acute rebound downregulation, but can cause NMS and much agony so this would be stupid.


Accute rebound downregulation? Youd end up with the same withdrawal a ton more severe, that doesnt make any sense.

Just stop memantine and let your autoreceptors upregulate with low dose prami.


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## crayzyMed (Nov 2, 2006)

And dont forget to stop memantine for a while.


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## Ehsan (Mar 21, 2009)

Guide 4 Dummies said:


> I will start Pramipexole 0.75 mg twice daily.


there is no need to take such a high dosage, i think.
taper down from a dose that you feel good with it.


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## crayzyMed (Nov 2, 2006)

Man thats terrible, i hope you can get off it soon


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## Ehsan (Mar 21, 2009)

maybe it's hard to bear but give more time to your body to adapt.


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## Ehsan (Mar 21, 2009)

good luck. be patient!


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