Do amphetamines (dopamine releasing) and dopamine agonists(for RLS) interact badly?

[JackiesBabyy]

Or, even if not badly, would they effect each other at all if they were taken at seperate times? Out of curiosity, what if you were to take both? Pharmacologically speaking, I don't know how releasing agents and agonists together would work. I know dopamine antagonists aka antipsychotics negate or severely dull the effects of dopamine release.

I have both ADHD and RLS, and am prescribed vyvanse in the morning and adderall in the afternoon. I have RLS all the time that worsens at night, so would it be worth asking for pramipexole or ropinirole for the RLS symptoms at night? I've always had it but it slowly gets more severe as time goes on and I didn't know there were drugs that can get rid of it that easily until a friend of mine took it and told me how great it worked for him AND as a side bonus it helps ED(which I have from smoking so much AM-2201 powder last year, it doesn't go away even after not touching the stuff for almost an entire year). Upon looking them up and reading more, they've also been shown to be effective for depression in clinical trials which I also suffer from from time to time. (I'm not bipolar, I just get episodes of depression and times of being normal.) So not only will it make my RLS go away, it may also be beneficial to two other problems I suffer from. I honestly don't even care about the side effects like nausea and other parkinsons med side effects if it has the potential to help me that much.

Of course, I'm only getting my hopes up for it to cure my RLS, the other things will just be nice bonuses. But it's not worth it if I'd have to stop stimulants all together. So what do you think?

Pramipexole and ropinirole are (I think) strong agonists at d2 and d3, weak agonists at d4, and don't have enough affinity at d1 to make any difference. So how do you think they'd interact with stimulants, or even if they'd interact at all if taken seperately?

Side question: What are the main purposes of the d1-4 receptors? Correct me if I'm wrong but what I know so far is...(I know the following isn't everything they do, just what I've read)
d1 = receptor responsible for pleasure and euphoria
d2 = wanting things, libido, and overactivation is the main culprit responsible for amphetamine psychosis
d3 = movement, so involved in parkinsons and RLS
d4 = I don't know but I've read problems with the d4 receptors may be the one that has most to do with ADHD. anyone know more about this?
I know one of them is also responsible for vomiting but I forgot which.

I posted a thread similar but less pharmacology related on OD and no replies, so I figure I'll ask here and ask some more things while I'm at it.

 

[sekio]

Dopamine receptors don't have individual "roles" assigned to them, the brain does not work that way.

Have you tried reducing your amphetamine dose? I think you should talk to your doctor, not a bunch of random people on the 'net.

 

[JackiesBabyy]

Dopamine receptors don't have individual "roles" assigned to them, the brain does not work that way.

Have you tried reducing your amphetamine dose? I think you should talk to your doctor, not a bunch of random people on the 'net.

The stimulants didn't cause the RLS, I started them a few months ago, the RLS i've had since I was a kid, getting progressively worse as I got older. (not taking the stimulants for a day or even taking more doesn't help or affect the RLS.) So I looked up treatments and they said first line was pramipexole/ropinirole, 2nd line was benzos (which i've had before and don't help one bit, they made me fall asleep a bit faster but i'd still lay there and kick my legs and need to get up some.), 3rd was gabapentin (low chance of working usually, thats why its not tried first) and 4th line is opiates which work for everyone butttttt they're opiates but most people are fine on one of the DA agonists, only met one person who got intolerable side effects.

 

[sekio]

You really should be talking to your doctor then. Honestly I would start with the simplest fixes before moving onto hardcore dopamine agonist drugs though. It looks like there are a lot of other causes of RLS. Fix the underlying condition, not the symptoms.

The most commonly associated medical condition is iron deficiency (specifically blood ferritin below 50 µg/L[14]), which accounts for 20% of all cases of RLS. A study published in 2007 noted that RLS features were observed in 34% of patients having iron deficiency as against 6% of controls.[15] Conversely, 75% of individuals with RLS symptoms may have increased iron stores. Other associated conditions include varicose vein or venous reflux, folate deficiency, magnesium deficiency, fibromyalgia, sleep apnea, uremia, diabetes, thyroid disease, peripheral neuropathy, Parkinson's disease and certain auto-immune disorders such as Sjögren's syndrome, celiac disease, and rheumatoid arthritis. RLS can also worsen in pregnancy.[16] In a 2007 study, RLS was detected in 36% of patients attending a phlebology (vein disease) clinic, compared to 18% in a control group.[17]

An association has been observed between ADHD, and RLS or periodic limb movement disorder. Both conditions appear to have links to dysfunctions related to the neurotransmitter dopamine, and common medications for both conditions among other systems, affect dopamine levels in the brain.[18] A 2005 study suggested that up to 44% of ADHD sufferers had comorbid (i.e. coexisting) RLS, and up to 26% of RLS sufferers had confirmed ADHD or symptoms of the condition.[19] A 2009 study updated this to report that 39% of RLS sufferers also might have ADHD compared to 14% of controls and that those showing signs of both had more severe RLS, suggesting that perhaps either the difficulties of RLS and low sleep quality caused ADHD-like distraction or that dopamine was a possible common factor and its improvement helped both, and that RLS sufferers might wish to consider ADHD testing as well, but cautioned that neither condition was proven as the cause of the other.[20]

Have you had a blood panel done (Iron, glucose, B vitamins especially)? Do you eat lots of leafy green vegetables/red meat? Is the RLS associated with low blood sugar, that is, does it get worse if you haven't eaten? Does magnesium supplementation help? Do you get enough non-drugged sleep? Do you ever take days off of amphetamine, does it help or worsen your RLS? How about stress (cortisol)?

If you can fix your RLS with daily iron and b vitamin supplements (or more veggies, or more sleep), you'll probably kick yourself if you go on dopamine agonists instead and permanently fuck your sex ddrive or whatever.

Dopamine agonistic drugs like ropinirole et cetera are vastly different from what you'd "expect" because many of them are selective , or partial, agonists - whereas dopamine is nonselective and acts as a full agonist on most dopamine receptors. This explains why most of them aren't "pleasurable" and don't have effects like cocaine/amphetamine. But due to genetic variations its really hard to predict how people will respond to them. I think it would be down to personal experience and your doctor's advice whether combining the two would be of any benefit.

 

[JackiesBabyy]

You really should be talking to your doctor then. Honestly I would start with the simplest fixes before moving onto hardcore dopamine agonist drugs though. It looks like there are a lot of other causes of RLS. Fix the underlying condition, not the symptoms.



Have you had a blood panel done (Iron, glucose, B vitamins especially)? Do you eat lots of leafy green vegetables/red meat? Is the RLS associated with low blood sugar, that is, does it get worse if you haven't eaten? Does magnesium supplementation help? Do you get enough non-drugged sleep? Do you ever take days off of amphetamine, does it help or worsen your RLS? How about stress (cortisol)?

If you can fix your RLS with daily iron and b vitamin supplements (or more veggies, or more sleep), you'll probably kick yourself if you go on dopamine agonists instead and permanently fuck your sex ddrive or whatever.

Dopamine agonistic drugs like ropinirole et cetera are vastly different from what you'd "expect" because many of them are selective , or partial, agonists - whereas dopamine is nonselective and acts as a full agonist on most dopamine receptors. This explains why most of them aren't "pleasurable" and don't have effects like cocaine/amphetamine. But due to genetic variations its really hard to predict how people will respond to them. I think it would be down to personal experience and your doctor's advice whether combining the two would be of any benefit.

Haven't had a blood test but haven't mentioned RLS to my doctor yet, I take a multivitamin with iron every day, food doesn't affect it, I take trazodone for sleep and it's pretty hit and miss, it does nothing for the RLS but if the symptoms aren't too bad that night it'll successfully knock me out and keep me out for the night, if it doesn't put me to sleep in a half hour I'll take one more and that may work, but then there's nights it's really getting to me and I end up losing a ton of sleep get maybe an hour or two total. Amphetamine doesn't affect it at night because it's worn off, but if I don't take anything at all the daytime RLS will noticeably worse. Dunno if it's placebo or not though as I this same old feeling in my legs since looooooong before I started adderall.

What do you mean mess up my sex drive? It's been almost non-existent anyway ever since quitting AM-2201, before that it used to be about normal for a male my age. Nowadays I'll get mildly horny once a week or so, down from the original a few times per day. While I understand it won't make me high, most reports did say their sex drive went up and I didn't see any where it went down. But either way, I'm not counting on it helping, as nothing else really has, I just mentioned that'd be a nice bonus if it did. Forums I read say that while dopamine agonists aren't the safest thing out there but since the doses for parkinson's are much higher than the doses for RLS(if memory serves RLS people were on 2-4mg ropinirole, parkinson's people were on 30+mg doses and their reports were the nasty ones with unbearable side effects). Where did you hear about them actually making sex drive worse though? I think if mine got any worse i'd be asexual

 

[sekio]

Have you stopped the trazodone to see if that helps, or are you dependent on it for sleep? It's conceivable either the trazodone or the mCPP produced are causing you to be excessivley twitchy - I know that diphenhydramine can aggravate RLS too. Traz is a rather broad spectrum anti-serotonin drug & mild SSRI so it's also conceivable that its suppresing your libido.

I was misunderstood on the sexyual dysfunction thing, it's dopamine antagonists that cause the long term loss in libido. DA agonists cause things like compuslive gambling in high doses. I still think that non-pharma treatments seem a better option, but low dose da agonists may well be effective if you need them. I just haven't heard a lot of people raving about their efficacy...

 

[JackiesBabyy]

Have you stopped the trazodone to see if that helps, or are you dependent on it for sleep? It's conceivable either the trazodone or the mCPP produced are causing you to be excessivley twitchy - I know that diphenhydramine can aggravate RLS too. Traz is a rather broad spectrum anti-serotonin drug & mild SSRI so it's also conceivable that its suppresing your libido.

I was misunderstood on the sexyual dysfunction thing, it's dopamine antagonists that cause the long term loss in libido. DA agonists cause things like compuslive gambling in high doses. I still think that non-pharma treatments seem a better option, but low dose da agonists may well be effective if you need them. I just haven't heard a lot of people raving about their efficacy...

Yeah, I read some crazy stories of people on high parkinson's doses of 30+mg who either spend their life savings on new stuff/gambling, and then a 50 year old woman who cheated on her husband with over 50 different men while on it. just out of curiousity, is it known/theorized pharmacologically why dopamine agonists cause these extreme uncontrollable urges? I wish I knew what thought process/rationalization their brain used to tell them that they need to gamble ALL of their money RIGHT NOW! Or that they need to buy whatever they're compulsively shopping for, etc.

Having ADHD I have horrible impulse control but even I can't imagine a way to rationalize that

 

[cannibalsnail]

I am prescribed Pramipexole and Ritalin (for RLS and PI-ADD). I actually found the Pramipexole produced an unusual euphoria from the Ritalin which I do not normally have.

Oddly enough Pramipexole gives me mild insomnia while Ritalin actually calms my legs down enough that I can sleep on it.

 

[JackiesBabyy]

I am prescribed Pramipexole and Ritalin (for RLS and PI-ADD). I actually found the Pramipexole produced an unusual euphoria from the Ritalin which I do not normally have.

Oddly enough Pramipexole gives me mild insomnia while Ritalin actually calms my legs down enough that I can sleep on it.

Possibly because of dopamine receptor upregulation from the agonist?

 

[cannibalsnail]

I doubt it. Pramipexole upregulates D2 type receptors. I suspect its because it occupied D2 type receptors with partial agonisation so the excess dopamine was forced to bind to D1.