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Moderate use of levodopa along witth SSRI/ SNRI to treat depression. Wise?

/navarone/

/navarone/

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Hi ADDs.

As I've stated on another post im under 75 mg of effexor daily as a fisrt step to try to fight my lethargic depression.
It's been alsmost 2 weeks now and i cant really say that I have encountered any noticeable negative side effects and it has somehoe helped me with my lethargy (thats why I have chosen an SNRI over a SSRI even if I was really tempted to go for paroxetine after hearing some incredible stories about it).

Now, however, I've been an ex meth addict and I have also ocasionally fucked with MDMA a bit to much after my meth addiction. I honestly feel that my motivation, my ability to feel a rewarding sensations from pleasurable expriences has dimished incredibly and it hasn't changed over the years, I'm frequently experiencing anhedonia, avolition, unability to experiencing emotions other than stress and boredom and simply an unability to experience satisfaction even in situation where I achieve something gratifying. This has also interfeared with my studies and some relationships.
So um suspectin that after the harm I've done to my self I compromised my
reward system.

This thought has started to become a fear for my future and I am coonsidering to do something about it instead of just waiting for it to fly away.

Along with effexor (which in very high doses can also act a partial dopamine reuptake inhibitor) I was considering add a moderate dose of levodopa to my actual therapy. I've tried wellburtin and It didnt do any good, actually i disliked it.

I've got come pills from long ago containing 100mg of levodopa + 25 mg of carbidopa which are almost exclusively used to treat parkinson symptoms.

I was considering to take half a pill 2-3 times a day and see if it could improve my conditions. On the instruction booklet there is a non endign list of posible negative side effects but considering very low doses taken gradually, woult it be a good idea to give it a try?

I would be very gratefull if someone could give me some advices or warnings on this.

Thanks.

-Nav
 
I had a similar feeling of what you had. I went hard for over 5 years at raves, and was very flat at the end of it, and getting very few natural highs.

I tried so many things to help, smart drugs, natural herbal crap, anti-depressants (SSRIs and NARIs), L-Dopa, a low dose of Amisulpride, and other drugs.

I then went on Ritalin, then dexAmphetamine for over a year.

A few of them helped in the short term, but nothing helped in the long term.

The only thing i have tried, and works in the long term, is Buprenorphine. The first few weeks on it were amazing, then the effect stabilized. I was on it for 3 years, and it worked the whole time. Of course all drugs have side effects, and that is why i spent the last 6 months comming off it, to see what my brain is like now with no drugs in it, and if i have got my natural high back. Not sure yet.

L-DOPA incraeses Kappa receptors - that is bad.
Anything that gets you high will increase Kappa receptors. Kappa receptors directly lower dopamine. It is your brains way of stopping you getting high in the long term.

Buprenorphine blocks Kappa receptors, (the only drug i know that blocks it) so Buprenorphine can really help flat people who have abused drugs in the past, and gives the best anti-depressant effect possible.
 
Pramipexol (Mirapex), a dopamine agonist, has been shown to be useful in treating anhedonic depression, so theoretically, L-DOPA should serve the same purpose. Boehringer-Ingelheim actually has a patent for a future antidepressant consisting of a Pramipexol-Zoloft combo ( http://www.freepatentsonline.com/EP1093369.html ).

From what I recall though, L-DOPA may be neurotoxic in the long term, while pramipexole is actually supposed to be neuroprotective.

Another issue might be that dopamine overstimulation by L-Dopa, and even more so a D3-specific agonist like Mirapex, tends to exacerbate hedonistic-addictive behaviors, which you might be especially at risk for as a ex-meth addict (of course, there's also the possibility that your meth addiction was a shortsighted attempt at self-medicating your dopamine deficiency).

Ritalin has helped me handle my anhedonia to some degree, although its ultra-short half-life did at times make me fiend to redose every 90 minutes. After 2 weeks of Ritalin LA, I can say that the sustained release formulation seems much safer in that regard, not to mention being much easier on the bowels.
 
Thanks a lot for the replies. I'll take into account your advices.

However, isn't L-DOPA the natural precursor to dopamine? so why whould it be neurotoxic?

I'm almost certain sure that L-DOPA is the last metabolic precursor of the endogenous dopamine synthesis that starts from phenylalanine/tyrosine.

I was also considering tyrosine supplements (which conversts to dopamine at a much much slower rate while L-Dopa converts directly into dopamine) but they are hard to find here in my country and plus I don't feel like spending the rest of my days eating cheese lol.

Dr. Beat BTW, how does L-DOPA increase kappa receptors if it's the natural precursor to dopamine, could you explain that to me a bit further?

Thanks a lot, keep it coming
 
I dont think LDOPA is much of a neurotoxin in low doses, you dont need massive doses for treating anhedonia. I think its definatly safe.

Indeed, pramipexola is also worth looking into, it has alot of science behind it and is succesfully used for depression, the adaptation period however isnt much fun.

Another option is trivastal, altough it isnt a full agonist like prami, its more gently and doesnt need to be carefully titrated.

Tyrosine probably wont do much more then a placebo pill.
 
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Sure, I second Medievil's suggestion to look at Trivastal if dopamine agonists are being considered for anhedonic/lethargic depression. It seems to have a lot going for it.
 
I just looked it up, Very interesting and it doesn't cost shit here.

Initially I was a bit dubious about taking antiparkinsonian drugs but reading on wikipedia, it states that its indicated for:

-Treatment of pathological cognitive deficits in the elderly (impaired attention, motivation, memory, etc).

- Anhedonia and treatment-resistant depression in unipolar and bipolar depressives (off label).

Just what I need since I'm suffering from both to a certain level.

Thanks
 
Just started my Piribedil treatment today! Took a 20mg (instead of 40mg version, don't want to fuck around to much with antiparkinson drugs) pill in the morning and another one at noon and i have to say i do already feel some difference, the instructiion booklet advices that the treatment should be gradual from one pill a day slowly up to 4 a day to reach full effects.
Surprisingly though unlike reuptake inhibitors this thing works pretty fast.
I doubt it's placebo but my anhedonic disorder got slightly better, i'm feeling a bit more interested that usual. About imprroved mental conditions, well I cannot notice anything yet we'll have to wait a week or so.

Anyone else here has experience this compound?

I'll keep ya updated with the trialing.

Ciao
 
Yeah, it starts working from day 1 for me too, works good for my anhedonia. Didnt really trial a long time tough.
 
/navarone/ said:
Yeah, I guess my first experience was more placebo like cause recently to feel any significant effects i had to take up to 60-80mg. Too bad the half life is so short.
Click to expand...

Arent you using the time released version? If i take it in the morning it lasts untill 6 o clock in the evening.
 
There is only one brand here (Trivastan 20/40mg) and it's not in extended release form, in fact you shoudl take it 3-4 times a day according to the manual. It works pretty good at high doses but when it comes down I feel soo drowzy......zZz.....zZz
 
/navarone/ said:
I just looked it up, Very interesting and it doesn't cost shit here.

Initially I was a bit dubious about taking antiparkinsonian drugs but reading on wikipedia, it states that its indicated for:

-Treatment of pathological cognitive deficits in the elderly (impaired attention, motivation, memory, etc).

- Anhedonia and treatment-resistant depression in unipolar and bipolar depressives (off label).

Just what I need since I'm suffering from both to a certain level.

Thanks
Click to expand...



I somehow think the antiparkinsons drugs mean selegeline,, benzhexol etc, but not L-DOPA as the response to a little too much L-DOPA isn't likr that to the antiparkinsons drugs, but is characterized by an uncontrollable writhing type motion. L-DOPA is a step past the negastive biofeedback point in dopamine synthsis (the regulatory step is that of tyrosine hydroxylase making L-DOPA from tyrosine)
 
fastandbulbous said:
I somehow think the antiparkinsons drugs mean selegeline,, benzhexol etc, but not L-DOPA as the response to a little too much L-DOPA isn't likr that to the antiparkinsons drugs, but is characterized by an uncontrollable writhing type motion. L-DOPA is a step past the negastive biofeedback point in dopamine synthsis (the regulatory step is that of tyrosine hydroxylase making L-DOPA from tyrosine)
Click to expand...

Ldopa doesnt cause uncontrollable movements in people without parkinson, i beleive they tested it on subjects with manganese poisoning.
 
The problem with L-Dopa is that its positive effects seem to vanish very quickly with regular use. I know that this is the case for many medications but I think its particularly the case with L-Dopa.-DG
 
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