Novel (realistic) Antidepressants

[streetsurfer]

I am borderline PD and I have tried everything. Please, suggestions?

 

[nuke]

amineptine

 

[jasoncrest]

I am borderline PD and I have tried everything.

What have you tried?, list them, this is the only way we can tell you what interesting antidepressant you have not taken...

(and what PD means?)

 

[Helios.]

PD there stands for Personality Disorder.

Willie Nelson advocates the use of marijuana as an antidepressant.
I'm not saying he's wrong or right about that, or that marijuana would be the right antidepressant for everyone, but it's worth looking in to.

 

[Dr.Heckyll]

Try amisulpride in a low dose (50mg in the morning is standard, up to 2 x 100mg can be taken, but the higher doeses might not work better than the 50mg), this has worked wonders for me and at least on other person who had a chance to try it. It's also completely free of side effects.

 

[dunwich]

Willie Nelson advocates the use of marijuana as an antidepressant.
I'm not saying he's wrong or right about that, or that marijuana would be the right antidepressant for everyone, but it's worth looking in to.

Worth looking into...perhaps. However, in general, marijuana probably isn't the solution for depressive symptoms. Now, im not saying that it surely wont work, but in these cases it will probably just end up exacerbating everything even if it does help in the beginning. And with something like BPD I would think that pot is really not the answer, but I am not well versed in that subject. Just my 2cents.

 

[jasoncrest]

Have you tried tetracyclic or tetracyclic-like antidepressants?
They are the only AD that work for me...

Maprotiline
(brand name Ludiomil in the USA and UK)

Used in the treatment of affective disorders. Dosage 75 - 150mg/day. Inhibitor of norepinephrine reuptake. Terminal plasma half-life in healthy subjects about 58 hours. Incidentally seizures reported. Low incidence of anticholinergic or cardiovascular effects. Normaprotiline is a major metabolite. The combination of maprotiline with moclobemide or paroxetine has been suggested for treating therapy-resistant depressions.

Mianserin
(brand names Bolvidon, Tolvon, Lerivon.....)

Antidepressant agent. Distinct pharmacological profile. Insignificant anticholinergic properties, inhibitive effect on 5-HT2 mechanisms. Enhances norepinephrine turnover, presumably by blocking §a§2 adrenergic receptor sites. Maintenance dosage 30 - 60 (90)mg daily. Plasma half-life in healthy subjects 14 to 33 hours; in patients over 60 years 33 ± 15 hours. Major metabolite is normianserin. First dose effect in young subjects reported. Studied as a treatment of sexual dysfunction induced by SSRIs. Proposed in the treatment of alcoholism. It has been reported that low doses of mianserin may be a promising option for the treatment of acute neuroleptic-induced akathisia. It has also been published that mianserin may increase the efficacy of fluoxetine and significantly shorten its onset of action. Beneficial in reversing sexual function caused by SSRIs in women.

Mirtazapine
(brand name Remeron in the USA, Zispin in the UK)

Presynaptic §a§2 adrenoceptor antagonist. Noradrenergic and specific serotoninergic antidepressant (Na SSA), enhances noradrenergic and serontoninergic transmission, probably via its presynaptic §a§2 adrenoceptor blocking effect. Post synaptic 5-HT2/5-HT3 antagonist. Compared with mianserin much weaker inhibition of noradrenaline uptake. Enantioselectivity: antidepressant effects presumably linked to the (R)-enantiomer. Pharmaco-EEG studies. Increased nocturnal melatonin secretion reported. Claimed to be devoid of interaction with cytochrome P450 system. T1/2 (about 20-40h) justifies a once daily prescription. Absolute bioavailability approximately 50%. Steady-state achieved within 3-5 days. Around 100% of the oral dose is excreted via urine and faeces within 4 days. In vitro metabolic pathway: (S)-enantiomer: 8-hydroxylation (catalyzed by CYP 2D(6), (R)-enantiomer. N(2)-demethylation and N(2)-oxidation (catalyzed by CYP3A). Preferred metabolic in vitro route for the (S)-(+)-enantiomer is 8-hydroxylation catalyzed by CYP2D6, and for the (R)-(-)-enantiomer the (N)2-desmethylation and the N(2)-oxidation catalyzed by CYP3A. Some authors advice the precription of mirtazapine and mianserin in nocturnal dosing regimen rather than daytime for avoiding excessive sedation and performance impairment. Initial trial in opioid detoxification. May be linked with the 5-HT2/5-HT3 blocking properties, as typical symptoms of opioid withdrawal can be linked to the stimulation of those receptors. A beneficial effect on sexual functioning has been observed in both sexes. Succesfully studied in the treatment of panis disorder. A pilot study suggests the efficacy of mirtazapine in treating the irritable bowel syndrome.

 

[jasoncrest]

ATYPICAL ANTIPDESSANTS
(Drugs with an indication other than "depression" but that show antidepressant properties.)

Adinazolam
Anxiolytic
(brand name Deracyn in the USA)

Exists also in sustained release formulation. Antidepressant and anxiolytic agent. Studied in the treatment of depression at a dosage of 10mg/day vs placebo. Dosages of 20mg to 90mg/day also used. Rapid onset of action and minimal anticholinergic side effects. Trials in psychotic disorders foreseen. Phase III clinical trials in panic disorder. It has been reported that the slow-release formulations of adinazolam and alprazolam, prescribed in panic disorder, are better tolerated than clomipramine, but do not offer advantages in terms of efficacy. Halof-life about 2.3 hours.

Amantadine
Antiparkinsonian
(brand name Symmetrel in the USA, Lysovir in the UK...)

Amantadine may work as an antidepressant thought several mechanisms thought to be related to antidepressant activity (dopaminergic, noradrenergic, serotoninergic, MAOAA blocking effect). May work as an antidepressant through several mechanisms thought to be related to antidepressant activity, but the mode of action is still unclear.

Amisulpride
Antipsychotic
(brand name Solian in the USA and UK...)

At lower doses stimulatory effects. Quick onset of action. Elimination half-life about 12 to 19 hours. Clinical trials in dysthymia. Studied as an antidepressant in Europe. This indication is already accepted in ITA and Port.

Clenbuterol
Bronchodilatator
(brand name Spiropent...)

Very potent bronchodilator with selective ß2 adrenergic stimulating activity. Antidepressant effect has been reported, but controlled studies are missing.

Cyproheptadine
Antihistamine
(brand name Periactin in the USA and UK...)

Antihistaminic agent with antidepressant properties. [...] Clinical trials in the management of affective disorders at a dosage of 8mg up to 32mg daily.

Orphenadrine
Muscle-relaxant
(brand name Norflex...)

At doses up to 500mg/day, antidepressant properties reported.

Sibutramine
Antiobesity
(brand name Meridia, Reductil....)

Potential antidepressant with fast onset of action, not affecting cardiovascular functions.

Almost all new-generation antipsychotics can help against depression too: Ziprasidone (Geodon), Aripiprazole (Abilify), Risperdone, etc....

In the list above, I didn't put the Japanese drugs with antidepressant properties, they are commercialized in Japan only:
-indeloxazine
-bifemelane
-flutazolam (another interesting benzo...)
-rilmazafon
-sapropterine
-tandospirone

 

[rashandreflex]

Orphenadrine
Muscle-relaxant
(brand name Norflex...)

i believe orphenadrine has some pretty strong anticholinergic action, which i would guess would be extremely unpleasant day-to-day (i had a very bad experience with orphenadrine so perhaps i am a bit biased but still...)

two other suggestions:
1) seroquel (quetipiane)...i have known a couple people who have felt that fairly low doses of seroquel lifted their depression
2) ketamine: researchers found that a dose of ketamine seemed to imrpove depressed people's moods for about a week (but then it would need to be re-administered)

 

[streetsurfer]

Been on
Moclobemide (aurorix) (made me feel detached),
citalopram,(Cipramil)(worked at first then took me years to get off it)
escitalopram(Lexapro)(anxious,weird feeling)
zoloft(Sertraline),(zombie)
Paroxetine(helped but caused anxity attacks),
inipramine(12yo treatment for add, dirty nasty drug),
Atomoxetine (made me want to kill myself)
Mirtazapine (Avanza) Half dose knocked me out for 15 hours!
St johns wart (made anxiety and depression worse)
Prozac, Makes me agressive to the point of rage
selegiline - a really good drug but sedating, seems to lose effectiveness after a while like all the rest
Dexamphetamine - dependence, abuse, mania, erratic behaviour
Ritalin - so buzzy, bad anxity coming down, only last for an hour, abuse, addiction etc

I am on effexor at the moment, I am take a different dose each day by opening the capsules and taking the time release balls a little at a time. I know it will end in tears.
I am also on lamictal 250mg day....undecided how it is working, no side effects except makes my vision blurry...I think.
I also take a b complex and about 12 grams of fish oil a day

Prozac by far makes the biggest difference (for the few days it works for) effexor probably second (such bad constipation and urinary hesitation)


My main problem is social anxiety. I make everyone else nervous I come into contact with. Also while I can be bright and cheery when I am engaged in conversation, the minute I loose that stimulation my thoughts become negitive and repetatative and intrusive.

Thanx for your suggestions, but I have no idea where to begin... I am in Australia, I will have to check the PBS..

 

[streetsurfer]

PS Ketamine is my number 1 fav drug in the universe. I feel so damn normal on it. Do any of the above drugs have nmda antagonist properties?

 

[Splatt]

Why don't you try Valpro / Epelim. Ask your doctor about it. It's used to treat epilepsy most of the time but can really balance out moods and is a natural product. Just make sure you eat something with it and are you prone to stomach ulcers? Aspirin is also bad to use with this product. If prozac works i guess try that but I have a thing against prozac.

Just relax your face and eyes, nervous energy can turn bizzarre between people and can cause all sorts of misunderstandings, it comes out naturally and is often misread for people with your disorder.

 

[jasoncrest]

PS Ketamine is my number 1 fav drug in the universe. I feel so damn normal on it. Do any of the above drugs have nmda antagonist properties?

There are prescription drugs that are NMDA antagonists:
-Amantadine (which I quoted above) is a NMDA antagonist. It's prescribed for Parkinson's disease. As I said above it could have antidepressant properties..
-Memantine is another NMDA antagonist. It's prescribed for Alzheimer. The people who have tried it seem to like it, it has recreational dissociative properties, like Ketamine. But unlike Ketamine, it has neuroprotective properties. It also seems to do wonders against many diseases (surely including depression...)

These 2 drugs are interesting, you should try to convince a doc to prescribe one of them to you, off-label...

 

[Helios.]

If antidepressants worked there wouldn't be so many of them.

 

[almost-]

A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression.
Zarate CA Jr, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, Charney DS, Manji HK.
Arch Gen Psychiatry. 2006 Aug;63(8):856-64.

CONTEXT: Existing therapies for major depression have a lag of onset of action of several weeks, resulting in considerable morbidity. Exploring pharmacological strategies that have rapid onset of antidepressant effects within a few days and that are sustained would have an enormous impact on patient care. Converging lines of evidence suggest the role of the glutamatergic system in the pathophysiology and treatment of mood disorders. OBJECTIVE: To determine whether a rapid antidepressant effect can be achieved with an antagonist at the N-methyl-D-aspartate receptor in subjects with major depression. DESIGN: A randomized, placebo-controlled, double-blind crossover study from November 2004 to September 2005. SETTING: Mood Disorders Research Unit at the National Institute of Mental Health.Patients Eighteen subjects with DSM-IV major depression (treatment resistant). INTERVENTIONS: After a 2-week drug-free period, subjects were given an intravenous infusion of either ketamine hydrochloride (0.5 mg/kg) or placebo on 2 test days, a week apart. Subjects were rated at baseline and at 40, 80, 110, and 230 minutes and 1, 2, 3, and 7 days postinfusion.Main Outcome Measure Changes in scores on the primary efficacy measure, the 21-item Hamilton Depression Rating Scale. RESULTS: Subjects receiving ketamine showed significant improvement in depression compared with subjects receiving placebo within 110 minutes after injection, which remained significant throughout the following week. The effect size for the drug difference was very large (d = 1.46 [95% confidence interval, 0.91-2.01]) after 24 hours and moderate to large (d = 0.68 [95% confidence interval, 0.13-1.23]) after 1 week. Of the 17 subjects treated with ketamine, 71% met response and 29% met remission criteria the day following ketamine infusion. Thirty-five percent of subjects maintained response for at least 1 week. CONCLUSIONS: Robust and rapid antidepressant effects resulted from a single intravenous dose of an N-methyl-D-aspartate antagonist; onset occurred within 2 hours postinfusion and continued to remain significant for 1 week.

Full text as pdf: http://www.sendspace.com/file/eguvvi



Future Treatments for Depression, Anxiety, Sleep Disorders, Psychosis, and ADHD:
http://www.neurotransmitter.net/newdrugs.html

 

[rnd.id.]

Sibutramine
Antiobesity
(brand name Meridia, Reductil....)

Potential antidepressant with fast onset of action, not affecting cardiovascular functions.

Are you sure about that? I remember reading that sibutramine has particularly bad effects on the cardiovascular system. I don't know if that is true, but Wikipedia seems to agree somewhat.

Too bad, since otherwise the triple reuptake inhibition would make it interesting as an antidepressant (although the dopamine reuptake inhibition is rather weak according to Wikipedia). I'm quite curious what the triple reuptake inhibitors that are currently being developed will be like.

@almost-:
Funny that they only actually mention ketamine halfway through the abstract. Is this is to let the "shock" sink in gradually?

 

[lil angel15]

Would Mirtazapine be safe to use during a MDMA/LSD comedown?

 

[Splatt]

I know someone that mixed Remeron/Avanza with MDMA and survived. Not that that data is enough to make it safe.

 

[Tsukasa]

What is your diet like? and your day to day activities?

 

[Pillthrill]

I do to. Was an Wellbutrin XL for a year and then it quit working now I'm on Lamictal Or whatever, as a mood stabilizer