Rozzer

Any experience with Remeron/Mirtazapine or an SSRI??

68 posts in this topic

Wellbutrin worked for a few months in the beginning. My fits of rage became almost non-existent, sense of time got normalized, had better focus and concentration. Sleep was a bit better too.

Not to mention the blocking of the nicotine receptors, which literally erased my addiction to nicotine. After those months all began to creep back. Craving for nicotine, loss of focus & concentration, rage, all got back to what it was before I started Wellbutrin. Like it stopped to latch on to my receptors at all.

I have not had Concerta/ Ritalin before, since doctors usually perscribe in this order; 1:Wellbutrin or Strattera 2:Concerta/ Ritalin.

Methylphenidate is known to be more effective for ADHD, but it makes HPPD symptoms worse too. There are some similarites between Bupropion and Methylphenidate, both having a NDRI effect. But Methylphenidate also acts as a releasing agent for DA and NE.

I talked with some people in the old forum who had used Ritalin and said it made the HPPD much worse. Though I don´t know if these people had diagnosed ADHD (memory failure..)

A thesis is that people with ADHD have less receptors for DA/NE and also less release of these neurotransmitters. Some doctors estimate this system to be at 40% functionality in a ADHD person, compared to 100% functionality in a healthy person. Which also means that these type of drugs has a different effect in an ADHD brain.

So, maybe it won´t increase visuals for me? For people with ADHD and bipolar they also add a "mood stabilizer" usually a anti-EP drug such as Ergenyl, Carbamazepine, Lamictal and even Keppra. Like speeding up and then limiting the speed to a perfect level.. This could also negate the HPPD increase from Methylphenidate, possibly.

I´ll be the first guinea pig with both conditions diagnosed and both drugs (Concerta & Keppra) in use it seems! So I´ll post data here regarding the combo.

Interesting regarding Keppra. I got spasms, trembles and neurological pains aswell. And massive DP/DR, still in Wonderland but it´s changed to Creepyland.. ;)

I did feel some increase in mental clarity with Lamictal, but I seems I´m a bit allergic to calcium channel anti-EP meds, so I had to quit it.

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I've been on Prozac since I developed hppd. 16 years ago! 8 months or so into the disorder. I wish I could have stayed off and not gone onto meds as quickly but I literally couldn't have handled it any longer. (And i had no idea of hppd or even the slightest inkling what i had done). So Prozac possibly saved my life. Allthough by most reports I'm about the only one that its helped much.

I think I've read that Prozac is one of the least 'selective' of the ssris so I think maybe that's why it worked so well for me for years. Throw enough mud and some will stick and all my symptoms lessoned considerably. (Depression lifted which was my more pressing symptom at the time, dp/dr lifted and the visuals even lifted, still had some bad anxiety but i easily dealt with this through a vigorous exercise regime. unfortuneately the birth of my son and the stress/lack of sleep and potentially even just time itself brought on a relapse and its never really been the same since.

Unfortunately it's gave me no direction in which way to go next. Whether it be dopamine or serotonin based meds. (Currently on low dose of keppra, clono and pzac (old habits die hard). (Tried various ssris since with none having the initial effect Prozac did). Would like to try Wellbutrin but its like blood out of a stone with the medical profession here. They see it more a smoking cessation aid and not an anti-d in this country.

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Wellbutrin worked for a few months in the beginning...

Wellbutrin also increases dopamine. If memory serves, it reduces dopamine reuptake and slightly reduces dopamine production. It was the first dopamine med I tried - and was remarkable. But anything more than 75mg / day for a few days causes bad symptoms. Fortunately found Sinemet helpful. While anything that increases dopamine will increase norepinephrine, they all differ in how much NE gets made. IMO, NE can be trouble for HPPDers even though it is known for attention/focus and many of us suffer such symptoms.

It is too bad it stopped working. You are still taking it? Reducing the dose might be 'eventfull' :huh:

Would like to try Wellbutrin but its like blood out of a stone with the medical profession here

Never mind that by design and definition, Wellbutrin IS an anti-depressant. Smoking cessation was an off-label discovery that has proved good enough to make it official.

Wellbutrin was originally with dosing of 450-600mg / day. Then some people got seizures ... drug re-evaluated and dosing dropped to 300-450 mg / day. Because of this bad episode, some docs are terrified of Wellbutrin just as some docs are terrified of benzos. Why aren't they scared of cars which cause 40,000 deaths each year???

Whomever thinks humans are logical and sensible in behaviour (our 'superiority' over animals) has there head stuck in the ground - - - we are REACTIONARY!

I think I've read that Prozac is one of the least 'selective' of the ssris so I think maybe that's why it worked so well for me for years

Very intersting observation. PD people often tollerate tricyclic antidepressants more than SSRIs ... and tricyclics are 'dirty' (affect lots of neurotransmitters)

Have long wanted to try an MAO but doctors are even more terrified by them. Had excellent experience with a MAO-B, which doesn't have the food reactions, but then neuro moved and noone wants to prescribe it anymore ... besides it does severly limit other meds that can be tried.

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I'm pretty sure the dopamine part of the Prozac is what made my eyesight sharper and unblurred my vision back then. Can't say for sure though obviously. Maybe if I could get on a 75mg or 150mg dose of Wellbutrin I'd know for sure. Does keppra have any effect on domaminergic neurons?

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Does keppra have any effect on domaminergic neurons?

Yes, sort of ... unsure. The documentation says it affect SV2 proteins (Synaptic Vessel #2) ... but can't find out what that is about (other than SVs contain neurotransmitters for release).

Since it does affect DR for me (and even more symptoms for some other members), I thought it did. And it has been tested for dopamine-knockout-mice to improve their condition (seizures). It is also used to extend Sinemet effect for RLS. And there is a drug trial to see if it helps PD people with Dyskinesia. With this in mind, it must have some effect on dopaminergic systems.

But it is in a class of drugs known primarily to affect acetylcholine. My brief DR experience with it, and another med that affects DR a tiny bit, Imipramine (which is anticholergic), and also an experience with Kodie in Australia (DPSelfHelp.com) who got DR from Pimozide (anti-psychotic) taken to treat his Torrettes but fixes the side-effect by taking Benztropine (anticholergic) - - - all this leads me to focus on the acetylcholine aspect of Keppra, not so much any dopamine affect. [ Is there an award for a run-on sentence? ... sorry, you'll have to read carefully ]

So in summary, Keppra affects dopamine directly to some degree and/or indirectly via the balance between dopamine and acetylcholine. [ pant :o ]

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Lol. Yeah I got 99% of that there visual. (I think lol). Cheers :) I'm certainly noticing some aspects getting better just over a week into my small dosage of keppra. Visuals are still there but I think about them less. DP/DR is better. And it hasn't cleared my blurred vision much but there's been a couple of eureka moments where I've seen through the brain fog as it were which has been nice but weird after having it so long and so intense. Only on 250mg twice a day so far though and it's effected my depression a bit too in a negative sense so I'm scared to up it too fast. It's certainly making me self realise and feel emotions that weren't there before so its worth persevering with at the moment.

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This really sounds great ... so, yea, don't up the dose anytime soon. Frankly, I really believe that even if a med isn't a perfect fit, just 'rattling' the symptoms around (such as you describe) is useful. This may sound strange, but whenever you get something positive (eureka moments) try to calmly focus on the feeling (sort of meditation) and see how long you can make it last. By 'exercising' these moments, you can train your brain to get better. I've used this and, in some cases its been remarkable, others just mild.

Glad you understand some of my gibberish. Some stuff is hard to explain ... either it requires more technical knowledge or its just an intuitive feel - - - very difficult to communicate either way.

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Hmm. It was going up and down but tonight's been the worst. I've had a severe migraine and head pressure, probably worse than I've had for years. Feel nauseous. Think I'm going to have to stop the keppra cos I'm constantly thinking negative thoughts. Which weren't nearly as bad 10 days ago before I started keppra. It can't be a coincidence lol.

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Do you have some B6 (or P5P) to add?

While it helped me, it wasn't enough. The longer on Keppra, the more unstable emotionally I get. Its a bummer

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Yeah, I was taking 300mg b6 with the keppra. Just stopped it cos like you say, I was turning into a basket case lol. right from the off. Don't really fancy being suicidal over xmas, il just have to put up with the brain fog at the mo and try out Wellbutrin if poss. Well, I spose your one of the few fellow hppdrs with mismatched pupils so I think there might be something in that. Allthough you say neurontin sorts that out for you, but I've took neurontin and while I felt a wee bit more settled my eyes were the same. Only took them for three days though cos someone swapped me for clono lol. The only time my eyes have realigned is when I first started the Prozac.

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It would be interesting if you could take Gabapentin longer.

Since Prozac seems to help you, there is little reason to stop.

Is your doc willing to try Wellbutrin? If so, I suggest getting the SR version (normally taken twice a day) and NOT the XL version. The SR can be broken in smaller pieces safely. Then you can start with lower doses. Some people have little adjustment problems when they start Wellbutrin. But it can be a very rough week for many. I started with only 75mg once a day (in the morning) and the first 4 days were very weird - bad enough that if it was not for some immediate benefits, I would have stopped.

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Yeah, I took lyrica for 3 months and that's it just ran out. That helped a wee bit. Anxiety wise anyway. Pretty sure gabapentin might be as good if not better over the same time period. So does Wellbutrin help with motivation and concentration? Cos that's two of my biggest bugbears at the moment. And a rough week how? 75mg wouldbe ok with clono to dull the edges no?

That's 2nd day off the keppra and I've levelled out. Mad eh, but I just got a new script of clono for the month after three weeks without it and took 1.5mg straight away, and it was like 'aaaahhhh'.

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And I've tried to convince the doc that Wellbutrin or 'zyban' as she calls it has been found to reverse ssri induced sexual dysfunction which I've had on n off since I tried Zoloft for 3 months. Seems my best bet to get it prescribed. As ever she didn't even have a clue about this action. But I think in America it's well known for that. Can't get an appointment with her till the new year so il Have to wait.

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does Wellbutrin help with motivation and concentration?

It is supposed to help with both. I had to switch to Sinemet and it does ... but not necessarily right away or when you think it might.

75mg would be ok with clono?

There is no problem taking them together (no drug interaction)

I tried Zoloft for 3 months

How did you react to this med?

Wellbutrin or 'zyban' as she calls it has been found to reverse ssri induced sexual dysfunction which I've had on n off ... Seems my best bet to get it prescribed.

Seems a good strategy SSRIs are notorious for sexual dysfunction. Wellbutrin is the only anti-depressant that tend to work the other way (increase dopamine and you increase motivation and testosterone).

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I've had a testosterone done recently and it's low or 'borderline' as she said. Borderline what I dunno lol. Getting it done again soon and she 'see where she goes from there', so that'll b a good time for me to mention the Wellbutrin.

Zoloft was not really a good fit. My eyesight sharpened a bit, but I didn't really feel natural or 'myself' with it and that's when the sexual dysfunction kicked in which was annoying. I just didn't like Zoloft at all. I've also tried escitalopram and mirtazipine when I had a massive relapse about 7-8 years ago. mirtazipine was horrible, don't think escitalopram was very successful but I was massively hppdd up, depression...massive dp/dp, brain zaps and 'anxiety attacks' every couple of minutes. Might be different when the brains not storming as it were. Both my main hppd episodes I wish I knew about clono. It's good for putting out fires for sure. Allthough i need at least 1.5mg to get something out of it.

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Have them test prolactin with your testosterone

There is an inverse relationship: dopamine (D2) --> Pituitary production of prolactin --> testosterone

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Yeah, il hit that on her. Shel be saying 'bring back the young naieve kid who didnt have a clue, wheres he gettin this shit from' lol. But it iz just trying to get the right peices of a jigzaw together i spose.x

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