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postSSRI (or maybe mdma?) Apathy: Methylphenidate and Modafinil have no effect

methylphenidate modafinil apathy fatigue brain fog anhedonia dysthymia

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#31 Tom_

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Posted 27 March 2013 - 03:39 PM

The research for Bupropion is very promising, the literature is also of high quality. There is no formal research I am aware of that suggests problems with memory - quite the opposite its effective in ADHD.

There is always Vanlafaxine and the MAOI/TCA.

#32 magniloquentc0unt

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Posted 30 March 2013 - 12:27 PM

well it has anticholinergic properties... by the way i could not find formal research either (it is actually very rare to find that kind of negative papers..), but from anectodes, it is one of the most often occuring symptoms. Also: it makes people angry and tense. I have never been angry or tense, so maybe i could benefit a bit from that, but i would probably not recognize myself anymore. Anyhow, Moclobemide is VERY interesting. And funnily enough, my psichiatrist mentioned it last thursday: i had never read about it, as i was part of the audience that goes "MAO inhibitors!!! thats potent stuff!! for the criminals!". Googling a bit makes it VERY promising: are there any particular papers you are aware of that are worth reading? Im interested in remission rates and lasting side effects after treatment discontinuation..

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#33 magniloquentc0unt

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Posted 23 April 2013 - 12:35 PM


Tianeptine day 10:

I believe something is actually going on. I dont have precise words to describe it. I can say that it feels very subtle, a process in background. Let's start by saying i have not had any side effects, besides maybe a bit of neck stiffness, but its something i notice either upon waking up or not at all. I had it from both methylphenidate and modafinil.


Some anectodes:

- It might be that some things, beautiful things, stuck me in a more "impressive" way. Sometime its just one color next to another, sometime its a flower, i even tought "wow, this house looks great!".

As i am an illustrator, i noticed i work more calmly and i am happier with the results, sometime. I think "wow, this shape/line looks great". I see this as a positive, as i am ever-unhappy with what i do, recently. This is slightly motivating. Its probably early to tell, as its only day 10, but i can say that the Fluoxetine turned me into a machine when it comes to work. I was so motivated its hard to believe.


-Another thing that i found interesting is how more impulsive i got. I was coming out of work and saw the tram approaching as soon as i turned the corner. The mental process "run/notrun" took half a second and already my legs were moving. Usually I take enough time to think about it that the chances to actually catch the tram drop enough for me to be happy with myself and have an easy decision "waiting the next one". I also seem to be able to speak my mind more care free. Usually i tend to be silent when i dont agree with someone and this creates a growing anger inside me that its difficult to get rid of.


-Another anectode is how i got semi-belligerant with a guy who was trying to hit on my girlfriend. This indeed gave me 10alpha male points which can never hurt, but afterwards i tought: "what the hell did i just do? thats not me!" This is like the second time in my life that something like that happens, as i am totally mellow person. It is funny because I had read a very similar anectode by a Tianeptine user, while the common belief is that tianeptine would make one more "easy going" (i believe its bulls***, as SSRI made me "easy going" and careless)


By the way, the dreaming-a-lot has kind of subdued. I dont dream as much as the first days, or at least i dont remember about it, one of the two. They are not particularly vivid as many believe them to be.


I still have the feeling theres some kind of filter somewhere in my brain that dampens everything, even the tianeptine effects, and i want to get rid of that stupid filter, but dont know how.


#34 anothermember

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Posted 23 April 2013 - 05:24 PM

Thx for your update and keep us updated further! Good Luck.

#35 nupi

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Posted 24 April 2013 - 09:43 AM

The research for Bupropion is very promising, the literature is also of high quality. There is no formal research I am aware of that suggests problems with memory - quite the opposite its effective in ADHD.

There is always Vanlafaxine and the MAOI/TCA.


I know it comes with good pedigree but it has it's share of issues - it definitely had some effect on memory for me and forget about it if you have any OCD or anxiety streaks. Venlafaxine I would stay away from, very effective at mood but worst side effects of any AD I ever tried and supposedly really bad withdrawal (though I was spared that somehow)....

#36 BioFreak

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Posted 24 April 2013 - 10:58 AM

About mood reactivity, this is something i have difficulty explaining to everyone. I dont "feel feelings"; but i do experience them and people can read them on my face. It is just they dont affect me. Id say it falls in the dissociation spectrum, but the descriptions of depersonalization and derealization ive read dont apply for me.
Before SSRI my dysthimia was definitely more melanchonic. now because of the permanently numbed emotions, i couldnt say: maybe the sadness is there and i just cant feel it.


And you are complaining? J/k... I wish I could feel emotions without them having affecting me.

I've been thinking about your problems, and to me there seem to be only to possibilities of what could have happened:

1. your dopaminergic receptors are downregulated and/or decreased in count (probably the same)...
2. there is nothing wrong with your dopaminergic system, but your inhibiting neurotransmitter systems are way to strong now.

Usually with ssris, dopamine gets depleted over time, but you said, that even dopamine agonists do no good. Normally, when ssris deplete dopamine, there should be more dopamine receptors over time.

So this leaves only one option(that I can think of) - your inhibitory neurotransmitters must be way stronger now.

In theory, increasing gaba activity should reduce gaba receptors in the long run, while not good for the majority, this might be what you need... but thats purely hypothetical... and I don't even know if this would be the appropriate course of action. Maybe there is some way to test each hypothesis for you so you can judge upon the effects.

What speaks against this theory is the fact that you are displaying strong effects of low dopamine (and maybe even acetylcholine).

Nevertheless, you could try to increase your dopamine receptor count (cdp choline).

Ever thought about that?

Edit: I too think that MDMA is the real culprit here. The most likely cause seems to be dopamine receptor downregulation, together with neurological damage.
Increasing serotonin through 5-htp / tryptophan does not make much sense other then further surpressing the dopamine system which in turn could increase dopamine receptors(which is a good thing, but would first increase your symptoms as dopaminergic action would be lowered even more).
If i were you, I would do the following:
1. not use any stimulants for a (long)while. give your dopaminergic system a chance to recover
2. use cdp-choline to increase dopamine receptors in the long term. This may take a while
3. try to regenerate your brain. the uridine stack is a good place to start. Also, this is LONG TERM.
4. Add other neuroregenerative substances - noopept, alcar, maybe cerebrolysin although it sucks injecting it daily
5. find other neuroregenerative substances and use them as well
6. provide all the building blocks necessary to repair the brain, in short, everything a baby would need for healthy brain development.

Do this, and do this for 3-12months at least without stimulant use... and you might have a chance to regenerate your brain. You will see that its working when your symptoms improve. Also do a lot of cardio, and eat well.

you could also add some strong antioxidants to the mix, i.e. NAC.

Edited by BioFreak, 24 April 2013 - 11:12 AM.

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#37 magniloquentc0unt

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Posted 29 April 2013 - 11:05 AM

Thanks a lot for you extensive answer and sorry i could not answer earlier
I am happy about your inhibitory neurotransmitters hypotesis... I must say that, from my understanding, dopamine is tightly linked to libido, and i have no problem left in that area. I get libidinous very often and i enjoy the act of having sex, it is just it seems, to me, that there is some dampening going on, somewhere. It all feels very distant. I feel like im not in the moment, never fully aware.
As for dopamine receptors count, i've already been told to look into sulbutiamine.

1- havent been using stimulants "ever" in life (no history of coke, speed etc, just mdma couple of times and weak ketamine another time), have tried methylphenidate and modafinil for some days, to no avail. I do not think ive undergone great neurological damage from this, even thou i have to admit that after doing mdma i "felt a little bit stupider", and i dont know if it has faded yet or i just got accustomed to this feeling.
2- have some inositol+choline caps left, ill try to take a couple daily for a while
3- have tried the uridine +DEA +Choline combo for two months or so and am not very impressed

honestly i have a suspect. That i was like that before SSRI, but simply tought it was normal

#38 deeptrance

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Posted 30 April 2013 - 08:18 PM

This is an interesting thread. I'm glad you're getting some good results from tianeptine. Keep on searching for other solutions because tianeptine is reported by many people to "wear off" after a period of a few months to a few years. I had been excited about trying it myself but was discouraged by these reports.

Do you have any history of brain injury, such as concussions? If you don't get enough relief from serotonergic intervention then you could consider seeing a neurologist to determine if any part of your brain is malfunctioning, such as the HPA axis, as this can have a major impact on every aspect of your life.

I think we tend to focus too much on a few neurotransmitters as though our brains were that simple but there's a lot more to life than dopamine, serotonin, norepinephrine, and GABA. We talk about those a lot because they've been studied a lot and they're the easiest for us to understand.

In other threads on this forum I've learned that choline supplementation can have a negative impact on depression, so you might want to be cautious with that.

#39 magniloquentc0unt

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Posted 16 May 2013 - 01:38 PM

No i do not have a history of brain injury... maybe when i was kid i fell down the stairs and ended up to the hospital for a while, nothing big...
anyhow, i decided to continue with the Tianeptine, but i will take some nootropics alongside, i wish to try them. Aniracetam and Sulbutiamine in particular

#40 magniloquentc0unt

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Posted 16 May 2013 - 04:49 PM

also im really puzzled by tianeptine aswell... usual reports talk about a tangible effect that can be felt upon the first dose.. idk...

#41 magniloquentc0unt

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Posted 17 May 2013 - 12:43 PM

So what ive been understanding about my situation recently is: that there is a strong social anxiety base that has always been here and i got used to, and may be caused the fogging.
Also, a thing that really hurts me is how bad my memory has gotten: i forget things all the time, dont pay attention. This happened maybe because of the few MDMA i did, maybe because of the cannabis i sometime smokes, maybe the SSRI.
I really wish to improve my memory and learning: I must say that while on SSRI i could learn and be interested in many different topics!

#42 lourdaud

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Posted 17 May 2013 - 08:04 PM

Lamotrigin may be worth a shot

#43 magniloquentc0unt

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Posted 21 May 2013 - 11:05 AM

i dont know why it should? from a quick search i see cognitive decline....

#44 deeptrance

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Posted 21 May 2013 - 06:19 PM

Lamotrigine is commonly prescribed for depression now, mainly for people with bipolar disorder. It's not an unreasonable suggestion. I took it for a while and it was helpful but I stopped taking it because of a cumulative toxic reaction I was getting after being on it for 2 years.

A useful drug that helps with depression and social anxiety is buspar (buspirone). It has a good safety profile and doesn't appear to have negative effects on cognitive function. I'm on it now, at a very low does because I'm hyper-sensitive to serotonergics, but I do notice it having a positive effect even at my micro-dose.

You probably know about the effect of aniracetam on social anxiety in mice. One study proposes that the antidepressant effect of aniracetam is due to a reduction in "submissiveness". I tried ani for that reason, cuz I tend to be socially submissive and it plays into depression. I was unable to determine if ani helped me or not because of other things I use that overwhelmed any effect it may have had.

Edited by deeptrance, 21 May 2013 - 06:20 PM.

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#45 magniloquentc0unt

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Posted 21 May 2013 - 06:25 PM

funnily enough i ordered some aniracetam and some subultiamine 4 days ago. No, i was not aware of this study you mentioned about submissiveness, but it increases my eagerness: i am indeed very mellow and accomodating and sometime i get bitter and frustrated over it... looking forward to it! could you describe the buspirone experience a bit? ive heard about it some times

#46 lourdaud

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Posted 22 May 2013 - 01:15 PM

i dont know why it should? from a quick search i see cognitive decline....


Well it's a wild card I admit but I've seen several anecdotal reports where lamotrigine has helped with the symptoms you describe..

#47 Olon

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Posted 22 May 2013 - 05:17 PM

Lamotrigine plus quercetin help me against these kind of symtpoms (schizophrenia, however, not MDMA brain damage). An other drug that does this for schizophrenics is minocycline, but it did nothing against my sensory gating problems.

#48 magniloquentc0unt

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Posted 22 May 2013 - 05:21 PM

lol i took minocicline many times! for acne! never knew it was used for schizofrenia.. wondering if it might have played a role

#49 Olon

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Posted 22 May 2013 - 07:42 PM

Starting and stopping schizophrenia drugs many times is probably not so good for brain health.

#50 magniloquentc0unt

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Posted 23 May 2013 - 10:00 AM

from wikipedia:
"Rare but serious side effects include
fever, yellowing of the eyes or skin, stomach pain, sore throat, vision changes, and mental changes, including depersonalization.[26][27]"

FUCKING.HELL.

#51 magniloquentc0unt

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Posted 23 May 2013 - 10:08 AM

adding to that, i have also used the super frownedupon Accutane... thats cool these acne meds are really nice...

#52 Olon

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Posted 23 May 2013 - 08:22 PM

Accutane sounds crazy: depression, anxiety, aggression, psychosis, suicide. Wow.

Did you ever observe a change in motivation by minocycline?

#53 magniloquentc0unt

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Posted 23 May 2013 - 08:25 PM

honestly i could not say in retrospective, since i was unaware of the fact that its also used for schizofrenia i probably did not pay attention. Anyhow, last time i used it was, i think, one and a half year ago... i am since then on a mini dose of accutane, but that did not alter my mood in any way, i have been paying attention carefully

#54 magniloquentc0unt

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Posted 10 July 2013 - 12:07 PM

Hi guys, wanted to update the situation a bit! My anticipatory anhedonia has slightly improved, in the sense that when thinking about an event in the future, i feel slightly interest, i would almost say REMOTELY excited at the tought of doing something.
this is a big step forward. The problem is that i still lack the cognitive sharpness i used to have... abstract thinking is impossible, i forget things, cant follow people in conversation most of the time... on top of that, im extremely fatigued as always.

Since the last update ive been on the following stack regularly (more or less):

Tianeptine 3x12.5mg
Omega 3 DHA and EPA, 2 grams a day
Uridine UMP, 500mg a day
Choline 500mg a day
Inositol 500mg a day

-to that, add a month or so of DMAE and NAC use, which i discontinued in order to "narrow down" the stack size to the most essential.

I have now decided to try to address other symptoms i have, for example some sort of Irritable bowel syndrome (IBS) that i have which might be related to dietary intolerances, so ive decided to cut back on lactose and dairy products overall.
Also, one thing that was bothering me a lot was the inability to dream: not only i used to dream maybe once a week, but the memories of the dream were so vague, remote, fragmented and dull (as opposed to vivid) that i decided to look into that too.
I've been taking Galantamine with Choline for a couple of night and already theres a big improvement, dreamt twice and it was so much better than any dream i had in the past 2 years!!!

I have also ordered Vinpocetine and HuperzineA, and tried taking all of three together at low dose. I wanted to do some sort of attack dose to figure out quickly how much of a problem my Ach levels are. I have the feeling it might address that slight disconnection sensation i have been experiencing.

Also, i beg for advice on which of these three (galantamine, huperzine, vinpocetine) to start messing with, and how to proceed... I have also read that too much ach (Precursors+Inhibitors) might cause downregulation and mess with dopamine, resulting in depression... has any one experience with that?
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#55 protoject

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Posted 11 July 2013 - 08:12 PM

Hi guys, wanted to update the situation a bit! My anticipatory anhedonia has slightly improved, in the sense that when thinking about an event in the future, i feel slightly interest, i would almost say REMOTELY excited at the tought of doing something.
this is a big step forward. The problem is that i still lack the cognitive sharpness i used to have... abstract thinking is impossible, i forget things, cant follow people in conversation most of the time... on top of that, im extremely fatigued as always.

Since the last update ive been on the following stack regularly (more or less):

Tianeptine 3x12.5mg
Omega 3 DHA and EPA, 2 grams a day
Uridine UMP, 500mg a day
Choline 500mg a day
Inositol 500mg a day

-to that, add a month or so of DMAE and NAC use, which i discontinued in order to "narrow down" the stack size to the most essential.

I have now decided to try to address other symptoms i have, for example some sort of Irritable bowel syndrome (IBS) that i have which might be related to dietary intolerances, so ive decided to cut back on lactose and dairy products overall.
Also, one thing that was bothering me a lot was the inability to dream: not only i used to dream maybe once a week, but the memories of the dream were so vague, remote, fragmented and dull (as opposed to vivid) that i decided to look into that too.
I've been taking Galantamine with Choline for a couple of night and already theres a big improvement, dreamt twice and it was so much better than any dream i had in the past 2 years!!!

I have also ordered Vinpocetine and HuperzineA, and tried taking all of three together at low dose. I wanted to do some sort of attack dose to figure out quickly how much of a problem my Ach levels are. I have the feeling it might address that slight disconnection sensation i have been experiencing.

Also, i beg for advice on which of these three (galantamine, huperzine, vinpocetine) to start messing with, and how to proceed... I have also read that too much ach (Precursors+Inhibitors) might cause downregulation and mess with dopamine, resulting in depression... has any one experience with that?


ok im sorry if i missed anything in this thread but really go for citicholine not any other type of choline if youre looking to upregulate dopaminergic activity. citicoline specifically upregulates dopamine receptors. also you dont need very much and i found that its benefits showed more over time with taking it. Whatever you do, don't overkill if you dont feel it immediately. the change happens over time.

also I dont think theres a big need to be increasing ACH so much by using both hup/ or galantamine plus choline. i think you could be going into overkill territory there. Just a thought so please err on the side of caution.

Edited by protoject, 11 July 2013 - 08:14 PM.


#56 magniloquentc0unt

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Posted 12 July 2013 - 10:53 AM

yes indeed it might be a bit of an overkill.. at first i took one of each for a day and felt completely wired, in a so-so way.
now ive tried galantamine, a couple of days alone, and i plan taking a break from it now, as i feel it gives me some sort of pushy/nervous feeling.
On the other hand, it also was extremely helpful for my hypersomnia, i was definitely more awake, to the point i couldnt sleep a couple of hours last night between 4 and 7 in the morning! this has not happened in the past 4 years, im pretty sure.
I think ill stick with the huperzine in combination with teanine and some cola, it seems to be helpful.
by the way, i have now finished my Choline+Inositol and already have cdp choline ready to replace that... Im most definitely doing better, I also believe it is thanks to the tianeptine

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#57 magniloquentc0unt

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Posted 12 July 2013 - 07:32 PM

I am absolutely sure that huperzine is the MOST useful nootropic ive ever tried! even after modafinil and ritalin which did nothing (might want to give them a shot now)
The productivity and cleanness of the process of work i had today and yesterday i have not had in a year or so.. I've been also taking theanine (100mg or so) and drinking coke





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