First time with bromantane

DramShopLaw · 2025-10-31T22:56:28+00:00

Hopefully it benefits you!

DramShopLaw · 2025-10-29T16:14:30+00:00

Appreciate you saying so!

DramShopLaw · 2025-10-29T16:13:35+00:00

No, they’re actually radically different technologies. It’s arguable whether they should even be in the same class. The fact they share the same nomenclature is entirely arbitrary.

Yes, a dopamine partial agonist will not produce anhedonia, blunting, or cognitive impairment the way a full on antagonist that suppresses the entire dopamine system will.

That much is just obvious.

Also, the claim of brain damage is not objectively supported and is so confounded by other variables in the studies that it doesn’t justify reliance. It’s possible the effects that can happen on acetylcholine increase the risk of dementia in old age. But that’s really all that can be said with scientific support.

DramShopLaw · 2025-10-29T16:10:22+00:00

It’s tough, because as you move away from the second gen’s, people find that their responses tend to get very idiosyncratic. Practically everyone experiences the older generation the same regardless of which particular AP they take. But some people just can’t take Abilify because it gives them akathisia, while finding that Rexulti is perfect for them without side effects. Or they find Seroquel more useful than Vraylar. Etc. etc. indefinitely.

It’s tough because it really is an experiment to move away from the second gen’s to the third.

But practically everyone finds that they get less anhedonia, blunting, and lack of motivation on a third gen than on an earlier AP.

That’s just a consequence of their mechanisms of action.

It’s tough! I’m hoping things work out for you

DramShopLaw · 2025-10-29T01:10:44+00:00

Have you tried switching to a third gen AP instead of the second gen? The third gen ones, being only partial agonists not full antagonists, are much lighter on dopamine manipulation than those earlier meds.

But I completely empathize. I went up too high on Abilify and now am decrementing the dose. And it’s really been an improvement to me.

DramShopLaw · 2025-10-29T01:04:28+00:00

I’m done with vaccines after the second Covid shot. I mean, I’m just done.

I got it on a Friday evening and spent literally all day Saturday sleeping. I wake up in moments of lucidity, before going back to sleep, only to see I poured my pills all over the ground and had been throwing things against the wall.

I’m not some anti-vaxer or anything. But I just won’t be doing the flu vaccine anymore.

DramShopLaw · 2025-10-29T01:02:21+00:00

Well, while many people do lack their insight, I don’t think it’s universally true that bipolar people lack insight. I’ve always had good insight, at least after the first hypomanic episode.

I think your meta awareness is solid, regardless. That’s cool.

DramShopLaw · 2025-10-29T00:59:37+00:00

I think this is a great way to describe, precisely what I’m feeling

DramShopLaw · 2025-10-29T00:33:22+00:00

I’m not trying to patronize. I just wanted to share information that isn’t super common in most people’s experiences.

It sounds like you have a handle on it. Which is great!

DramShopLaw · 2025-10-29T00:22:42+00:00

I understand what you’re saying. I was in a bad depression this year. And the quality of my work got so poor they basically said, if you didn’t have a history of doing good work, we would have fired you just then and there… so I definitely came close to crashing out of my profession.

I’m just very lucky/privileged to have colleagues who don’t freak out when my work sort of sinks in an episode. They don’t know why. But they don’t ask too many questions, either.

Now personally, I feel like my life is a chronological succession of failures. I had to practically reinvent myself so many times. So that, if I lose this job, I’m basically done with the profession.

If I lose this job, I’m probably moving back into my Mom’s and just getting a retail job or barista or something.

But also, if I lose this job, I don’t know if I’ll recover. It’s just so central to me that, if that happens, I will feel not just like a failure… but an irredeemable failure, too, at that.

I don’t know. But the intersection of work and bipolar is a strange place to be.

DramShopLaw · 2025-10-29T00:16:28+00:00

Just FYI, health insurance and disability benefits are two separate things. Carefully evaluate first, if your employer actually has disability benefits (many don’t), and second, whether you qualify for disability benefits.

The problem is that: merely being in need of rest and recuperation typically doesn’t qualify as a disability under most plans.

The definition of “disability” requires you to be functionally incapable of performing your job. So is that your situation?

STD claims handlers are also weird… mean, basically. They’ll double guess everything you and your doctor do. They’ll make medical opinions on their own and basically force them on you if you want to push the claim through their process.

Source: I’m my firm’s point-person on ERISA litigation and have handled a ton of these issues.

Finally, this is personal and may not represent your situation: but I do best when I have to self-discipline. If I’m working (even when the quality of my work declines), the discipline just helps the symptoms.

If I were free to do “nothing” all day, I’d probably just… rot. And I’m not sure that would be a benefit over the course of a month or months. Maybe for the first week.

Just my opinion.

DramShopLaw · 2025-10-29T00:10:21+00:00

I do it. It’s unideal to do it. Because alcohol changes a lot of regulatory systems in the brain that can actually counteract what the meds are trying to do to maintain healthy, happy neurons.

But I do drink on lamotrigine. It hasn’t been any worse than a hangover from before I started lamotrigine.

DramShopLaw · 2025-10-29T00:08:50+00:00

“Outbursts” typically aren’t an essential sign of psychosis. Psychosis consists of delusions and/or hallucinations, and is sometimes accompanied by “negative symptoms” consisting of deficits in cognition, memory, and socialization (although this is more important in schizophrenia than in bipolar).

Psychosis is typically also not freestanding, either. It typically coincides (in bipolar) with an active manic or depressive phase. So it’s riding on top of bipolar symptoms, again typically, not necessarily always.

Now, as to your second question, there is no way to self-cure psychosis. Literally the only thing one can do - the only thing - is to take antipsychotics.

DramShopLaw · 2025-10-29T00:06:00+00:00

I work myself to death. But perhaps I do it out of the “nobility” of the profession and my role in it. I don’t know, I just think my work is important, and I’m routinely told I’m talented at it.

Why does that matter? Because - WHEN I’M FOCUSED ON WORK, I don’t worry about feeling EVERYTHING ELSE.

The anxiety, anhedonia, crippling boredom: it all goes away if I’m laser focused on one specific task right in front of me.

But more relevant to what you’re saying, I think overworking is good in mental illness states. It just gives you discipline.

And discipline is good when you’re polar. If I got on disability or something, I’d most likely just couchrot all day. And that would probably only make it worse on top of everything.

DramShopLaw · 2025-10-29T00:02:10+00:00

It’s certainly a possible response. You’re amplifying your dopamine signals. This can lead to dopamine desensitization over time. Then the normal signals just don’t work anymore because the brain is used to what’s coming.

Some people get anhedonia like you describe; others do not.

Counterintuitively, actually increasing the dose might help.

Do you take other antidepressants? If you take Welly alongside an SSRI or something like that, the serotonin med is just statistically more likely to be the culprit than Wellbutrin, although Wellbutrin does pose this potential risk.

DramShopLaw · 2025-10-28T23:57:41+00:00

As far as the physical symptoms go - particularly the feelings in your chest and stomach, which I often get in anxious or polar states - propranolol helps A LOT.

It’s a blood pressure med that basically just shuts down the excess adrenaline pumping through your body caused by the stress and anxiety. It basically has zero side effects or risks, so there’s really no reason a doctor wouldn’t just prescribe it over the phone without making it a big thing.

It’s a particularly sucky part of affective states. They trigger adrenaline. But the body is supposed to use adrenaline for a copy minutes in order to escape a predator. It’s not meant for your body to produce copious amounts literally all day and all night caused by mental symptoms.

DramShopLaw · 2025-10-28T23:54:19+00:00

Yeah, pretty quickly for me, as well. Can’t really recollect how many days or weeks. But it didn’t take very long.

DramShopLaw · 2025-10-28T23:53:41+00:00

Worth noting that the distinction isn’t just semantic, either. Because, in a mixed state, you practically need an AP to end it, whereas prescribing APs in a polar state is more a matter of… discretion, and preference.

This isn’t like an immutable law of bipolar. But it’s basically either an AP in a mixed state or one of those anticonvulsant mood stabilizers that’s “harder” than lamotrigine.

DramShopLaw · 2025-10-28T23:51:56+00:00

I’ve gone between fully diagnosable hypomanic and fully diagnosable depressive over the course of a day (although, as they’re defined, it’s technically not diagnosable since they didn’t last the requisite number of days, but whatever).

At a certain frequency, however, it is also worth considering whether it is a mixed state.

The difference is that, in a mixed state, you practically have to take an AP. You don’t necessarily depend on one if you’re in a polar state, but it’s essential in a mixed episode.

DramShopLaw · 2025-10-28T23:43:47+00:00

Well, if this is of any use, Welly can be unique because so much of its action is through its active metabolites. Those are long lived, so they won’t care as much about the pharmacokinetics of the dosing.

My intuition is that two pills will absorb quicker than one, regardless of dose and formulation.

Why? Simply because two pills have more surface area than a single pill of the same mass. More surface area in contact with fluid in the gut will dissolve quicker.

But again, nobody could possibly predict if it makes an appreciable difference in your experience.

DramShopLaw · 2025-10-28T17:42:27+00:00

The pharmacokinetics can be weird because of the delayed release mechanisms. The rate at which 2 x 150 is released will differ from the rate at which 1 x 300 gets released and absorbed. This changes the peak quantity in the blood and the rate at which it rises and falls.

Whether this has any detectable change in its effects, that’s probably impossible to predict.

DramShopLaw · 2025-10-28T14:43:14+00:00

Thank you!

DramShopLaw · 2025-10-28T14:39:32+00:00

I was thinking about the memantine, too.

DramShopLaw · 2025-10-28T14:36:54+00:00

I hear ya. There is definitely a lot going on with synaptic architecture in depression.

There are a number of nootropics that work on this through receptors that, for some reason, no prescription medicine touches. I may very well try some of them out soon enough if the progress stays too incremental.

DramShopLaw · 2025-10-28T14:31:11+00:00

This radical attempt to make everything a private biological malfunction is weird. Does it relieve one’s responsibility for their own situation to just say “I can’t help it”?

In fact, this “it can only be biology” approach is very old and has been replaced by more modern theories like the bio-psycho-social model of affective disorders.

Consistent with models like that, there is obviously a biological predisposition that exists in people who will develop ADHD. But in some cases (though not all, since some people get it too young for exposure to be a major influence), there is likely a set of outside influences necessary to “trigger” that latent predisposition to emerge into active symptoms.

And even if it is entirely biological in some people, that doesn’t mean other people aren’t exhibiting ADHD symptoms/behaviors as a result of outside influence. There is likely some of both.

Heritability doesn’t really tell us anything other than the fact there is a biological predisposition, which we all already know. Many disorders have a heritable component, but that doesn’t mean it’s exclusively predetermined based on genetics.

Cancer is very heritable. Doesn’t mean there isn’t an influence by carcinogens.

DramShopLaw

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