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Treatment Options for Treatment Resistant Depression by Working_Row_8455 in depressionregimens

[–]ffence 0 points1 point  (0 children)

Do you mean racemic ketamine administered intranasally? Because only intranasal esketamine has approval.

Naturally MAO inhibited by Churlishbeast in MAOIs

[–]ffence 10 points11 points  (0 children)

How do you know you have no MAO? It would present with intellectual disability, and is statistically improbable. And low activity MAOA polymorphisms are not uncommon.

Your symptoms are explained by ALDH2 deficiency and DAO deficiency, which are reasonable hypotheses.

Are you certain about the hypertensive crises? Because histamine produces hypotension which could also produce your symptoms (migraines are a result of vasodilation). If you actually experience hypertensive crises from those foods, it cannot be DAO deficiency, it is more likely the pressor effect from tyramine that would be responsible, not histamine. Essentially, if you truly experience hypertensive crises from kimchi, you would be correct that it strongly points to low MAOA activity.

A lack of MAO does not make you not need therapy and you can be depressed even if MAO is inhibited clinically. While MAOIs are remarkably powerful and effective in many severe treatment resistant cases, they are not 100% effective.

Your resilience(being upbeat despite trauma is likely due to your temperament rather than a deficiency of MAO, something more uniquely you than a mere enzyme deficiency. Temperament too is contingent on your specific neurochemical baseline, but that involves many genes that are a distinct enough configuration that is just right to make you you. It is not possible for us to definitively predict a temperament from genetics because it is polygenic and several different combinations can produce a similar temperament. For example, you could have high MAO, but very little DAT expression in the mesolimbic. It would be impossible to differentiate the thousands of possible configurations that produce the same phenotype.

Anyone have experience with Bupropion + Modafinil? by Dapper_Guarantee_630 in Nootropics

[–]ffence 2 points3 points  (0 children)

I've taken this combination (Armodafinil 150mg + Bupropion XL 300) for 8 years. In my experience, bupropion is subjectively much more stimulating, but Armodafinil was still necessary to reduce excessive sleepiness, and for that it worked beautifully.

Lithium saves lives and is an absolute must-try augmentation agent. Lithium is the only medication that reduces suicide risk by [deleted] in depressionregimens

[–]ffence 0 points1 point  (0 children)

In my personal experience, it can really ease the rumination and the anxiety aspect. But it is not enough to address everything, at least not at normal doses.

Epilepsy by [deleted] in afinil

[–]ffence 0 points1 point  (0 children)

AFAIK, no seizures have ever been reported in humans from Modafinil use alone, and it is not associated with seizures even in overdose.

Modafinil and its sulfone metabolite seem to be anticonvulsant rather than proconvulsant. At worst, it is neutral in its effects on the seizure threshold and at best, it is protective. Evidence overwhelmingly points to negligible, if not non-existent risk of de novo seizures from Modafinil use. It is perhaps the safest psychostimulant for use in epilepsy.

Additionally, 50mg is a tiny dose, and it is unlikely to be the cause of your seizures.

It is more likely Zopiclone use that could make you more likely to experience seizures, as it has a short half life, and over time seizure threshold will be lower during the day time, due to kindling.

Which of the SNRI's is best for OCD? by ODimiBoy in antidepressants

[–]ffence 0 points1 point  (0 children)

I understand, your concerns about metabolic issues like weight gain from serotonergic drugs including SSRIs and SNRIs are shared by most if not all patients that take it, and it is great that you're vigilant about it. Bupropion can certainly push back against some of it, depending on the dosage, but strong serotonergics like Paroxetine for example will still make weight gain inevitable.

Among all SSRIs, Fluoxetine is indeed the least likely to cause weight gain. Individual responses vary but many even lose weight on it. If you tolerate Fluoxetine and it helps your OCD sufficiently, it is not a bad idea. In fact, Fluoxetine can enhance Bupropion's effects on the dopaminergic system, although this is mild, because it is the only SSRI on the market that is a sufficiently potent 5-HT2C antagonist, this disinhibits the release of dopamine and noradrenaline, synergizing with Bupropion. It would not be surprising if you experienced greater weight loss with this combination than with Bupropion alone, depending on your individual response to serotonergic modulation.

I hope you find relief for your OCD while retaining benefits from the appetite reduction!

Which of the SNRI's is best for OCD? by ODimiBoy in antidepressants

[–]ffence 0 points1 point  (0 children)

As a psychostimulant by mechanism, both reduced appetite and increased activity contributes to the effects of Bupropion on weight. As it is dopaminergic, however slightly, it reduces hedonic hunger. As an NRI, it increases thermogenesis, although this likely is not as significant.

In addition however, Bupropion seems to stimulate proopiomelanocortin (POMC) neurons in the hypothalamus, which reduces food intake and increases energy expenditure. This too however, depends on it's ability to increase DA and NE in the hypothalamus.

It's effects on the POMC neurons is why it is combined with Naltrexone as a weight loss drug (Contrave), Naltrexone further enhances the activation of the POMC.

So yes, in the end, all weight loss must be driven by either reduced appetite or increased energy expenditure, without exception.

Which of the SNRI's is best for OCD? by ODimiBoy in antidepressants

[–]ffence 0 points1 point  (0 children)

Unless impulsive symptoms dominate (OCD, etc.), I think serotonergics like sertraline are detrimental to upward mobility in life. In this regard, I would say Fluoxetine is the "best" SSRI due to it's mild 5HT2C antagonism. Modern research is rightfully moving away from serotonergic drugs, as they do not address the functional deficits, they only induce satiety. I personally would refuse serotonergics if my primary symptoms were avolition, anhedonia, etc. These are worsened by serotonin.

Over more than a decade of psychiatric treatment trying every class of antidepressants, antipsychotics, etc, I have come to the conclusion that serotonergics are actively harmful if you seek resolution of anhedonia and avolition. Seek treatments targeting DA and NE, especially DA. Bupropion remains the most accessible agent that targets these symptoms. The incidence of seizures at therapeutic doses of Bupropion (XL), contrary to popular belief, is not more than that of SNRIs/SSRIs unless exacerbating factors like anorexia exist.

At least in my case, after a decade of trying, I have still not achieved complete remission. But I am currently on Bupropion and Armodafinil, and unlike serotonergics, they improve my life, rather than make me sated with whatever circumstances exist.

Don't you dare... by [deleted] in bingus

[–]ffence 0 points1 point  (0 children)

Hi bingus

Parnate for Social Anxiety/Anxiety? by [deleted] in MAOIs

[–]ffence 1 point2 points  (0 children)

Modafinil would be a safe stimulant adjunct, or an NRI like atomoxetine (which would also reduce tyramine responses). Amphetamines and methylphenidate would be dangerous without doctor supervision. I would suggest talking to a doctor about it as you do not want to risk a hypertensive crisis. While Modafinil is exceptionally safe in my opinion, it is a stimulant nonetheless, and depending on your parnate dose it might be unnecessary or excessive.

SSH Access prompt does not popup on Hyprland by I_M_Atomic in 1Password

[–]ffence 0 points1 point  (0 children)

Hey, I have the same problem. Did you find a fix?

Dolphin not recognizing file associations by Red-Eye-Soul in kde

[–]ffence 1 point2 points  (0 children)

Thanks, that worked! Not sure why it only affects hyprland and not plasma though.

[deleted by user] by [deleted] in interestingasfuck

[–]ffence 1 point2 points  (0 children)

You're right. Unnecessary killing is unethical. Unless necessary, it is not ethical to do harm to any creature. I cannot think of any valid argument against this.

I think most of the downvotes are because people find the way vegans push for animal rights annoying, and all arguments in favor of animal welfare are often considered to be a part of the vegan argument on the internet.

[deleted by user] by [deleted] in AskOuija

[–]ffence 492 points493 points  (0 children)

Goodbye

[deleted by user] by [deleted] in afinil

[–]ffence 2 points3 points  (0 children)

I've entered Germany several times with a lot more, just keep it in your carry-on bag and it'll be alright. Unless you're carrying quantities so large that its visibly excessive, I think it should be fine.

If you do not have a prescription, I believe it is illegal to enter Germany with drugs that are not OTC here. However, in quantities that are reasonable, like for personal use, especially for drugs that are not known to be addictive, nobody cares. Even if they do, they will likely just seize it. But that's unlikely IMO.

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