Posted by Ritch on April 5, 2002, at 9:08:21
In reply to Re: This is starting to scare me..sometimes :-), posted by JohnX2 on April 5, 2002, at 1:00:29
>
> Mitch,
>
> From that patent:
>
> "The best previously known therapies for treating emotional lability involve the drugs amitriptyline, amantadine, and levodopa. Although reports such as Udaka et al 1984 and Schiffer et al 1985 (complete citations are provided below, before the claims) indicate that these compounds may be effective in helping reduce pathological displays of emotion in some patients, they make it clear that none of these prior art drugs are effective in all patients, and even in patients who receive some benefit, the effect usually stops far short of an effective cure. A common practice for many clinical neurologists is to prescribe amitriptyline and amantadine, one at a time, in the hope that one of them might be able to provide any level of improvement in the patient's condition. However, all both fall short of offering an effective cure. In addition, levodopa is not satisfactory, since it has other effects and is a relatively powerful drug. "
>
>
> I wonder what is so special about amitriptyline, amantadine, and levodopa in emotional lability?
> What's the connection between those meds, hmmm? This patent filing was backdated to 1992. Would an amitriptyline response be similar to a nortriptyline response (one of your fav. meds)?
>
> John
John,My guess is that they are all facilitating dopaminergic function via different mechanisms. Amantadine is a DA receptor agonist (I think), and levodopa does its part (I can't remember how), BUT amitripytline has a strong anticholinergic effect and anticholinergics indirectly boost dopaminergic function. The nortripytline doesn't seem to do that much good (at the doses I can tolerate-max 25mg/day) unless I throw in a "pinch" of an SSRI with it. What the nortrip. *does* do very well (with that tiny bit of SSRI) is improve ADHD symptoms a lot. My exotropia also goes away and my eyes "snap" together and stay together so I can read without one or the other wandering off all the time. Hmmm. That is interesting. Adderall did that too, but the plain dexedrine doesn't help as much (for exotropia) unless I up the dose to 5mg. The Adderall had a pronounced anticholinergic effect whereas the dexedrine doesn't seem to have any. Odd.
Mitch
poster:Ritch
thread:100774
URL: http://www.dr-bob.org/babble/20020402/msgs/101962.html