Posted by medlib on April 12, 2002, at 12:49:35
In reply to Re: help -- serotonin-mediated flush? » medlib, posted by katekite on April 12, 2002, at 9:19:41
Hi Katie--
It sounds like you've really done your homework and it's paid off in a beneficial med change; many Babblers wish they could say the same. A number of PB members who have no medical background have taught themselves psychopharmacology and neurobiology in self-defense; they weren't getting the help they needed from their pdoc "experts." I'm very grateful to quite a number of these PB experts; I've taken their posts to my pdoc to bolster my case for med changes on many occasions over the last 2 1/2 years.
Re 2 meds you mentioned: Neurontin and Wellbutrin have at least one thing in common other than their reputed antidepressant effect--no one knows (or will admit to knowing) exactly how either of them works. More is "known" about how each of them *doesn't* work than how it does. Wellbutrin is the only drug classed as an AD which is thought to have no direct effect on serotonin. (Serotonin, btw, is considered to be a calming, not an activating, NT-- at least for most people.)
Articles on Neurontin cite tests which appear to rule out direct action on *any* of the major brain NTs. I did find 1 citation on Medline, a review article in the Journal of Epilepsy Research, whose abstract itemized 6 possible hypotheses about Neurontin's mechanism(s) of action. 1 of the 6 concerned serotonin. Unfortunately, this journal is not online, so full text of the article is available only at selected medical school libraries or from the NLM. On a different note, Neurontin is not metabolized in the body (it's excreted in the urine unchanged); so it has no metabolites which could account for its action.
I do have an idea of how you feel about an ADD diagnosis, though. Not everyone presents with the typical symptom pattern for a disorder or disease. I never had academic difficulties and my attention span is the opposite of most ADDers. I shift gears mentally only with the greatest of difficulty, and multi-tasking isn't a realistic option for me. Also, I find methylphenidate typically stimulating (have been on it for 2+ years w/out "poop out"). But....dexadrine puts me to sleep! And one ADD expert on PB mentioned that both extremes of the attentional spectrum are considered ADD symptoms. So, I don't know. I haven't researched it, and probably won't; it's peripheral to my primary dx, double depression; and other priorities seem more pressing right now. Interesting, tho.
Hope you continue to improve on Ritalin. But, if you do have a problem, there are several other stimulants which may work as well, perhaps even better!
Well wishes--medlib
poster:medlib
thread:102572
URL: http://www.dr-bob.org/babble/20020408/msgs/102877.html