Posted by KaraS on April 9, 2005, at 0:13:37
In reply to Re: Read this before answering my previous post » KaraS, posted by franco neuro on April 7, 2005, at 10:30:35
Hi Franco,
>
> Well, it's day nine and it's still kicking my butt. I wasn't as tired yesterday but as the evening progressed I got more and more wiped out. It's got to be the norepinephrine. According to Goldstein, NE is itself an NMDA antagonist. Which is probably why the Wellbutrin is helping me with pain. I'm certainly not getting any dopamine boost.
Sorry to hear that the Wellbutrin is still tiring you out. How long do you plan to trial it? (I wonder if rEEG could have predicted that response. I'm so sick of trying things that don't work out as I'm sure you are too.)
> Hmm...I'll have to talk to Braverman about this. Are you on any thyroid med?
Yes, I have been taking thryoid medication for a few years now. How about you?
> Yes since dopamine and prolactin have an inverse relationship, any drug that antagonizes dopamine could raise prolactin.
I didn't know that either. So you think that amisulpride is probably not any worse in this respect than any other antipsychotic?
> Are you sure you weren't thinking of huperzine? :-)
Nope. I was thinking of hydergine. I just knew it was a "smart drug" so I associated it with Ach. (but thanks for trying to save me :-))
> That's the question. I need either a direct NMDA-receptor antagonist or a drug that suppresses glutamate to keep it from stimulating the NMDA-receptor and apparantly dopamine autoreceptors. I haven't tried memantine yet. It's a direct NMDA antagonist, as is amantadine. It can be purchased from an overseas pharmacy, although it's quite expensive. The only one I've tried was Neurontin about 8 years ago. I only took a small dose for a short time but it did help. I should have stayed on it and pushed it up but I had no clue back then. Neurontin is an antagonist at the NMDA glycine receptor. It also should antagonize glutamate to a degree. I'm sure you're aware that it's Dr. Goldstein's #1 oral medication. By the way guaifenesin is also a mild antagonist at the NMDA glycine receptor. I have some and am going to give it another try at Goldstein's recommended dose of 1200mg twice per day.This may seem like a dumb question, but if you suppress glutamate do you run the risk of increasing anxiety (because glutamate eventually becomes GABA)? Also, if you keep glutamate from stimulating dopamine autoreceptors, does that then lead to downregulation or a decrease in the number of those DA autoreceptors? Guaifenesin is the stuff in cough syrups that is supposed to loosen mucous, right? You can get that in pills? Is it over the counter? I'm very curious as to how that will work for you. Have you thought about acamprosate at all?
> Than there's Lamictal. It suppresses glutamate output. That's the one that's helping my friend big time. But I'm not sure if it's because he's bi-polar. And Lamictal is a major bi-polar med. But it has ended virtually all of his physical symptoms. It took a few months to kick in and he's up to 400mg but he loves it.
Yikes! 400 mg. is a lot of Lamictal, isn't it? I don't remember if your friend is taking anything else besides Lamictal. Have you been diagnosed as bipolar? My doctor thinks I might have a soft bipoloar condition because I haven't responded fully to antidepressants and I have periods of more anxiety/agitation.
> I need to get moving with this but without any dopamine it's tough to make a decision and get going. By the way the guy in Florida found relief with a combination of Baclofen, Mirapex, Chlorzoxazon, and Guaifenesin.Wow. That's quite a cocktail. Has he been on Mirapex for long or is this a new addition? It seems like all of the people on this board who have tried it, developed a great deal of fatigue on it after a while (though not initially).
I hear you about the need to get moving on this. Likewise I can't seem to make treatment decisions either. I also find that I can't concentrate enough to do further research. The small amount of doxepin I'm taking may be adding to the mental fog. I'm really impressed that you're able to study all of this so intensely and comprehend it.
My sister has offered to pay for me to get the rEEG analysis done. I don't know whether to take her up on it. I don't want to waste the money. (I'd also like to be able to pay her back someday but don't know if that will be possible.) Down deep I don't think that anything is really going to help. I'm also afraid that if the scans suggest my best treatment meds, that they would be something that I can't tolerate for some reason. (That would be heartbreaking.) My last concern is the way that success may be defined according to this system. Perhaps an SSRI that lifts mood a lot but doesn't help (or even decreases) motivation would be considered success. I have a friend who was happy as can be on antidepressants but he couldn't get up off of the couch to save his life! Is that "success"?
> It's a vicious circle. NMDA/glutamate over-excitibility decrease dopamine, decreased DA causes NMDA/glutamate to become more excited, which decreases DA more, which...etc.,etc.,etc. Have to break the downward spiral.
How do you know for sure that this pertains to your case? Do you take any supplements like NAC or reduced glutathione to help combat this neurotoxicity?K
poster:KaraS
thread:473033
URL: http://www.dr-bob.org/babble/20050408/msgs/481893.html