Posted by g_g_g_unit on May 12, 2009, at 9:15:26
In reply to Re: memantine for anhedonia? » g_g_g_unit, posted by SLS on May 12, 2009, at 6:28:18
note: i am only repeating what i was told (and admittedly took with a grain of salt) so don't shoot the messenger. he also, i should add, has nothing to do with my memantine trial, which is being conducted by a psychiatrist who has very little experience with the drug either (at least outside of treating Alzheimer's), and is going ahead based on research OCD-related research i sent him when pushing to trial the drug
> How does he determine this?he said glutamate hyperactivity might be a state more common in PTSD or schizophrenia where one literally experiences overactive imprinting, i.e. floods of unpleasant images, etc
>
> > (which would conventionally call for him to prescribe Neurontin);
>
> Or, and especially, Lamictal.
>
> > if anything, given my persistent anhedonia, faltering memory, etc. he thought it might be a case of the opposite.
>
> Are you bipolar?not as far as i know.
>
> I am not sure that memantine by itself is helpful for anhedonia. I know that lamotrigine is. As I am now taking memantine for nearly 4 weeks, I believe that I am benefiting from it, but anhedonia is not among the symptoms that it is helping with. I have more energy and motivation, and some improvement in cognitive impairment.motivation i could certainly do with; ditto cognitive improvement. my plan was too combine memantine with some kind of stimulant (since i feel like DA might also be an issue) - either DLPA/N-acetyl-tyrosine and/or a 'racetam and maybe even a small dose of st john's wort - though once he determined glutamate hyperactivity might not be an issue (a theory which i have a feeling you're going to hopefully discount), i suddenly become confused.
i realise that attributing essentialist characteristics to certain neurotransmitters is way too simplistic in terms of diagnosis, but does glutamate hyperactivity/underactivity generally present itself in clusters of recurring symptoms? what made you pursue the glutamate angle?
>
> I am trying to sell the idea to my doctor that a three-pronged attack against hyperglutamatergic activity would include:
>
> 1. lamotrigine: GLU release inhibition
> 2. memantine: GLU (NMDA) receptor antagonism
> 3. topiramate: GLU (AMPA/kainite) receptor antagonism.
>
> Each drug operates on glutamatergic neurotransmission through distinctly different mechanisms.
>
> By the way, how does gabapentin act as an antiglutamatergic?i have no idea.
>
> Thanks.
>
>
> - Scott
poster:g_g_g_unit
thread:895324
URL: http://www.dr-bob.org/babble/neuro/20090129/msgs/895340.html