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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by galkeepinon on July 4, 2003, at 1:12:14
Hi, Is anyone familar with GABA? I was reading a pillbook in the store the other day and looked up Topamax (I'm taking 200mg a day) and I noticed it noted the med "works" on GABA receptors. Can anyone be so kind as to explain to me what that means? The reason I ask is because a long time ago, my very first psychiatrist said she felt I needed medication, or/and I would do well on a med that would help with my GABA receptors. (Of course I have no idea what this all means that is why i am asking). I would love to hear if someone would be willing ot explain to me.
Thank you so very much in advance-this is very, very interesting! Look forward to hearing from someone who can explain.gal
Posted by Viridis on July 4, 2003, at 2:57:35
In reply to Topamax works on GABA????, posted by galkeepinon on July 4, 2003, at 1:12:14
GABA is short for gamma-aminobutyric acid, which serves various functions, including regulating activity of some brain cells (neurons). In anxiety disorders (and some forms of epilepsy) neurons in certain regions of the brain are overactive, sending out messages to other neurons that in turn trigger anxiety, panic, or seizure. In many cases this seems to be because either there isn't enough GABA available in the spaces between the neurons (synapses), or the neurons don't respond to it appropriately. GABA kind of "puts the brakes on" when key neurons start speeding up their activity too much.
Receptors in the membranes (outer lining) of the neurons bind GABA, and this sends a message to the cellular machinery to limit the signals it sends to other neurons. If there aren't enough receptors, or they're somehow defective, the "damping" effects of GABA don't occur.
Various meds act by increasing the availability of GABA, enhancing its ability to bind to receptors, or mimicking its effects at the receptors. Benzodiazepines like Valium, Xanax, etc. bind to a different part of the GABA receptors than GABA itself and change their structure a bit, making it easier for GABA to bind. Neurontin is thought to be similar enough to GABA to fool the receptors, and so on. I'm not sure how Topomax works, but there are lots of ways to activate the GABA receptors and therefore decrease overactivity of the neurons.
Posted by Viridis on July 4, 2003, at 3:33:03
In reply to Topamax works on GABA????, posted by galkeepinon on July 4, 2003, at 1:12:14
Based on a quick search, the proposed mechanism of action of Topamax actually involves three things (I'm paraphrasing from the Topamax website):
1) It's supposed to "enhance" the activity of GABA -- I didn't look into how it does this in detail, and I'm not sure anyone knows for certain.
2) It prevents certain other neurotransmitters (chemicals that carry messages from one brain cell to another) from binding to glutamate receptors; binding at these receptors can make key brain cells overexcitable, in contrast to the action of GABA at its receptors.
3) It "blocks sodium channels, thus decreasing excessive nerve-cell firing".
Basically, this means that by regulating the way certain charged atoms (ions; sodium in this case) move into or out of the cell, the rate at which the neuron sends messages to other neurons is decreased. This gets complicated (and I'm not an expert), but neuronal activity is highly dependent on the electrical charge differential inside the cell vs. outside. This is governed by the concentrations of ions (some positively charged, such as sodium, some negative). Limiting the ability of ions to flow into or out of the cell can prevent action potentials, essentially electrical "spikes" that cause messages to be sent to other neurons.
The goal of these meds is to keep the activity of crucial neurons at a normal level -- you want them to send warning signals when it's appropriate, but not be sending out these signals continuously. It's a bit like a thermostat -- if your house gets too cold, it should sense this and turn on the heat just long enough to fix the situation. But if it gets stuck and your furnace keeps pumping out heat, things can get pretty uncomfortable.
Posted by galkeepinon on July 5, 2003, at 15:01:47
In reply to Re: Topamax works on GABA????--followup » galkeepinon, posted by Viridis on July 4, 2003, at 3:33:03
Viridis, This is great!!! What's the site? I would love to read more. This is quite interesting. I was particularly interested in the blocking of the sodium channels, thus decreasing excessive nerve-cell firing. And comparing the process to a thermostat is more interesting-would love to get that site.
Thanks so much for the search you did-appreciate it-got a better picture now.
gal
> Based on a quick search, the proposed mechanism of action of Topamax actually involves three things (I'm paraphrasing from the Topamax website):
>
> 1) It's supposed to "enhance" the activity of GABA -- I didn't look into how it does this in detail, and I'm not sure anyone knows for certain.
>
> 2) It prevents certain other neurotransmitters (chemicals that carry messages from one brain cell to another) from binding to glutamate receptors; binding at these receptors can make key brain cells overexcitable, in contrast to the action of GABA at its receptors.
>
> 3) It "blocks sodium channels, thus decreasing excessive nerve-cell firing".
>
> Basically, this means that by regulating the way certain charged atoms (ions; sodium in this case) move into or out of the cell, the rate at which the neuron sends messages to other neurons is decreased. This gets complicated (and I'm not an expert), but neuronal activity is highly dependent on the electrical charge differential inside the cell vs. outside. This is governed by the concentrations of ions (some positively charged, such as sodium, some negative). Limiting the ability of ions to flow into or out of the cell can prevent action potentials, essentially electrical "spikes" that cause messages to be sent to other neurons.
>
> The goal of these meds is to keep the activity of crucial neurons at a normal level -- you want them to send warning signals when it's appropriate, but not be sending out these signals continuously. It's a bit like a thermostat -- if your house gets too cold, it should sense this and turn on the heat just long enough to fix the situation. But if it gets stuck and your furnace keeps pumping out heat, things can get pretty uncomfortable.
>
Posted by Ame Sans Vie on July 5, 2003, at 15:09:47
In reply to Re: Topamax works on GABA???? » galkeepinon, posted by Viridis on July 4, 2003, at 2:57:35
...a reference to Psychotria viridis, the tryptamine-containing psychedelic plant species? Just wondering. }:-)>
Posted by Viridis on July 5, 2003, at 19:09:01
In reply to Have to ask--is your name........... » Viridis, posted by Ame Sans Vie on July 5, 2003, at 15:09:47
Hi Ames,
Interesting... I hadn't thought of that!
I chose this "screen name" because it seemed to capture several things at once. "Virid" means "green" in Latin (or Greek, possibly -- I'd have to check). So it turns up in the names of various species of organisms that are green -- e.g. there's also a green tree python (Morelia viridis), various plants with green flowers have the specific epithet "viridiflora", etc.
I like the color green, plus I'm quite environmentally inclined ('green"). And, I consider myself fairly naive ("green") about psychiatric medications, especially when I first started lurking/posting here. So, it just seemed to fit, plus I figured that name wasn't likey to be taken or similar to others.
But your idea is a good one, although I haven't partaken of that particular natural substance (at least in the plant form).
On a completely different subject, I've been intrigued by your posts on Mirapex. I seem to respond well to dopaminergics, and mentioned it to my pdoc last time I saw him. He was aware of it, but said it was still fairly new as a psychiatric med, and he hadn't yet prescribed it. He did seem receptive to the idea though, if my current meds (which are working quite well) should become less effective. So, I may give it a try one of these days.
Best,
Viridis
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