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Dr. Bob is Robert Hsiung, MD,
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Posted by bulldog2 on May 23, 2008, at 17:43:43
In reply to Re: A Question To Scott About Memantine » bulldog2, posted by SLS on May 23, 2008, at 17:38:20
> > I have a feeling that memantine might have a beneficial effect on my mind due to the nmda partial antagonism. Unfortunately at even a low dose of 5 milligrams I feel overly stimulated. On the other hand some report feeling a drunken like response which is quite different from my experience. Would it be worth while to try 2.5 milligrams or would that be a waste of time. Is the intense stimulation at 5 milligrams a sign this is not the right drug for me.
>
> I really don't know. I think you are going to have to be somewhat of a pioneer here.
>
> Are you bipolar? ADD AD/HD?
>
> What other drugs are you taking?
>
> How long have you been taking memantine?
>
>
> - Scott
>
>Atypical depression, adhd, anxiety, social phobia, and possibly a little bpII (p-doc not sure). Currently only on klonopin and deplin which helps a bit. If I could get memantine to a reasonable dose might try a stim again.
Posted by SLS on May 23, 2008, at 21:34:00
In reply to Re: A Question To Scott About Memantine, posted by bulldog2 on May 23, 2008, at 17:43:43
> > > I have a feeling that memantine might have a beneficial effect on my mind due to the nmda partial antagonism. Unfortunately at even a low dose of 5 milligrams I feel overly stimulated. On the other hand some report feeling a drunken like response which is quite different from my experience. Would it be worth while to try 2.5 milligrams or would that be a waste of time. Is the intense stimulation at 5 milligrams a sign this is not the right drug for me.
> >
> > I really don't know. I think you are going to have to be somewhat of a pioneer here.
> >
> > Are you bipolar? ADD AD/HD?
> >
> > What other drugs are you taking?
> >
> > How long have you been taking memantine?
> >
> >
> > - Scott
> >
> >
>
> Atypical depression, adhd, anxiety, social phobia, and possibly a little bpII (p-doc not sure). Currently only on klonopin and deplin which helps a bit. If I could get memantine to a reasonable dose might try a stim again.I hope you are able to better tolerate it this time around. It might be interesting to try amantadine (Symmetrel) if you just can't make memantine work for you. It is a NMDA antagonist with pro-dopaminergic properties. You would know in two weeks if it would be of any help. The impression I get of Symmetrel is that it is rather benign, but not robustly effective for depression. However, your hyperkinetic reaction to memantine might indicate that you are an amantadine responder. At the very least, amantadine might help with the ADHD.
- Scott
Posted by bulldog2 on May 24, 2008, at 14:48:16
In reply to Re: A Question To Scott About Memantine » bulldog2, posted by SLS on May 23, 2008, at 21:34:00
> > > > I have a feeling that memantine might have a beneficial effect on my mind due to the nmda partial antagonism. Unfortunately at even a low dose of 5 milligrams I feel overly stimulated. On the other hand some report feeling a drunken like response which is quite different from my experience. Would it be worth while to try 2.5 milligrams or would that be a waste of time. Is the intense stimulation at 5 milligrams a sign this is not the right drug for me.
> > >
> > > I really don't know. I think you are going to have to be somewhat of a pioneer here.
> > >
> > > Are you bipolar? ADD AD/HD?
> > >
> > > What other drugs are you taking?
> > >
> > > How long have you been taking memantine?
> > >
> > >
> > > - Scott
> > >
> > >
> >
> > Atypical depression, adhd, anxiety, social phobia, and possibly a little bpII (p-doc not sure). Currently only on klonopin and deplin which helps a bit. If I could get memantine to a reasonable dose might try a stim again.
>
> I hope you are able to better tolerate it this time around. It might be interesting to try amantadine (Symmetrel) if you just can't make memantine work for you. It is a NMDA antagonist with pro-dopaminergic properties. You would know in two weeks if it would be of any help. The impression I get of Symmetrel is that it is rather benign, but not robustly effective for depression. However, your hyperkinetic reaction to memantine might indicate that you are an amantadine responder. At the very least, amantadine might help with the ADHD.
>
>
> - Scott
>
>The 5 mg of memantine reminded me of a dose of ritalin that refused to giveup.
Posted by undopaminergic on May 24, 2008, at 16:38:35
In reply to A Question To Scott About Memantine, posted by bulldog2 on May 23, 2008, at 17:08:11
> I have a feeling that memantine might have a beneficial effect on my mind due to the nmda partial antagonism. Unfortunately at even a low dose of 5 milligrams I feel overly stimulated. On the other hand some report feeling a drunken like response which is quite different from my experience. Would it be worth while to try 2.5 milligrams or would that be a waste of time. Is the intense stimulation at 5 milligrams a sign this is not the right drug for me.
>
> thanks
> bulldog2If you find 5 mg excessive, then by all means try a smaller dose. It may or may not be a waste of time.
Posted by bulldog2 on May 24, 2008, at 17:03:00
In reply to Re: A Question To Scott About Memantine, posted by undopaminergic on May 24, 2008, at 16:38:35
> > I have a feeling that memantine might have a beneficial effect on my mind due to the nmda partial antagonism. Unfortunately at even a low dose of 5 milligrams I feel overly stimulated. On the other hand some report feeling a drunken like response which is quite different from my experience. Would it be worth while to try 2.5 milligrams or would that be a waste of time. Is the intense stimulation at 5 milligrams a sign this is not the right drug for me.
> >
> > thanks
> > bulldog2
>
> If you find 5 mg excessive, then by all means try a smaller dose. It may or may not be a waste of time.i've always found that the starting doses of psychotropic drugs are too much for me. I wonder if more people would be complaint with their ads if docs would be willing to adjust their doses downward. I remember a doc many years ago who told me that some of his patients would respond to Elavil 25 mg and not need more than that. Many people abandon their ads because they literally feel like cannot deal deal with the amount of stimulation they are experencing. Years ago i satrted zoloft at 50 mg (standard starting dose) and was literally hallucianting. I abandoned the zoloft trial when 25 mg might have been the right amount for me. Docs keep looking for drugs with a one dose fits all approach and that just doesn't allow for individual reponses to these meds.
Posted by Sigismund on May 24, 2008, at 18:04:53
In reply to Re: A Question To Scott About Memantine, posted by bulldog2 on May 23, 2008, at 17:25:16
> Unfortunately at even a low dose of 5 milligrams I feel overly stimulated. On the other hand some report feeling a drunken like response which is quite different from my experience. Would it be worth while to try 2.5 milligrams or would that be a waste of time. Is the intense stimulation at 5 milligrams a sign this is not the right drug for me.
Stimulation can come in various forms.
Did it feel awful for you?
Can you say a little more about how the stimulation felt for you?
> Another annoying side effect was that my head felt very full like my blood pressure was going up along with a headache.I assume you don't mean that your sinuses were filling up?
Posted by Sigismund on May 24, 2008, at 18:09:33
In reply to Re: A Question To Scott About Memantine, posted by bulldog2 on May 24, 2008, at 14:48:16
Now I've read your informative description of 5mg memantine as like a dose of Ritalin that refused to give up.
(For me, Ritalin in low doses was fine and in high doses was frightful.)
So I imagine memantine will disrupt my sleep.
I wonder how long the half life is?
Posted by bulldog2 on May 24, 2008, at 18:57:51
In reply to Re: A Question To Scott About Memantine » bulldog2, posted by Sigismund on May 24, 2008, at 18:09:33
> Now I've read your informative description of 5mg memantine as like a dose of Ritalin that refused to give up.
>
> (For me, Ritalin in low doses was fine and in high doses was frightful.)
>
> So I imagine memantine will disrupt my sleep.
>
> I wonder how long the half life is?I believe the half life is over three days. The problem with stimulation for me is you need to come down and relax. the stim was not unpleasant but was never ending for me. however the paradox is that some feel nothing at low doses and feel drunk at high doses. Some sleep very well on the med but My klonopin didn't even help me on the med. I'm trying to decipher what my reaction to memantine is telling me about my brain chemistry. There is a dopaminageric feeling for me with this med. I will try at 2.5 to see my reaction is. So the question is what is an nmda partial antagonist doing to brain chemistry. I mean I saw where memantine is being investigated for anxiety? Very puzzling..Shows how much we don't know about brain chemistry..
Posted by Sigismund on May 24, 2008, at 21:41:40
In reply to Re: A Question To Scott About Memantine, posted by bulldog2 on May 24, 2008, at 18:57:51
So how long did the stimulation last for?
Not half a week!?
Posted by bulldog2 on May 25, 2008, at 10:09:26
In reply to Re: A Question To Bulldog About Memantine, posted by Sigismund on May 24, 2008, at 21:41:40
> So how long did the stimulation last for?
>
> Not half a week!?36 straight hours..went thru the night..for some reason my nightly klonopin did not work..but remember this was my experience..others claim it is benign and feel nothing at low doses
so let's see how 2.5 milligrams does..will start on Tuesday..If I can get the dose up to 10 milligrams might give adderall a go..That pooped out after three days..
Posted by bleauberry on May 26, 2008, at 17:06:52
In reply to A Question To Scott About Memantine, posted by bulldog2 on May 23, 2008, at 17:08:11
Hey, I'm trying memantine too. Well, not this very day, but next day or two. I sampled one 5mg dose a week ago just to feel it out. I noticed an incease of tinnitus but not much else. At least it didn't totally blow me away like many meds do. So that means I'm ready to take a closer look.
Posted by undopaminergic on May 28, 2008, at 6:41:18
In reply to Re: A Question To Scott About Memantine, posted by bulldog2 on May 24, 2008, at 18:57:51
>
> I believe the half life is over three days. The problem with stimulation for me is you need to come down and relax. the stim was not unpleasant but was never ending for me.
>Why not just stay up and enjoy the stimulation, however long it lasts?
> however the paradox is that some feel nothing at low doses and feel drunk at high doses.
>I think you might feel it too, at high doses.
> Some sleep very well on the med but My klonopin didn't even help me on the med.
>I didn't experience any notable effects of it on sleep. However, the doses that produce drunkenness and "weirdness" may actually be useful to promote sleep.
Klonopin is really not the best drug for sleep. However, if you combined it with midazolam (Dormicum, Versed) or triazolam (Halcion), it may keep you from waking up as the short acting drug is wearing off.
Posted by undopaminergic on May 28, 2008, at 6:42:32
In reply to Re: A Question To Bulldog About Memantine, posted by bulldog2 on May 25, 2008, at 10:09:26
>
> so let's see how 2.5 milligrams does..will start on Tuesday..If I can get the dose up to 10 milligrams might give adderall a go..That pooped out after three days..
>If memantine is stimulating enough, you may not need the Adderall.
Posted by SLS on May 28, 2008, at 7:27:23
In reply to Re: A Question To Bulldog About Memantine, posted by bulldog2 on May 25, 2008, at 10:09:26
Hi Bulldog.
Undopaminergic has offered some great insight into your treatment plan. I doubt I could offer anything more. Perhaps adding Lamictal would offer a synergistic effect with memantine as they both decrease glutamatergic neurotransmission.
- Scott> > So how long did the stimulation last for?
> >
> > Not half a week!?
>
> 36 straight hours..went thru the night..for some reason my nightly klonopin did not work..but remember this was my experience..others claim it is benign and feel nothing at low doses
>
> so let's see how 2.5 milligrams does..will start on Tuesday..If I can get the dose up to 10 milligrams might give adderall a go..That pooped out after three days..
Posted by bulldog2 on May 28, 2008, at 15:37:36
In reply to Re: A Question To Bulldog About Memantine, posted by undopaminergic on May 28, 2008, at 6:42:32
> >
> > so let's see how 2.5 milligrams does..will start on Tuesday..If I can get the dose up to 10 milligrams might give adderall a go..That pooped out after three days..
> >
>
> If memantine is stimulating enough, you may not need the Adderall.Thanks for the input.
From what i've read about memantine it will probably not do much for adhd which I have a very severe case of. So I will probably need something in addition to memantine for that.
Posted by undopaminergic on May 28, 2008, at 18:15:23
In reply to Re: A Question To Bulldog About Memantine, posted by bulldog2 on May 28, 2008, at 15:37:36
> >
> > If memantine is stimulating enough, you may not need the Adderall.
>
> Thanks for the input.
>
> From what i've read about memantine it will probably not do much for adhd which I have a very severe case of. So I will probably need something in addition to memantine for that.
>I found that one of the most prominent effects of memantine was an improvement of attention and sustained concentration. Both the quantity and quality of my reading was significantly enhanced. On the other hand, it did not do enough for my motivation or my enjoyment of life.
Posted by bulldog2 on May 28, 2008, at 19:00:34
In reply to Re: A Question To Bulldog About Memantine, posted by undopaminergic on May 28, 2008, at 18:15:23
> > >
> > > If memantine is stimulating enough, you may not need the Adderall.
> >
> > Thanks for the input.
> >
> > From what i've read about memantine it will probably not do much for adhd which I have a very severe case of. So I will probably need something in addition to memantine for that.
> >
>
> I found that one of the most prominent effects of memantine was an improvement of attention and sustained concentration. Both the quantity and quality of my reading was significantly enhanced. On the other hand, it did not do enough for my motivation or my enjoyment of life.perhaps the addition of a stimulant would be beneficial
Posted by cumulative on May 28, 2008, at 19:38:41
In reply to Re: A Question To Bulldog About Memantine, posted by undopaminergic on May 28, 2008, at 18:15:23
Huh, undopaminergic, I thought it was the other way around. You mentioned an improvement in anhedonia and "meaningless" exploratory behavior, more than concentrative stimulation.
Tolerance?
Posted by Sigismund on May 28, 2008, at 20:39:04
In reply to Re: A Question To Bulldog About Memantine, posted by cumulative on May 28, 2008, at 19:38:41
Meaningless exploratory behaviour is what children do.
Posted by cumulative on May 28, 2008, at 20:52:54
In reply to Re: A Question To Bulldog About Memantine, posted by Sigismund on May 28, 2008, at 20:39:04
Perhaps I could have phrased that better. By "meaningless" I meant without a specific productive goal in mind from the start.
I've often found play to be just as enriching and enlightening as work, maybe even more. Stimulants help me work, but after the initial tolerance sets in they don't aid with anhedonia.
I mean ... for instance ... reading a random book, or deciding on a whim to go fly a kite and meet people, or dancing for no reason.
This is what people that are the opposite of "anhedonic" do ... and anhedonia relief/motivational benefits were what I was hoping memantine might help with. I thought Undopaminergic mentioned effects along these lines, but perhaps it stopped working as well for that?
Posted by undopaminergic on May 29, 2008, at 1:47:34
In reply to Re: Sigismund, posted by cumulative on May 28, 2008, at 20:52:54
> Huh, undopaminergic, I thought it was the other way around. You mentioned an improvement in anhedonia and "meaningless" exploratory behavior, more than concentrative stimulation.
>Yes, I did, because that was what I remembered from my initial experiements with memantine a long time ago. My recent experience, however, has been different, and more along the lines of attention and focus; also, at least intermittently, there has been a reduction in my usual symptoms of (mild) depersonalsation and derealisation (DPDR).
Kappa-opioid agonists, such as Salvinorin A, are one class of drugs known to produce symptoms of DPDR. One might therefore speculate that dynorphin - the endogenous kappa-agonist - is responsible for maintaining these symptoms in me. However, one would also expect a kappa-antagonist like buprenorphine to reverse a dynorphin-maintained DPDR syndrome, and so far, there are no clear indications to that effect.
Massive dopaminergic/noradrenergic elevation, such as that experienced from my first doses of selegiline + PEA, was also capable of resolving DPDR to an even greater extent than memantine.
> Perhaps I could have phrased that better. By "meaningless" I meant without a specific productive goal in mind from the start.
>
> I've often found play to be just as enriching and enlightening as work, maybe even more. Stimulants help me work, but after the initial tolerance sets in they don't aid with anhedonia.
>
> I mean ... for instance ... reading a random book, or deciding on a whim to go fly a kite and meet people, or dancing for no reason.
>Spontaneity might perhaps be an appropriate term?
> This is what people that are the opposite of "anhedonic" do ... and anhedonia relief/motivational benefits were what I was hoping memantine might help with. I thought Undopaminergic mentioned effects along these lines, but perhaps it stopped working as well for that?
>Perhaps it might be explained by my use of pramipexole at some point after my initial memantine experiments but before my recent trial of memantine. Pramipexole is a dopamine D3/D2-agonist, which is higly anti-anhedonic, but perhaps it densensitised my D3-receptors or other important components of the hedonic-sponteity circuits - if such a thing exists?
Posted by cumulative on May 29, 2008, at 5:34:28
In reply to Depersonalisation-derealisation, posted by undopaminergic on May 29, 2008, at 1:47:34
Hmm, interesting. Apparently memantine has a D2 agonism component as well. I wonder if that is simply a consequence of NMDA antagonism in the limbic brain, and whether this effect is clinically relevant and responsible for anti-anhedonic effects.
Hey ... as for KO-antagonism and dynorphin, I think you might enjoy this thread on the great mindandmuscle:
http://www.mindandmuscle.net/forum/index.php?showtopic=28350
Posted by cumulative on May 29, 2008, at 5:41:37
In reply to Re: Depersonalisation-derealisation, posted by cumulative on May 29, 2008, at 5:34:28
Whoops, I meant *agonism.
The basic idea, I think, is that the -rebound- from the short-acting salvia divinorum is anti-anhedonic.
Posted by Sigismund on May 29, 2008, at 16:05:12
In reply to Re: Sigismund, posted by cumulative on May 28, 2008, at 20:52:54
Hey, there's no misunderstanding.....I just thought it worth remarking that what you (or whoever it is?) appreciated from memantine is something healthy young people do naturally.
I would like to do more of this myself.
Posted by SLS on June 16, 2008, at 6:34:17
In reply to Re: Sigismund » cumulative, posted by Sigismund on May 29, 2008, at 16:05:12
I suffered a horrific descent into depersonalization and derealization when I was 20. The only thing that I would like to mention at this juncture is that persistent anhedonia seems to be a major contributor to the induction of DP/DR. When this is added to depression and anxiety, things really get intense. It took me over 10 years to get over my "trip". I felt like an observer from above myself while I was interacting with my environment. It was extremely distressful and produced much anxiety. It was relentless.
I have since had a few short episodes of DP/DR. Each of these episodes were induced by an increase in chronic anxiety and anhedonia.
Unfortunately, the presence of depression makes it extremely difficult to process the thoughts and feelings coming from DP/DR. When depression remits, it becomes much easier.
- Scott
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Dr. Bob is Robert Hsiung, MD,
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