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baclofen and memantine and friends

Posted by JohnX on October 7, 2001, at 3:06:09


Been a long while since I've posted to
this newsgroup. In case anyone remembers me
I had been suffering from intractable dysthymia/
pseudo-bipolar II disorder with strange reactions
to medications centering around somewhat bizarre
headaches and bruxism with hypo-mania and/or severe
emotional numbing.

Anyways, I'm doing fairly well on Lamictal and
have since added a dose of zyprexa (5 mg/day) but
still struggle with klonopin addiction as this is
the only thing that releives pain in my head and jaw.

I've made some interesting observations regarding
my pain and how it is affected by medications and
have since seen a decent neurologist who suggested
taking the anti-spasmodic Baclofen (a GabaB agonist).
I've tried everything in the book and he was
a little skeptical that he could help, but I had
never gone this route. Interestingly, what I learn
about Baclofen is somewhat in-line with my thoughts about trying the medication memantine.

I'm wondering if anyone has experience with this Baclofen medication? I was initially trying to talk my pdoc doctor into letting me import memantine (a non-competitive nmda antagonist, listed as a muscle-relaxant in the Merck index), because it seemed to have a lot of qualities that may alleviate my problems. But since I've looked into this Baclofen, it has a lot of the same properties in regards to its anti-spasmodic activity and also interesting properties possibly relavent to my scenario (addiction,
tolerance, mood-swings, twitching, blah, blah..).

Here's my poop:

- On the anticonvulsants, Lamictal being the best,
I get relief from spasms and it seems to do a good
job of relieving my major depression at 150 mg/day.
I'm still dysthymic. Above 150 mg/day I get a
severe pressure in my head
(which I have experienced on other meds).
My new pdoc had me augment the lamictal with
trileptal and it instantly made the pressure in my
head really bad, so I punted it.
- The following meds "releave" the severe pain in my
head and jaw (which can get locked tight):
- Serzone (completely , punted due to drowsiness)
- Adderall (although I grow tolerant after 2-3
days). Klonopin alleviates the Adderall tolerance.
But I got trapped with klonopin tolerance. Off
of adderall due to manic episodes and physician
- Klonopin
- dextromethorphan (in robotussin-DM).
This is a non-competitive NMDA antagonist like
memantine, but not good to take in high dose.
- large doses of benadryl (diphenhydramine).

Crud that makes my pain *bad* usually accompanied
by severe emotional numbing:

- St. John's Wort,Zoloft,Wellbutrin,
bumping the dose of Lamictal.

The "Crud" that makes the pain bad also happened
to be the most effective anti-depressants. For a short
while at the therapeutic dose the powers that be
would relieve my depression for a short while (minutes,
hours, one time for 2 days), and then I would snap
into severe emotional numbing and pressure in head
and jaw.

(Information overload).....

I found my experience on Aderrall interesting as
it relieved my pain and depression, unlike anything
else. I also found it strange that I develop rapid
tolerance to it stand alone and no tolerance problem
with Klonopin. After researching SSRI induced bruxism,
and with some feedback from others, I found that
the area of the brain that modulates the facial muscles
is in the prefrontal cortex. For schizophrenics (not
me) a "negative" psychosis (severe emotional blunting)is thought to be associated with hypo-dopamanergic
frontal cortex. Curiously I see a pattern, meds that
treat "negative psychosis", i.e. increase dopamine
up in that area, also relieve my pain. This would be
5ht-2 antagonists, dopamine agonists, klonopin (which
can relieve dopamine receptor supersensitivity).

So I'm hoping zyprexa helps me without the serzone
drowsiness that caused me to crash my car, but the
jury is still out. I would prefer a "cleaner" alternative, and it seemed that memantine was an interesting route. I got the pdr from NTII (the company
sponsoring its clinical trials in the US), and it
listed a zillion treatments: -alzheimers,parkinson,anti-addiction/tolerance,anti-dyskenesia. Curiously it also listed "pressure in the head" as a possible side effect. When I asked about this I found that it could be caused by an osmotic imbalance which would induce water retention in the brain (which has this darn skull around it giving the pressure no-where to relieve itself). Hmm. Anyways this is also symptomatic of cerebral ischema which memantine supposedly treats (so I guess the side effect potential for pressure in the head is like when they list depression as a side effect in the pdr of
an anti-depressant).

Man, just looking for an end to this saga.
Am I on the right track, or am I neurotic?





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