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Re: Starting on Topomax for Migraines. Advice anyone?

Posted by Mitch on November 13, 2001, at 12:58:51

In reply to Re: Starting on Topomax for Migraines. Advice anyone? Mitch, posted by JohnX2 on November 13, 2001, at 9:48:15

>Anyways, I did a bit
> of research on tension headaches, which are
> less vascular, and more related to muscle
> contraction spasms. I found that SSRIs can induce
> them in an area of the brain where dopamine
> counteracts acetylcholine in the stimulation of
> the masseter (jaw) muscles. These dopamine neurons
> are unique in that they do not contain self
> regulating auto-receptors. Their firing is gated
> by serotonin receptors (proportional to 5ht-1a
> post synaptictic and inversely proportional to
> 5ht-2a receptors) at the junction and also by
> dopaminergic projections from a pool of dopamine
> neurons at the VTA where there are other somotodendric
> dopamine neurons gated in a similar manner but by
> many afferents (it does have the same serotonin
> input). The serotonin input can be exacerbated
> by stress. Stress can cause greater serotonin
> impulses due to interesting cross talk with
> the noradrenergic stress center (the locus
> coerulus) and all this indirectly can lead to
> bruxism and tension headache because of the
> goofed up dopamine modulation. In the hypo-dopaminergic
> state a dopaminergic med like Adderall makes the
> headache go away, so do 5ht-2a antagonists. This
> is in the literature and also my experience.


Aha! So, that's why I grind my teeth and get headaches from Zoloft. That is interesting about the 5-HT2a antagonists. Maybe you ought to pitch some Serzone in there (if you are not already)? I noticed that when I took Serzone I had greatly reduced *agitation* and restlesslness and didn't experience any headache or stomach upset (at low doses). The trouble with Serzone was mild pruritis and amyblyopia (big time-had difficulty reading).
Maybe a little Serzone with a little Adderall in combination with a mood stabilizer?? Hmm.

Mitch


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