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Re: Starting on Topomax for Migraines. Advice anyone? Mitch

Posted by JohnX2 on November 13, 2001, at 18:31:22

In reply to Re: Starting on Topomax for Migraines. Advice anyone?, posted by Mitch on November 13, 2001, at 12:58:51


Guess what Mitch,

The paper discussing this phenomena was
specifically siting cases of Zoloft! I can
send you a print if you send me an email address.

It recommended buspar as one anti-dote, another
is a 5ht-2a antagonist. It suggested Serzone (which
worked great for me) or possibly Remeron (not quite
great). Didn't mention atypical anti-psychotics, but
I believe that a dabble of zyprexa et. al may do the
trick to.

The future of the serotonin drugs are either stand alone
SSRIs with *clean* 5ht-2 antagonism (not dirty like serzone)
and/or an SSRI with a mixed in clean 5ht-2 antagonist.
Get rid of those potential rls,eps,sexual dysfunction,
tension headache,agitation, side effects...
But what pharmaceutical company will win this horse
race? Tell me and I'll buy the stock!
There are from what I understand clean (selective)
5ht-2a antagonists in the pipeline and with celexa and
prozac going off patent I could see those manufacturers
bundling the clean 5ht-2a meds with the generics in one
pill....

-john

> >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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URL: http://www.dr-bob.org/babble/20011113/msgs/84138.html