Posted by franco neuro on April 7, 2005, at 10:30:35
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 7, 2005, at 3:12:47
Well, it's day nine and it's still kicking my butt. I wasn't as tired yesterday but as the evening progressed I got more and more wiped out. It's got to be the norepinephrine. According to Goldstein, NE is itself an NMDA antagonist. Which is probably why the Wellbutrin is helping me with pain. I'm certainly not getting any dopamine boost.
> I have the antibodies also. I read that they are in response to a protein in the thyroid gland and not to the thyroxin itself. (I wouldn't put money on it though.)
Hmm...I'll have to talk to Braverman about this. Are you on any thyroid med?
> Same here but particularly with the APs. I don't think there's any long-term data on low dosage usage of them for depression. Have you considered MAOIs at all?
I have considered MAOI's, but I'd like to work the NMDA/glutamate angle first.
> I've also heard it affects prolactin levels.
Yes since dopamine and prolactin have an inverse relationship, any drug that antagonizes dopamine could raise prolactin.
> No, I was thinking about hydergine. I just didn't know enough about it.
Are you sure you weren't thinking of huperzine? :-)
> What NMDA antagonist do you have in mind? Have you tried memantine? Emme is currently using it in low dose (alone I believe) and has had some success as an antidepressant.
That's the question. I need either a direct NMDA-receptor antagonist or a drug that suppresses glutamate to keep it from stimulating the NMDA-receptor and apparantly dopamine autoreceptors. I haven't tried memantine yet. It's a direct NMDA antagonist, as is amantadine. It can be purchased from an overseas pharmacy, although it's quite expensive. The only one I've tried was Neurontin about 8 years ago. I only took a small dose for a short time but it did help. I should have stayed on it and pushed it up but I had no clue back then. Neurontin is an antagonist at the NMDA glycine receptor. It also should antagonize glutamate to a degree. I'm sure you're aware that it's Dr. Goldstein's #1 oral medication. By the way guaifenesin is also a mild antagonist at the NMDA glycine receptor. I have some and am going to give it another try at Goldstein's recommended dose of 1200mg twice per day.
Than there's Lamictal. It suppresses glutamate output. That's the one that's helping my friend big time. But I'm not sure if it's because he's bi-polar. And Lamictal is a major bi-polar med. But it has ended virtually all of his physical symptoms. It took a few months to kick in and he's up to 400mg but he loves it.
Ketamine is his #1 overall med but he uses it in IV or nose or eye drops, etc. I'm not going to find a doc who'll do that. But it also can be taken in pill form. It's one of those abused drugs so they might be reluctant to prescibe it. His other biggee is IV lidocaine. I might have a doctor who would do that. But it's really not practical.
There's Baclofen which is a GABA B agonist. It's supposed to be really good for multiple chemical sensitivity. Pretty much all of the anti-epilepsy meds block glutamate to some degree.
Also, Goldstein says that histamine may stimulate the NMDA receptor. Which is probably why antihistamines often help with diffuse pain. I've recently discovered this with Benedryl.
I need to get moving with this but without any dopamine it's tough to make a decision and get going. By the way the guy in Florida found relief with a combination of Baclofen, Mirapex, Chlorzoxazon, and Guaifenesin.
It's a vicious circle. NMDA/glutamate over-excitibility decrease dopamine, decreased DA causes NMDA/glutamate to become more excited, which decreases DA more, which...etc.,etc.,etc. Have to break the downward spiral.