Posted by franco neuro on April 18, 2005, at 14:51:32
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 15, 2005, at 16:05:58
> What are the lidocaine and ketamine used for? What are the rationales behind their usage? Too bad Dr. Goldstein doesn't have a list of doctors who follow his protocols. (I'm assuming that his book doesn't give this info and that he doesn't have a website with this info either.)
The lidocaine and ketamine IV's are used as a test to see which oral meds you would most likely respond to. They can also be a treatment in and of themselves. Lidocaine predominantly suppresses glutamate release. Whereas ketamine is an NMDA receptor antagonist. If you find that the lidocaine relieves some or all of your symptoms than you should probably try a drug like Lamictal or Parafon Forte which suppress glutamate release. If, on the other hand, the ketamine helps more, than a drug like amantadine, memantine, etc. may be the place to start. Both ketamine and lidocaine are available in a pill form but they are not as effective and have potentially more side effects. The IV's also don't require weeks or months of taking before you feel an effect. You should know with the initial IV if it's going to help or not. It's all about saving time and not having to spend months or years popping meds haphazardly until you come up with a winning combo.
> How did you find the doctor in Arizona? I made a mistake in my last post when saying that I reside near you. I think I was confusing you with Elroy or Chris O or someone else who lives in San Diego. Anway, I have a friend in Arizona that I visit occassionally so this might be a doctor for me to keep in mind for the future. (It wouldn't be Dr. Dharma, would it?)
I just did a google search for "ketamine IV" and came across a site for RSD (regional sympathetic dystrophy). This Arizone doc is using an in patient 5 day course of ketamine. Not what I want or need. Here is the link:
There's also a doc in Philadelphia doing the same thing. They are trying to claim it's a "new protocol" that they discovered. Of course Dr. Goldstein has been using IV ketamine and IV lidocaine for pain for years. God the egos in the medical profession are ridiculous. I've contacted a couple of RSD support groups in the area and am trying to get some more info. I think I can get the lidocaine IV as part of a vitamin IV from an alternative doc I have gone to before. I'd rather just get the lidocaine but what can you do. By the way I wish I lived in San Diego. It's supposed to be a nice place.
> I felt very sexually hypersensitive when I stopped Zoloft. Someone here suggested that it was because of dopamine surging back.
I believe that's it exactly. While some SSRI's may increase dopmine with chronic long term use they usually supress DA in the short term.
"SSRI's, acting through the 5-HT2C receptor, increase extracellular 5-HT which acts acutely on 5-HT1 receptors of several types in the VTA to inhibit DA secretion." "Tuning the Brain"
You know too much serotonin can be a problem. Particularly when it's high in comparison to DA. Most people, including most doctors, are completely unaware of this do to the glorification of the SSRI.
> I hadn't heard of Amerge. I'll have to check it out. Another med that came to my mind when reading your last paragraph is tianeptine. Have you considered that one?
Amerge (naratriptan) is usually used to treat migraines. It blocks the 5-ht1b receptor which should lower serotonin levels. I'm going to try and stick with Goldstein's heavy hitters. At least initially. I just wish I could find a doc to help me with this. Darn it's frustrating!