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Re: Anyone who had rapid cycling and got it to sto » Chairman_MAO

Posted by SLS on October 26, 2005, at 8:40:28

In reply to Re: Anyone who had rapid cycling and got it to sto » SLS, posted by Chairman_MAO on October 25, 2005, at 22:18:12

> For such severely agitated states, I have a lot of faith (purely intellectual, that's what I say "faith"; you'll never find this in clinical use here for some reason--perhaps that's because I kinda made it up myself & kinda took some of it from obscure Russian literature) in high-dose (5-20mg/day) clonazepam (barbiturates along with or in lieu of BZDs for extreme cases) + galantamine 2-24mg/day. If necessary, small amounts of lithium, lamotrigine, other mood stabilizers, or minute amounts of a DA blockers (haloperidol, molindone (I think this one has been forgotten for some reason), or atypicals) would get it under control. Alternatively, a new "atypical" DA agonist such as pramipexole or ropinirole could work in place of the antagonist. Abilify might be really useful here as well. If you understand how ACh counterbalances DA, what the BZD receptors do, how galantamine mitigates cognitive impairment/myorelaxation of BZDs, etc, you will see how, for all the cool or "novel" treatments we seem to have, there are tons more with relatively few side effects that no one ever gets to even try.
>
> I'd like to hear comments on my theory.

I like Klonopin. It did a better job of controlling my first iatrogenic dysphoric mania than lithium did.

I think your ideas are interesting, but it is sometimes difficult to test radically different strategies without risking for a decompensation of someone's condition. I don't know if one can simply consider a low dose of a DA agonist the mirror image of a higher dose of a DA antagonist such that the same result is obtained. It still might be psychotomimetic. Of course, reaching the end of the rainbow might not be without a journey of risk.

I understand that there is an ACh - DA balance in certain brain regions and functions, however, I don't know specifically which ones you are referring to. As far as BZD receptors and their facilitation of GABA neurotransmission, I am again a bit puzzled by where you are going with this.

I'll try to check in with you later.

Take care.


- Scott

 

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