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Re: 5HT2a receptor variation and adverse reactions

Posted by Cairo on August 5, 2006, at 10:51:50

In reply to Re: 5HT2a receptor variation and adverse reactions, posted by SLS on August 5, 2006, at 8:20:22

Never tried an MAOI, tianeptine, nefazodone or EMSAM. I rely on my pdoc to prescribe, but frankly he doesn't seem to know what to do with me. Since I'm exquisitely sensitive to caffeine (even decaf coffee can bring about 2-3 hour sweat fests), I haven't tried the Strattera that was prescribed for me since I'm afraid to take the 10mg dose. I've never tried other stims as Wellbutrin upped the panic attacks and my gut says to avoid anything that stimulates. Modafinil works only marginally, but taking too much increases anxiety. It makes me more alert, but not really awake, if that makes sense.

I used Remeron years ago when my fibromyalgia was first diagnosed and my symptoms were not as advanced and it was a good sleep aid at 15mg, but weight gain was prominant and they switched me to trazodone and the march to find an AD that worked for pain and atypical depression began.

Come to think of it, amitriptyline 50mg at bedtime for sleep was the very first med I tried back then and I tolerated it (except for weight gain). A recent trial of 5mg amitriptyline made me into a walking zombie. Could this point to a problem with receptor function or other pharmacodynamic issue or one of drug interaction (such as enzyme inhibition)? If I were a poor metabolizer, it would have shown up back then on these drugs, me thinks. Maybe all the meds I've tried have messed up my receptors and made things worse.

Once I tried low dose risperidone for one week or so and it nipped some of my fibromyalgia flare symptoms in the bud. My very smart Rheumatologist agreed to prescribe it, but she has since closed her practice. Increasing the dose made symptoms worse, but 0.5mg was the golden ticket. I tried it a second time several months later, but it didn't seem to work. Would this point to a 5HT2a receptor problem?

http://ajp.psychiatryonline.org/cgi/content/full/160/10/1830

I almost feel as if a long washout period would be beneficial for me to "reset" everything. Is that possible? The only thing I must have is for sleep as I simply can't manage without it.

I would greatly appreciate any insight.

Thanks!

Cairo

> What about using Remeron to offset 5-HT2a stimulation?
>
> Tianeptine? It's sort of like a reverse SSRI.
>
> Nefazodone? Sort of a yucky drug, but works for some people. Some mild SRI combined with 5-HT2a blockade.
>
> Have you ever tried an MAOI?
>
> What happens when you take a stimulant?
>
> Emsam looks interesting. It seems to have energizing and anxiolytic properties at the same time.
>
>
> - Scott


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