Posted by mtdewcmu on April 30, 2011, at 23:49:44
In reply to PLEASE READ.Pro/con:Gabapentin-agitated depression, posted by jmb2012 on April 30, 2011, at 20:21:15
> Hi. New poster, long-time site user.
> Me: 29 y/o non-traditional Pre med student with a pretty high amount of innate and stress-induced agitated-depression. Diagnosed about two years ago but definitely been with me since early childhood. On low dose lexapro to prevent the "darkness" from taking over.Are you planning to go to med school? I would not attempt that with my preexisting psych issues. I read that a lot of previously healthy people become suicidal in response to all the pressure and competition.
> The lex was effective at limiting the severe drops in mood. Never suicidal but experienced cycles of excessive worry/over thinking--> fried-brain depression--> pretty serious anger and aggression (the only "lift" in mood)--> back to "fried brain" depression and so on. Ruined some potentially incredible life experiences.
> I don't handle chronic, unavoidable, non physical stress well. IF I had to climb a mountain or fend off a bear I'd do much better. But having to wake up and face something that is unremittingly unpleasant, and totally unavoidable is not my strong suit. It's why I am in therapy.
> The lex wasn't cutting it alone.
> We tried buspar then lamictal. Nothing
> Then we tried gabapentin. At first nothing. Went off for 4 months, forgotten until last winter break. In a desperate attempt to slow my brain and relax I took a larger dose of gabapentin-(gp) from 300mg to 1200mg.
> GABAPENTIN:
>
> THE GOOD:
> Profound improvement of mood and a slowing of my brain. I felt normal, above normal, I felt good. I was able to focus, socialize and enjoy pretty much whatever I was doing. I was the best, most functional, most charming, considerate and peaceful version of my self. If I could be like that all the time, I thought, I could face anything. It was incredible. I had never felt so normal and able to enjoy life. In other words I was on a drug. I wish my brain naturally was more like this. Alas. Over time the extremely short active life of GP began causing a roller coaster effect during the day. I would take it, 1-2 hours later I felt the lift of mood and increase of happiness/positivity. 2-3 hours after that I felt myself begin to plunge back into my normal state of blah/moodiness/keyed up adrenaline response. So I'd take it again and the cycle continued. A moderate tolerance developed but it was ok. Getting tears in my eyes while working the pediatric unit in the hospital had is drawbacks.
>There is a time-release gabapentin now. It wasn't developed for psychiatric use, but maybe you would find it useful anyway.
> THE BAD: Psychological, physical, both or otherwise- dependence has developed. I have NEVER been addicted to anything. I understand the process and condition much better now. You are free of your defective mind when high. The better part of you is able to rise and express itself. GP gets you functionally high. I get it now when junkies say " I'm sick man. I need my medicine". While I have not experienced any serious somatic (body) symptoms- jitteryness, some dizziness maybe-- I have DEFINITELY experienced psychological ones. It's either the contrast between my natural, base, mental state and my GP elevated state, straight up physical withdrawal symptoms or a combo of both but when that stuff wears off I am not happy. Everything comes rushing back in with the force of a torrent breaking through a dam.
>I found gabapentin pleasant at first, but the effect quickly diminished to where I could not tell if I had taken any. Ergo, I wasn't that impressed with it. But my history is not free from "real" recreational drug use. So, presumably, I've had better.
> *Briefly*: the mechanism of GP is still somewhat in question right? Recent studies however have identified it's activity on voltage gated ion channels- exerting a membrane potential and anti-"kindling" stabilizing effect. They also discovered it acts on a number of enzymes, the net result of which supposedly reduce GLUTAMATE synthesis and release while increasing GABA production and slowing or inhibiting its breakdown. GP's activity on glutamate metabolism strikes the strongest note with me. IT FEELS, no proof, that when the GP wears off the brain compensates for it's reduced glutamate load. That or like benzos the brain becomes unable to properly regulate the GABA/GLUTAMATE inhib/excitatory balance. AGAIN THIS IS ALL SPECULATION. PLEASE SOUND OFF ON THIS IF ANY ONE CARES.
>
> FINAL: I am in love with this drug. I am in love with the way it brings out my best. It's like meditation/happiness in a pill. I will not be able to tolerate it's kinetics though so I am doing two things: 1. Getting an rx for Lyrica. This is not something I do lightly. I know that I am going to have the same if not worse dependence issues on pregab as I am having with GP. BUT I cannot function without some effective form of brain brakes. I have ordered some Dilantin in a last ditch effort to avoid going on a gaba drug. The scant evidence for low dose ( 100-150mg) efficacy in brain impulse control is appealing but un-conclusive. We will see.
>Why Lyrica? It appears to have about the same half-life as gabapentin. I have not heard of Dilantin being used in psychiatry, so I assumed it was dangerous or had some unbridgeable issue.
Do you think you may be investing more power in gabapentin than it really has? Maybe it's not doing all that much for you.
Even though gabapentin is no heroin or crack, it concerns me how you are describing your relationship to this med. It sounds like you could be a full-blown drug addict waiting to happen. Are you sure you want to move up to Lyrica, which is actually a controlled-substance (if barely)? I think you would be better served to nip the potential addiction problem in the bud and look for non-addicting meds that may work. Since you have had some success with anticonvulsants, perhaps try some others that are used in psychiatry, like Depakote or Topamax (I haven't tried those, they just came to mind). Anticonvulsants are not often used as monotherapy outside bipolar, so maybe experiment some more with antidepressants.
I don't like to be a wet blanket, and I don't expect to be live a completely clean life in the future. But while you still haven't experienced a serious drug problem and thus have a choice, you should probably give some thought to whether you want to blindly feed this need for a chemical escape hatch, or if you should go the other route and look for meds/solutions that are less, not more, likely to become an obsession. Just feel like it needed to be said.
> That's it really. PLEASE comment or ask me questions. This is a huge post and I only burden this site with it because I have not seen many detailed GP/Agitated depression experiences posted.
>
> I pray that that the road I have traveled so far can offer some assistance to others. If you are walking a similar path in similar shoes please comment. This is an incredible, horrible drug but I seem to need it.
> Thanks and blessings to those who listened. Our modern life is not natural. It puts stresses on our system we have not had time to evolve into. I pray that peace comes to all of us.
>Hope you stick with us. It was an entertaining post.
poster:mtdewcmu
thread:984211
URL: http://www.dr-bob.org/babble/20110418/msgs/984239.html