Posted by SLS on February 16, 2012, at 7:07:43
In reply to Re: parnate agitation » SLS, posted by g_g_g_unit on February 16, 2012, at 5:34:27
> > > Just an update: I saw my psychiatrist today. He believes irritability is a potential side-effect of increased adrenergic activity and doesn't necessarily point to Bipolar.
> > >
> > > Regardless, he's prescribed Depakote (250-500mg) to take in the meantime in the hope that it might curb side-effects and allow me to reach a higher dose of Parnate.
> > >
> > > I asked about clonidine for sleep. He's going to look into its safety and also thinks it might be a useful option to control overstimulation.
> >
> >
> > I like what your doctor had to say.
> >
>
> Yeah, he's a smart guy. I kind of wish he'd opted for something like klonopin - I thought it might be easier to reap an instant effect, and that it would also help insomnia. But he isn't a big fan, alas.
>
> > If you do opt for clonidine, be aware that a rather sizable percentage of people experience depression as a side effect. However, it might be exactly what you need as a sympatholytic. Prazosin, another sympatholytic drug, is sometimes used in PTSD to reduce anxiety and improve sleep. Of course, there is propranalol.
> >
> > http://www.consumerreports.org/health/best-buy-drugs/prazosin-for-ptsd/overview/index.htm
> >
> > "Prazosin is the most thoroughly studied drug in regard to PTSD and sleep among the class of medications known as alpha-1 blockers. In addition to preventing nightmares and insomnia, it can help improve overall symptoms, such as flashbacks, startle response, and irritability or anger, and it can be taken with an antidepressant."
> >
> > Good luck.
> >
> >
> > - Scott
>
>
> Thanks for the tip, Scott. It seems Prasozin is available here. However, didn't you say it decreases DA in the nucleus accumbens? Wouldn't that exacerbate anhedonia?Not necessarily.
As Linkadge has noted, there are regions of the nucleus accumbens that are hyperactive in depression. That would seem counterintuitive at first, but not if one thinks in terms of circuitry. That DBS in the nucleus accumbens leads to an antidepressant effect would corroborate this observation. DBS is inhibitory upon the propagation of nerve messages. It interferes with nerve function, and does not stimulate nerves to relay messages downstream. DBS attenuates rather than stimulates neuronal activity.
I've got all of these circuit interactions running around my mind, but couldn't begin to put them into words.
The bottom line is that prazosin might reverse anhedonia seen in depression by modulating the messages being sent to the nucleus accumbens (just one of the structures involved in the experience of reward and pleasure).
Let us pretend that this is all wrong. Theories often are. However, the observed effect of prazosin seems to reduce depression and anhedonia in some, but not all, people. If you intend to try prazosin, let me know and I will pass along a few observations.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1009862
URL: http://www.dr-bob.org/babble/20120212/msgs/1010428.html