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Re: question on minocycline » alchemy

Posted by SLS on January 31, 2013, at 15:09:26

In reply to Re: question on minocycline, posted by alchemy on January 31, 2013, at 13:02:21

> Wow, thanks Scott! Almost sounds too good to be true. I know that you have had some success with it. About how much do you think it has helped you and when did you start noticing its effects? Did you also notice that it helped with motivation or anhedonia? Sometimes it feels like it hurts my brain just to think!

I and one other person experienced an improvement within the first week. It is important to take note that we both are also taking Lamictal and Abilify. The other person achieved full remission within two weeks. I am not quite so lucky, but, from what I understand, it can take a full year for some people. I figure it is worth the wait. I would say that motivation and anhedonia are significantly improved in me. Although I have had brief "blip" improvements in the past that have been more robust, I have not felt this well consistently in 25 years. If I do get stuck, I would consider TMS or ketamine treatments to move things along.

To summarize, minocycline:

1. Reduces glutamate hyperactivity.
2. Reduces glutamate excitotoxicity (neuroprotective).
3. Reduces brain inflammation.
4. Increases neuroplasticity by enhancing the neurite growth produced by nerve growth factor (NGF).

Of these, I believe that it is #1 that is the most important for the acute improvement that occurs early in treatment. If so, then one might pursue the idea of adding an antiglutamatergic agent to enhance the effects of minocycline. Lamictal is an obvious choice. Memantine would be another drug to look at as well as N-acetylcysteine (NAC). I believe that #4 would also contribute to the acute therapeutic effect. It may be that the anti-inflammatory properties of minocycline become important to produce a sustained therapeutic effect. Interestingly, in animal models, adding minocycline to the TCA, desipramine, produced a greater antidepressant effect than desipramine alone. I am currently taking nortriptyline, another TCA.

The most important side effect of minocycline to screen for is brain swelling (pseudotumor cerebri). It is rare, but dangerous.

http://www.mayoclinic.com/health/pseudotumor-cerebri/DS00851/DSECTION=symptoms

Symptoms include:

* Moderate to severe headaches that may originate behind the eyes

* Ringing in the ears that pulses in time with your heartbeat

* Nausea, vomiting or dizziness

* Blurred or dimmed vision

* Brief episodes of blindness, lasting only a few seconds and affecting one or both eyes (visual obscurations)

* Difficulty seeing to the side

* Double vision (diplopia)

* Seeing light flashes (photopsia)

* Neck, shoulder or back pain


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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