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Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 23, 2018, at 8:16:19

In reply to Re: carbamazepine (tegretol) for social anxiety farshad, posted by linkadge on August 23, 2018, at 7:53:37

> The HPA axis is very complicated. Both high and low cortisol have been associated with anxiety. It is difficult to know, without a series of blood tests, whether one has abnormal cortisol.
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> Even if one has high cortisol, it is difficult to know the source. High cortisol can cause anxiety, but high anxiety can also cause high cortisol. High cortisol may not be the initial imbalance. For example, if other monoamines were out of wack (i.e. serotonin, gaba, norepinpehrine etc) this could cause cortisol to be out of control.
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> Many antidepressants and anxiolytics (especially the TCAs) will normalize the HPA axis (i.e. CRH) over time. For exampe, escitalopram (even though it increases serotonin) has been shown to normalize the HPA axis. Benzodiazapines inhibit cortisol.
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> Tegrol does have side effects and toxicities. It can affect white blood cells. It can impact the liver. It may also negatively impact neurogenesis and cell function (you can do a pubmed search). Tegretol is less 'clean' than gabapentin / lyrica. It can certainly make you feel tired, or weak. As a mood stabilier, it can also flatten out your mood / emotions. Like all anticonvulsants, it can also dampen cognition / thinking skills and motor co-ordination.
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> Valproate can also help anxiety, but it is a heavy medication. It can cause drowsiness, impaired co-ordination and cognition. This is the disadvantage of all the anticonvulsants.
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> I'm not saying don't try tegretol. I'm just saying that if you get tunnel vision one one mechanism, you can often miss the big picture. I.e. tegretol may inhibit CRH (i.e. and hence reduce an overactive HPA axis) but so can many other medications. Tegretol, for you, may have fewer side effects, or more side effects. Who knows.
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I think I have been trough every possible thing that could cause anxiety, last left is the crh-crhr1 system, btw crh is not cortisol it is Corticotropin-releasing hormone ''corticotropin'' not same as cortisol but I think you know that already.

most drugs in my experience has no direct effect on reducing crh , i guess there is no way to know but try carbamazepine and see if it works, I will let you guys know how things go if anyone cares, should have the drug soon about 2-3 weeks.
Valproate decrease CRH release also but it dosen't say where, it is important that it decreases in the hypothalamus becuase thats were crh is created.


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poster:farshad thread:1100299
URL: http://www.dr-bob.org/babble/20180728/msgs/1100552.html