Posted by zeugma on December 16, 2004, at 20:31:11 [reposted on December 16, 2004, at 21:58:28 | original URL]
In reply to Re: Should I just cut my losses or what?, posted by ravenstorm on December 16, 2004, at 12:25:01
Hi Tamara,
Thanks for the links about DMAE.
I do not believe the explanation that its manufacturers dropped DMAE from FDA approval for treatment of ADHD because of expense of clinical trials. The nootropic Aricept, which appears similar, has also been looked at for ADHD, but its effects appear to be marginal at best, and the actual FDA indication for such drugs is the treatment of Alzheimer's disease. They are useful for this purpose because they reverse the interoceptive (self-awareness) deficits that are linked both to Alzheimer's and to the lack of sel;f-awareness that typically accompanies dreaming. Consistent with this, I noticed one of the abstracts you linked to discussed DMAE's role in facilitating lucid dreaming. That is the last thing I need, because I suffer from narcolepsy, and this condition causes waking and dreaming consciousness to blur together (my therapist was shocked to hear that I routinely would awaken when I 'knew' I was dreaming, and that this happened constantly. She simply was unfamiliar with narcolepsy. I will withhold comment on whether this is excusable in a neuropsychologist. I have been forced to be my own neuropsychologist, because this field does not not appear to be well stocked with able practicitioners.).
I do not believe that ADHD resembles Alzheimer's in this regard; in fact many people with ADHD are extremely introspective and aware of their own mental processes, to the point where interoceptive stimuli become more salient than external ones.
Interestingly, nortriptyline, which I use to treat this problem (believe me, it is a TERRIBLE problem, as I simply cannot remain in a 'mixed' consciousness for very long- it literally feels like two forms of consciousness fighting for control of my CNS, and can be extremely painful as well as jarring) is a cholinergic antagonist, and this underlies some of its effectiveness in treating both depression and narcolepsy. It is also somewhat effective in treating ADHD (in fact I was prescribed it as a second-line treatment for ADHD). Clomipramine (but not Celexa) is also somewhat effective for ADHD. Clomipramine increases noradrenergic neurotransmission, and this causes indirect reduction of cholinergic neurotransmission. Norepinephrine and acetylcholine are 'opposite numbers' in the CNS (experts here are invited to evaluate this statement!).
There is a strong link on the one hand between norepinephrine's role in blocking REM, on the one hand, and cholinergic drugs' intensifying it. I do not believe that it is a coincidence that all known drugs that strongly and specfically suppress REM are used in the treatment of narcolepsy and depression, and are also somewhat efficacious in treating ADHD.
-z
poster:zeugma
thread:430543
URL: http://www.dr-bob.org/babble/alter/20041212/msgs/430551.html