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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by SuzieWong on June 17, 2004, at 4:58:11
Hi Chemist. You certainly seem to know your stuff and I was wondering if you could answer me a few questions regarding a couple of drugs and their effects on me.
I posted earlier about Folic Acid. I took one 400mcg tablet a couple of days ago and after 2 hours started to feel really agitated and jittery which developed into an unusual type panic attack. The anxiety was definately there all through the night and the next day. I wouldn't take another Folic Acid dose and I'm okay today.
I know that Folic Acid is supposed to activate Prozac which is why I took it because I want to keep the Prozac dose down as much as possible but certainly didn't expect the effect only one tablet had on me. I know I can be sensitive to medications but that seemed ridiculous. Do you know if the side effects I had could have been the Folic Acid activating the Prozac or increasing the effect of its dosage so that I suffered with sever anxiety from it? Or is it that Vitamin B drugs are jut anxiety producing....but one tablet certainly seems a bit ridiculous.
Also, last week I took Nytol for 2 nights because I don't sleep atall well. As you probably know, Nytol is an antihistamine and I slept really really well but I also felt very calm the following morning. However, after I had been up and about for a few hours, I started feeling really trembly and nervous. The leaflet with the Nytol said it can cause nervousness but I would have thought it meant while it was still in your system. This seemed to induce the nervousness once it was out of my system. Do you think this might indicate that I actually have high histamine levels which could be causing my anxiety and then when the antihistamine wore off my body started craving more hence the shakiness?
Would these effects wear off after more use. I stopped taking the Nytol because I didn't like these after effects but I'm back to not sleeping because of the effect of the Prozac.
I look forward to your learned response.
Many thanks
Posted by chemist on June 18, 2004, at 3:39:03
In reply to Question for Chemist re Folic Acid and Nytol, posted by SuzieWong on June 17, 2004, at 4:58:11
hello there, chemist here.. suzie, there is evidence that if you are deficient in folic acid that augmenting it will increase the efficacy of prozac. i spent about 3 hours looking in texts and in the lit for a rxn as you describe and came up with nothing. if you are deficient in folic acid, then taking it with prozac will help with the efficacy of prozac. as for your question about too much histamine, the answer is no: the sleeping stuff OTC blocks reuptake of histamine, thus makes you tired and sleepy. i can only sugest you hit the alternative board and look for an explanation for your folic acid rxn. sorry i cannot be of more help, and please do let me know if there is an answer...all the best, chemist
Posted by PeterJ on June 18, 2004, at 23:51:04
In reply to Question for Chemist re Folic Acid and Nytol, posted by SuzieWong on June 17, 2004, at 4:58:11
Suzie,
I was very interested in your post as I have had similar reactions to some of the drugs you mentioned.
Folic acid causes me to have severe anxiety and panic. I have taken it on two occasions, once several years ago and again last year. Each time within a few days the anxiety starts and soon becomes horrifyingly bad -- far beyond any level of anxiety I normally feel.
I have taken both non-prescription folic acid and Foltx, which is a prescription formulation of folic acid and B-12.
The Foltx was prescibed for me following a cardiac proceedure (angioplasty) since it was thought to be beneficial for healing after angioplasty. Despite this, I had to stop taking after a week or so. What is ironic is that a few months later new research found that Foltx actully makes the results of angioplasty worse, so they no longer advise its use for that purpose. If interested, see the link below:
http://www.heartcenteronline.com/myheartdr/home/research-detail.cfm?reutersid=3505&nl=4
Getting back to your question, I have also had an unpleasant reaction to Prozac, which caused very severe anxiety and panic. We re-tried Prozac at the very tiny dose of 1mg per day and even that caused tremendous nervousness which did not subside even over several weeks of use.
I get unusual reactions to many drugs. Some stimulate me, and others, which stimulate many other people, slow down or sedate me. But Prozac and folic acid stand out as particularly bad for causing anxiety.
Now, your not going to believe this, but I also had precisely the same reaction as you did to Benadryl (diphenhydramine). I took it at bedtime, and found that it was calming and helped me to sleep. However, about half way through the following day I found myself getting unusually nervous and angry in a way that is not typical for me. It was unpleasant and even frightening.
I have thought about the possible causes for these reactions. At this point, I should perhaps mention that I have a degree in biochemistry and have actually published some articles on the metabolism of psychiatric drugs, so I had some background which was helpful in trying to figure this out.
There are several mechanisms which may account for some of these effects.
First, acetylcholine may be involved. Folic acid is important in the synthesis of choline in the body. Choline, converted to acetylcholine can cause depression and anxiety in susceptible individuals. Benadryl is a strong anticholinergic and thus may acutely reduce such anxiety but the rebound may make it worse.
Serotonin may also be involved. As you know, Prozac is a serotonin uptake inhibitor. What many people don't know is that Benadryl also has some serotonin uptake inhibiting properties. In fact a few years ago, a study on OCD used Benadryl as a one of the placebo arms, but they found that some of the patienst on Benadryl improved beyond what was expected for a placebo. They went back and explained that this might be a serotonin effect of Benadryl.
Folic acid may have an effect on the synthesis and metabolism of serotonin due to its interaction with terahydropbiopterin. This is a very complex subject but it is possible that the folic acid could be increasing levels of serotonin or a methylated serotonin metabolite. Folic acid is very involved in what is known as methylation reactions and methylation state has a strong effect on mental and emotional function.
It's a big subject, but I think it is very interesting that we had similar reactions to so many drugs. It might be helpful for both of us to compare reactions to drugs to see which ones might help us. I have chronic anxiety as well as a sleep disorder ... speaking of which, I'd better stop writing now and go to bed.
I hope we can continue this discussion here. I also encourage you to contact me at the following email address (modified here to minimize spam) so we can keep in contact to compare drug reactions:
PeterJanet .... at .... mail ... dot .... com
Please be patient as I don't always have the time or energy to read this board. I hope you will keep in touch.
PeterJ
Posted by SLS on June 19, 2004, at 6:43:20
In reply to Re: Question for Chemist re Folic Acid and Nytol » SuzieWong, posted by PeterJ on June 18, 2004, at 23:51:04
This is the end of the thread.
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