![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 15 to 39 of 114. Go back in thread:
Posted by KaraS on April 3, 2005, at 13:38:38
In reply to Re: King Vultan » KaraS, posted by ed_uk on April 3, 2005, at 11:01:05
> Hi Kara!
>
> >I don't think that posters should be allowed to stop posting!
>
> It would be nice if people weren't allowed to turn their babblemail off!!!
>
> Ed xxx
Absolutely! It's so rude! ;-)k
Posted by franco neuro on April 3, 2005, at 20:51:37
In reply to Re: Anyone TIRED on Wellbutrin XL? » franco neuro, posted by islandangel on April 2, 2005, at 14:19:28
Hi IG,
Boy I really wish I could reach the point where I didn't have to do any more of this homework. It's really hard. Especially when you're already as messed up as I am. Your experiences with Elavil. as well as antihistamines, really got me thinking. I started at 10mgs but over time I had to keep upping it until I was taking over 125mgs a night to get to sleep. I always thought it was the antihistamine effect that knocked me out, which is the common wisdom. But I've been experimenting with whatever I could get my hands on lately, (thanks to "Tuning the Brain) so I tried some Benedryl. I had never tried it before. As it turned out, of course, it didn't make me sleepy at all. It was mildly analgesic, however. I have to look back through Dr. Goldstein's book but I'm pretty sure he mentioned that histamine may stimulate the NMDA receptor, which is why they help with pain in some neurosomatic patients. So, it wasn't Elavil's antihistamine action that knocked me out when I took it. After being an antihistamine, it hits the acetylcholine, NA, 5ht-2, and NA alpha-1. Yes it is a very messy drug. It has pretty strong anticholinergic activity, which is scary because we really need our acetylcholine! Especially if we don't want to end up with Alzheimer's. No SSRI ever knocked me out so i doubt it was the 5-ht2 effect. So it had to be the anticholingergic or norepinephrine interaction. Because I had to keep bumping it up I must have been becoming more and more depleted in chatecholamines. When I stopped it I think the bottom must have dropped out, because I really felt like I was dying. I felt week and had this strange tingly/sizzling like feeling down my left leg and in my pelvis and on the left side of my chest and torso. I swear to God I felt like my muscles were melting away. I think my brain/nervous system were in such a panic to get amino acids to make DA and NA that it was breaking down muscle tissue (protein) to get them. I tell you I still haven't recovered from it. I think I may have had something akin to a mild form of "neuroleptic malignant syndrome" of which Goldstein says,
"Although I encounter it only about once every ten years, neuroleptic malignant syndrome, a disorder of autonomic hypereactivity, fever, muscle breakdown, and apparent catatonia, is caused by standard neuroleptics and possibly by rapid cessation of IV amantadine infusion."
Elavil isn't a neuroleptic, but neither is amantadine. And I have read that it has been found to cause NMS and parkinsonism with chronic use. I really screwed myself!
By the way I'm not surprised that you've seen Dr. St. Amand. We CFS types get around. I've been to 50+ docs, including Majid "The Canary and Chronic Fatigue" Ali and have had my fillings replaced and have tried cholestyramine, and have taken nystatin for nonexistant yeast infection, etc., etc., etc. I only wish I had gotten around to seeing Dr. Jay Goldstein... :-(
Posted by franco neuro on April 3, 2005, at 21:18:35
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 2, 2005, at 15:54:49
Hi Kara,
All hail King Vultan! He makes sense...
Thanks for the links. That Goldstein one is in the book almost word for word. He does cover those to meds in the book. I must say I'm a bit wary of taking an antipsychotic, because I fear my DA levels are so low it may give me extrapyramidal symptoms or tardive dyskinesia. Amisulpride, however, is supposed to be a dopamine stabilizer. Lowering DA when it's high, and raising it when it's low. Would be interesting if it's true.> As Todd posited (King Vultan) why wouldn't medications like Parnate, selegiline, Ritalin downregulate dopamine autoreceptors in the same way that SSRIs downregulate serotonin autoreceptors? [Hydergine may also be a good med to try. It's reputed to be "neuroprotective" in chronic low doses. Golstein says, "Ergoloid mesylates, or Hydergine, is another diamond in the rough. It is a DA and Ach (mainly DA) agonist, is well tolerated, and two 1 mg tablets either work or not in 30 minutes."]
This is an excellent question and one that I've been pondering too. Why wouldn't chronically flooding the synapse downregulate the autoreceptor as it most likely would the post synaptic receptors? I wish I knew. This may be the million dollar question.
By the way I found a story on a CFS site posted by a guy who's trying to use Dr. Goldstein's protocol with his own doctor. His doctor has no clue what he's trying to accomplish but is willing to give him the meds. I guess this is what I have to do. I emailed him and it turns out he is in Florida. I emailed him asking for details and am waiting for his reply.
I need to make up a battle plan...
Posted by franco neuro on April 3, 2005, at 22:20:51
In reply to Re: Anyone TIRED on Wellbutrin XL? » franco neuro, posted by islandangel on April 2, 2005, at 14:19:28
Hi IA, (I have no idea why I put IG on the last one.)
Just wanted to add that I have been getting some transient slight itching, but mostly in the areas where I tend to get nerve pain. Except my hands, where I don't get any pain but do have very dry skin. The itching on my hands is oh so slight. No problem at all. I think it must have something to do with NE's effect on the tiny arterioles and capillaries that provide blood flow to the skin. Just a guess...
Posted by Steen on April 5, 2005, at 18:17:50
In reply to Re: Anyone TIRED on Wellbutrin XL? » islandangel, posted by franco neuro on April 3, 2005, at 22:20:51
I am starting on Wellbutrin XL tomorrow in hopes of helping me with menopause. I had a total hysterectomy 3 years ago and I am not able to take hormones due to a family history of breast cancer. Being without hormones has been awful, no energy, no sex drive and I did not want to take an SSRI d/t the problems with weight gain and sexual desire issues. Have any of you ever heard of taking Wellbutrin for something like this? I am currently on no medications (except for a low dose of blood pressure medication-after the hysterectomy problem), nor have I ever been, fortunately. I'm a little nervous about taking it d/t the problems people have cited with the anxiety and nervousness, but I start tomorrow. I like the idea of having a place to talk about this, though, so I hope it's OK that I responded to the posting. I hope it doesn't make me tired, because I'm battling feeling tired anyway, either from a little depression or lack of hormones or AGE!!!!
Thanks for listening!
Chris
Posted by KaraS on April 5, 2005, at 18:34:03
In reply to Re: Read this before answering my previous post » KaraS, posted by franco neuro on April 3, 2005, at 21:18:35
Hi Franco,
> All hail King Vultan! He makes sense...
>
> Thanks for the links. That Goldstein one is in the book almost word for word. He does cover those to meds in the book. I must say I'm a bit wary of taking an antipsychotic, because I fear my DA levels are so low it may give me extrapyramidal symptoms or tardive dyskinesia. Amisulpride, however, is supposed to be a dopamine stabilizer. Lowering DA when it's high, and raising it when it's low. Would be interesting if it's true.
I am also afraid of the APs (but then I'm becoming afraid of most meds these days). I didn't know that amisulpride is a dopamine stabilizer. I've also heard that it can have some less than desirable side effects.
> > As Todd posited (King Vultan) why wouldn't medications like Parnate, selegiline, Ritalin downregulate dopamine autoreceptors in the same way that SSRIs downregulate serotonin autoreceptors? [Hydergine may also be a good med to try. It's reputed to be "neuroprotective" in chronic low doses. Golstein says, "Ergoloid mesylates, or Hydergine, is another diamond in the rough. It is a DA and Ach (mainly DA) agonist, is well tolerated, and two 1 mg tablets either work or not in 30 minutes."]I also didn't know that about hydergine. I have always thought of it in terms of Ach only. Have you tried it?
> This is an excellent question and one that I've been pondering too. Why wouldn't chronically flooding the synapse downregulate the autoreceptor as it most likely would the post synaptic receptors? I wish I knew. This may be the million dollar question.Same here. Dr. Goldstein doesn't address that, does he?
> By the way I found a story on a CFS site posted by a guy who's trying to use Dr. Goldstein's protocol with his own doctor. His doctor has no clue what he's trying to accomplish but is willing to give him the meds. I guess this is what I have to do. I emailed him and it turns out he is in Florida. I emailed him asking for details and am waiting for his reply.
>
> I need to make up a battle plan...
I know what you mean but doesn't Dr. Braverman have a battle plan for you? Have you heard anything back from the guy on the CFS site?How's the Wellbutrin now? Any more energy from it? You might still get an antidepressant effect from it that will provide motivation without the overt early sense of stimulation, no?
K
Posted by franco neuro on April 5, 2005, at 20:45:21
In reply to Re: Anyone TIRED on Wellbutrin XL?, posted by Steen on April 5, 2005, at 18:17:50
Hi Steen...Welcome aboard!
Sorry to hear you're having some problems. You're not alone. I'm not too crazy about the SSRI's. I've been on Paxil and Zoloft and have pretty much had it with them. I don't see how killing someone's libido is going to help their depression. Having said that, they do appear to help some people. My sister being one of them.
If you're worried about fatigue and libido than Wellbutrin is probably a good medication to start with. For most people it is energy and libido enhancing. As a matter of fact, it is often prescribed to those already taking SSRI's to reverse SSRI induced sexual dysfunction and SSRI induced apathy. This is why I wanted to give it a try. Unfortunately I appear to be having a paradoxical response. I've been taking the SR version for a week and it's really knocking me out. However, it is helping with chronic pain. Go figure? Don't go by my experience though, because I have very odd brain chemistry. I plan on sticking with it for at least another week and then discuss with my doctor what to do next.
The only way you'll ever know if it's right for you is to give it a shot. Good luck! And feel free to post as often as you'd like... :-)
Posted by Steen on April 5, 2005, at 22:05:53
In reply to Re: Anyone TIRED on Wellbutrin XL? » Steen, posted by franco neuro on April 5, 2005, at 20:45:21
> Hi Steen...Welcome aboard!
>
> Sorry to hear you're having some problems. You're not alone. I'm not too crazy about the SSRI's. I've been on Paxil and Zoloft and have pretty much had it with them. I don't see how killing someone's libido is going to help their depression. Having said that, they do appear to help some people. My sister being one of them.
>
> If you're worried about fatigue and libido than Wellbutrin is probably a good medication to start with. For most people it is energy and libido enhancing. As a matter of fact, it is often prescribed to those already taking SSRI's to reverse SSRI induced sexual dysfunction and SSRI induced apathy. This is why I wanted to give it a try. Unfortunately I appear to be having a paradoxical response. I've been taking the SR version for a week and it's really knocking me out. However, it is helping with chronic pain. Go figure? Don't go by my experience though, because I have very odd brain chemistry. I plan on sticking with it for at least another week and then discuss with my doctor what to do next.
>
> The only way you'll ever know if it's right for you is to give it a shot. Good luck! And feel free to post as often as you'd like... :-)
franco neuro,
Thanks for answering. Did you have the side effects of being nervous, anxious and agitated? If so, how long did it last? I think if I know that it is only for a week or so, I can stand it. I'm worried because of other posts that I have read (I am not even sure it was on this website) about people having such long-lasting horrible effects. I wondered if they had significant problems prior to taking Wellbutrin and that's why the stories were so bad. Ah, but you're right. The only way I can tell is to try. I'll start tomorrow and we'll see. I'll check in.I hope your sedation problem is resolved. Maybe this too shall pass? I hope so. I imagine it is difficult to know that somewhere there is a halfway decent solution, but you can't quite find it. Good luck to you, too.
Steen
Posted by franco neuro on April 5, 2005, at 22:16:14
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 5, 2005, at 18:34:03
Hi Kara,
I was beginning to worry that everyone abandoned this thread. :-) The fatigue seemed to lesson yesterday but reappeared with a vengeance today. I had been taking 1/4 grain of Dr. Braverman's thyroid formula, but I stopped a couple of days ago. I decided to take it this morning and am wondering if that contributed to the fatigue, because I called his office today and they told me my thyroid antibodies came back high. So maybe the thyroid hormone is causing an immune reaction. I doubt it. I think it's the dopamine paradox and/or the double edged sword that is norepinephrine. I'll keep taking it for a while and see what happens.
> I am also afraid of the APs (but then I'm becoming afraid of most meds these days).
I know the feeling. I'm always afraid that I'll do more harm to my already messed up brain/body. But what I'm more afraid of is never feeling healthy again and having the rest of my life pass me by like the last few years have. Having said that, the AP's will probably be my medications of last resort.
> I didn't know that amisulpride is a dopamine stabilizer.
Here's what it says in Stephen M. Stahl's "Essential Psychopharmacology: The Prescriber's Guide", amisulpride:
-Is possibly a dopamine stabilizer and dopamine agonist.
-Theoretically blocks presynaptic DA 2 receptors at low doses.
-Theoretically blocks postsynaptic DA 2 receptors at high doses.
-May be a partial agonist at DA 2 receptors, which would theoretically reduce DA output when DA concentrations are high and increase output when DA concentrations are low.
-Blocks DA 3 receptor, which may contribute to it's clinical action.
-Unlike other atypical AP's, amisulpride does not have potent actions at serotonin receptors.> I've also heard that it can have some less than desirable side effects.
Amen. Any drug that blocks DA can have some scary side effects.
> I also didn't know that about hydergine. I have always thought of it in terms of Ach only. Have you tried it?You might be thinking of Galantamine, which is a cholinesterase inhibitor.
The million dollar question?
> Dr. Goldstein doesn't address that, does he?As a matter of fact, I started flipping through the nearly 500 pages of "Tuning the Brain" and managed to find this tasty tidbit...[] are my additions...
"I am being drawn to the conclusion that fatigue is, at least in part, related to NAc [nucleus accumbens] DA release, or the insufficiency thereof. PFC [prefrontal cortex], even mPFC [medial prefrontal cortex] , hypoactivity is common in neurosomatic disorders."
He continues...
"If the mPFC DA is insufficient, there will be hyperglutamatergic input to presynaptic D2 autoreceptors [BINGO!] on mesoaccumbens DA neurons, which is the apparent situation in neurosomatic disorders."
I new it had to do with the EAA's glutamate and/or NMDA. As a matter of fact this is pretty much the thrust of his whole theory. Earlier in the book he says...
"The ultimate goal increasingly appears to be (for most patients) to reduce the sensitivity of the NMDA receptor, one of the primary receptors for the excititory amino acid (EAA) glutamate."
Also,
"...it would make sense to decrease glutamate neurotransmission in a patient who has a disorder of synaptic gating, those who do poorly in high-stimulus environments, such as malls, and those who are overly sensitive to many sensory inputs as is frequently seen in CFS, FMS, IBS, multiple chemical sensitivities (MCS), PMS, and too many other 'esses' than I care to mention."
Oh man do car exhaust and chemical smells kill me. I can smell someone spraying perfume on half a block away! Everyone's always telling me "what are you talking about I don't smell anything." And sure enough someone will come around the corner with a perfume bottle in their hand.
This is turning into the mother of all posts. But that guy in Florida did get back to me and seems pretty real. I believe he may have consulted Dr. Goldstein on the phone but never saw him in person. He said he was lucky to have an alternative type doctor who, although she wasn't too keen on meds., was willing to help him out. As far as Dr. Braverman goes, he did give me the Wellbutrin but I'm not sure he's the guy to try out Goldstein's protocol with. You have to understand it's hard to see the guy in person. You're lucky to get a minute with him. My freind gave him "Tuning the Brain" a few months ago and now he acts like he doesn't remember it. And on his radio show a few weeks back he was virtually quoting from it. It's the ego thing again. But we'll see. If you read my post on the other thread below you'll see my argument as to why a paradoxical response to a stimulant almost has to be due to the autoreceptor. (I'm still waiting patiently for someone to respond to it. Any input will help.) Of course I'm no scientist and Dr. Goldstein does mention a possible problem with the DA transporter (but only in passing). But I doubt I'll ever boost my DA without first using a glutamate/NMDA antagonist. I should pummel my postsynaptic receptors with a stimulant just to make sure they're not just really downregulated. But I doubt this is the case. Ok I'll end this post now before I pass out...
Posted by Harlock on April 6, 2005, at 9:31:15
In reply to Re: Anyone TIRED on Wellbutrin XL?, posted by Steen on April 5, 2005, at 18:17:50
I've been on WB XL for many months and have been on some form of it (non-XL) etc, for years
It doesn't seem to help my depression at all, but it does give me energy. It can make you eat less too, and thus loose wieght. At least that's what it does for me.
I'm now gaining weight thanks to Symbiax (the zyprexxa part of it, I think).
I gained 8 pounds in 1.5 weeks! 160->168 in no time. Bad news.
Posted by islandangel on April 6, 2005, at 10:59:38
In reply to Re: Anyone TIRED on Wellbutrin XL?, posted by Harlock on April 6, 2005, at 9:31:15
Hi Harlock: Interesting about your experience with Wellbutrin. I gained at least 10 pounds or more while on Prozac a little over a year ago. Prozac made me even more of a zombie than the tiredness I feel with Wellbutrin XL so I actually feel lucky. Wellbutrin in the beginning made me a little nauseas and I didn't notice stomach growling when I hadn't eaten. BUT that was in the beginning, maybe the first 2 weeks. After the first 2 weeks that stopped. I hadn't lost anything on Wellbutrin but because my weight had already creeped up at an uncomfortable level with Prozac, I decided to diet by cutting carbohydrates, mostly sugars. Wellbutrin makes it EASIER to control your eating when you need to. It feels great to have complete control and not fall off the "wagon". One thing Wellbutrin hasn't helped me with is my terrible procrastination. As for the weight control, I've been able to lose about 7 pounds in the last month. And I have great control over what I eat. Before... with Prozac, I was hungry all the time! Good luck on your new med.
Posted by franco neuro on April 6, 2005, at 13:06:21
In reply to Re: Anyone TIRED on Wellbutrin XL?, posted by Steen on April 5, 2005, at 22:05:53
Hi, and thanks for the well wishes,
> Did you have the side effects of being nervous, anxious and agitated?
The fancy doctor in NYC that I'm seeing gives all of his new patients psych tests. My main psychological issues (which are secondary but no doubt related to my physical problems of chronic pain and fatigue) came up as anxiety and dysthymia (chronic low grade depression). So I was concerned about this very issue. But, I have had zero increase in nervousness or anxiety. Whatever tiny bit of agitation I've had I think is mostly due to my trying to fight through the fatigue and stay awake.
> I'm worried because of other posts that I have read (I am not even sure it was on this website) about people having such long-lasting horrible effects. I wondered if they had significant problems prior to taking Wellbutrin and that's why the stories were so bad.
Take everything you read on these psych websites with a large grain of salt. I hope my previous post/tirade about my experience with Elavil didn't scare you. Our problems and experiences are unique. My problem with Elavil was that I took it for too long and went to too high a dose and stopped it too quickly. On the other hand I had absolutely no problem stopping SSRI's. (Maybe because they weren't doing anything except killing my libido!) I think negative drug reactions tend to be over-represented on sites like this. After all, anyone who has found a medication/s that resolved their "issues" probably would be out living their life and not spending so much of their free time posting here. At least that's what I would be doing. :-)
> I'll start tomorrow and we'll see. I'll check in.
Good Luck!!! I may go to twice a day tomorrow...
Posted by steen on April 6, 2005, at 13:38:41
In reply to Re: Anyone TIRED on Wellbutrin XL? » Steen, posted by franco neuro on April 6, 2005, at 13:06:21
franco neuro,
Thank you. I did take my first dose this morning and I'm OK. I feel a little nervous, which is new for me, but not bad so far. I have a problem with taking decongestants because they do this to me, but it's not bad and I can stand it if the results are good.
Your story about the Elavil didn't scare me. I had read on some other site about Wellbutrin that someone was put in the hospital for hallucinations and another was ...., well you know, it was on and on. I was just concerned about the side effects being that severe. I do think you're right, though, about the types of problems discussed and why.
I purposely decided to take this first week of this when I was off work. I didn't want to experience a lot of problems while working. I work part time and make my own schedule, so it was easy to do it this way.
Anyway, so far so good. Of course, it's just the first day!!
I appreciate your answer and hope you find something for your pain.
steen
Posted by KaraS on April 7, 2005, at 3:12:47
In reply to Re: Read this before answering my previous post » KaraS, posted by franco neuro on April 5, 2005, at 22:16:14
> Hi Franco,
>
> I was beginning to worry that everyone abandoned this thread. :-) The fatigue seemed to lesson yesterday but reappeared with a vengeance today. I had been taking 1/4 grain of Dr. Braverman's thyroid formula, but I stopped a couple of days ago. I decided to take it this morning and am wondering if that contributed to the fatigue, because I called his office today and they told me my thyroid antibodies came back high. So maybe the thyroid hormone is causing an immune reaction. I doubt it. I think it's the dopamine paradox and/or the double edged sword that is norepinephrine. I'll keep taking it for a while and see what happens.
I have the antibodies also. I read that they are in response to a protein in the thyroid gland and not to the thyroxin itself. (I wouldn't put money on it though.)
> I know the feeling. I'm always afraid that I'll do more harm to my already messed up brain/body. But what I'm more afraid of is never feeling healthy again and having the rest of my life pass me by like the last few years have. Having said that, the AP's will probably be my medications of last resort.
Same here but particularly with the APs. I don't think there's any long-term data on low dosage usage of them for depression. Have you considered MAOIs at all?
> Here's what it says in Stephen M. Stahl's "Essential Psychopharmacology: The Prescriber's Guide", amisulpride:
> -Is possibly a dopamine stabilizer and dopamine agonist.
> -Theoretically blocks presynaptic DA 2 receptors at low doses.
> -Theoretically blocks postsynaptic DA 2 receptors at high doses.
> -May be a partial agonist at DA 2 receptors, which would theoretically reduce DA output when DA concentrations are high and increase output when DA concentrations are low.
> -Blocks DA 3 receptor, which may contribute to it's clinical action.
> -Unlike other atypical AP's, amisulpride does not have potent actions at serotonin receptors.I did know that it behaves differently at lower dosages so I guess that would mean it's a dopamine stabilizer. That's good info. Thanks.
> > I've also heard that it can have some less than desirable side effects.
>
> Amen. Any drug that blocks DA can have some scary side effects.
I've also heard it affects prolactin levels.
> > I also didn't know that about hydergine. I have always thought of it in terms of Ach only. Have you tried it?
>
> You might be thinking of Galantamine, which is a cholinesterase inhibitor.
No, I was thinking about hydergine. I just didn't know enough about it.
> The million dollar question?
> > Dr. Goldstein doesn't address that, does he?
>
> As a matter of fact, I started flipping through the nearly 500 pages of "Tuning the Brain" and managed to find this tasty tidbit...[] are my additions...
>
> "I am being drawn to the conclusion that fatigue is, at least in part, related to NAc [nucleus accumbens] DA release, or the insufficiency thereof. PFC [prefrontal cortex], even mPFC [medial prefrontal cortex] , hypoactivity is common in neurosomatic disorders."
>
> He continues...
>
> "If the mPFC DA is insufficient, there will be hyperglutamatergic input to presynaptic D2 autoreceptors [BINGO!] on mesoaccumbens DA neurons, which is the apparent situation in neurosomatic disorders."
>
> I new it had to do with the EAA's glutamate and/or NMDA. As a matter of fact this is pretty much the thrust of his whole theory. Earlier in the book he says...
>
> "The ultimate goal increasingly appears to be (for most patients) to reduce the sensitivity of the NMDA receptor, one of the primary receptors for the excititory amino acid (EAA) glutamate."
>
> Also,
>
> "...it would make sense to decrease glutamate neurotransmission in a patient who has a disorder of synaptic gating, those who do poorly in high-stimulus environments, such as malls, and those who are overly sensitive to many sensory inputs as is frequently seen in CFS, FMS, IBS, multiple chemical sensitivities (MCS), PMS, and too many other 'esses' than I care to mention."
>
> Oh man do car exhaust and chemical smells kill me. I can smell someone spraying perfume on half a block away! Everyone's always telling me "what are you talking about I don't smell anything." And sure enough someone will come around the corner with a perfume bottle in their hand.
>
> This is turning into the mother of all posts. But that guy in Florida did get back to me and seems pretty real. I believe he may have consulted Dr. Goldstein on the phone but never saw him in person. He said he was lucky to have an alternative type doctor who, although she wasn't too keen on meds., was willing to help him out. As far as Dr. Braverman goes, he did give me the Wellbutrin but I'm not sure he's the guy to try out Goldstein's protocol with. You have to understand it's hard to see the guy in person. You're lucky to get a minute with him. My freind gave him "Tuning the Brain" a few months ago and now he acts like he doesn't remember it. And on his radio show a few weeks back he was virtually quoting from it. It's the ego thing again. But we'll see. If you read my post on the other thread below you'll see my argument as to why a paradoxical response to a stimulant almost has to be due to the autoreceptor. (I'm still waiting patiently for someone to respond to it. Any input will help.) Of course I'm no scientist and Dr. Goldstein does mention a possible problem with the DA transporter (but only in passing). But I doubt I'll ever boost my DA without first using a glutamate/NMDA antagonist. I should pummel my postsynaptic receptors with a stimulant just to make sure they're not just really downregulated. But I doubt this is the case. Ok I'll end this post now before I pass out...You're too funny. What NMDA antagonist do you have in mind? Have you tried memantine? Emme is currently using it in low dose (alone I believe) and has had some success as an antidepressant.
K
Posted by franco neuro on April 7, 2005, at 10:30:35
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 7, 2005, at 3:12:47
Hi Kara,
Well, it's day nine and it's still kicking my butt. I wasn't as tired yesterday but as the evening progressed I got more and more wiped out. It's got to be the norepinephrine. According to Goldstein, NE is itself an NMDA antagonist. Which is probably why the Wellbutrin is helping me with pain. I'm certainly not getting any dopamine boost.
> I have the antibodies also. I read that they are in response to a protein in the thyroid gland and not to the thyroxin itself. (I wouldn't put money on it though.)
Hmm...I'll have to talk to Braverman about this. Are you on any thyroid med?
> Same here but particularly with the APs. I don't think there's any long-term data on low dosage usage of them for depression. Have you considered MAOIs at all?
I have considered MAOI's, but I'd like to work the NMDA/glutamate angle first.
> I've also heard it affects prolactin levels.
Yes since dopamine and prolactin have an inverse relationship, any drug that antagonizes dopamine could raise prolactin.
> No, I was thinking about hydergine. I just didn't know enough about it.
Are you sure you weren't thinking of huperzine? :-)
> What NMDA antagonist do you have in mind? Have you tried memantine? Emme is currently using it in low dose (alone I believe) and has had some success as an antidepressant.
That's the question. I need either a direct NMDA-receptor antagonist or a drug that suppresses glutamate to keep it from stimulating the NMDA-receptor and apparantly dopamine autoreceptors. I haven't tried memantine yet. It's a direct NMDA antagonist, as is amantadine. It can be purchased from an overseas pharmacy, although it's quite expensive. The only one I've tried was Neurontin about 8 years ago. I only took a small dose for a short time but it did help. I should have stayed on it and pushed it up but I had no clue back then. Neurontin is an antagonist at the NMDA glycine receptor. It also should antagonize glutamate to a degree. I'm sure you're aware that it's Dr. Goldstein's #1 oral medication. By the way guaifenesin is also a mild antagonist at the NMDA glycine receptor. I have some and am going to give it another try at Goldstein's recommended dose of 1200mg twice per day.
Than there's Lamictal. It suppresses glutamate output. That's the one that's helping my friend big time. But I'm not sure if it's because he's bi-polar. And Lamictal is a major bi-polar med. But it has ended virtually all of his physical symptoms. It took a few months to kick in and he's up to 400mg but he loves it.
Ketamine is his #1 overall med but he uses it in IV or nose or eye drops, etc. I'm not going to find a doc who'll do that. But it also can be taken in pill form. It's one of those abused drugs so they might be reluctant to prescibe it. His other biggee is IV lidocaine. I might have a doctor who would do that. But it's really not practical.
There's Baclofen which is a GABA B agonist. It's supposed to be really good for multiple chemical sensitivity. Pretty much all of the anti-epilepsy meds block glutamate to some degree.
Also, Goldstein says that histamine may stimulate the NMDA receptor. Which is probably why antihistamines often help with diffuse pain. I've recently discovered this with Benedryl.
I need to get moving with this but without any dopamine it's tough to make a decision and get going. By the way the guy in Florida found relief with a combination of Baclofen, Mirapex, Chlorzoxazon, and Guaifenesin.
It's a vicious circle. NMDA/glutamate over-excitibility decrease dopamine, decreased DA causes NMDA/glutamate to become more excited, which decreases DA more, which...etc.,etc.,etc. Have to break the downward spiral.
Posted by KaraS on April 9, 2005, at 0:13:37
In reply to Re: Read this before answering my previous post » KaraS, posted by franco neuro on April 7, 2005, at 10:30:35
Hi Franco,
>
> Well, it's day nine and it's still kicking my butt. I wasn't as tired yesterday but as the evening progressed I got more and more wiped out. It's got to be the norepinephrine. According to Goldstein, NE is itself an NMDA antagonist. Which is probably why the Wellbutrin is helping me with pain. I'm certainly not getting any dopamine boost.
Sorry to hear that the Wellbutrin is still tiring you out. How long do you plan to trial it? (I wonder if rEEG could have predicted that response. I'm so sick of trying things that don't work out as I'm sure you are too.)
> Hmm...I'll have to talk to Braverman about this. Are you on any thyroid med?
Yes, I have been taking thryoid medication for a few years now. How about you?
> Yes since dopamine and prolactin have an inverse relationship, any drug that antagonizes dopamine could raise prolactin.
I didn't know that either. So you think that amisulpride is probably not any worse in this respect than any other antipsychotic?
> Are you sure you weren't thinking of huperzine? :-)
Nope. I was thinking of hydergine. I just knew it was a "smart drug" so I associated it with Ach. (but thanks for trying to save me :-))
> That's the question. I need either a direct NMDA-receptor antagonist or a drug that suppresses glutamate to keep it from stimulating the NMDA-receptor and apparantly dopamine autoreceptors. I haven't tried memantine yet. It's a direct NMDA antagonist, as is amantadine. It can be purchased from an overseas pharmacy, although it's quite expensive. The only one I've tried was Neurontin about 8 years ago. I only took a small dose for a short time but it did help. I should have stayed on it and pushed it up but I had no clue back then. Neurontin is an antagonist at the NMDA glycine receptor. It also should antagonize glutamate to a degree. I'm sure you're aware that it's Dr. Goldstein's #1 oral medication. By the way guaifenesin is also a mild antagonist at the NMDA glycine receptor. I have some and am going to give it another try at Goldstein's recommended dose of 1200mg twice per day.This may seem like a dumb question, but if you suppress glutamate do you run the risk of increasing anxiety (because glutamate eventually becomes GABA)? Also, if you keep glutamate from stimulating dopamine autoreceptors, does that then lead to downregulation or a decrease in the number of those DA autoreceptors? Guaifenesin is the stuff in cough syrups that is supposed to loosen mucous, right? You can get that in pills? Is it over the counter? I'm very curious as to how that will work for you. Have you thought about acamprosate at all?
> Than there's Lamictal. It suppresses glutamate output. That's the one that's helping my friend big time. But I'm not sure if it's because he's bi-polar. And Lamictal is a major bi-polar med. But it has ended virtually all of his physical symptoms. It took a few months to kick in and he's up to 400mg but he loves it.
Yikes! 400 mg. is a lot of Lamictal, isn't it? I don't remember if your friend is taking anything else besides Lamictal. Have you been diagnosed as bipolar? My doctor thinks I might have a soft bipoloar condition because I haven't responded fully to antidepressants and I have periods of more anxiety/agitation.
> I need to get moving with this but without any dopamine it's tough to make a decision and get going. By the way the guy in Florida found relief with a combination of Baclofen, Mirapex, Chlorzoxazon, and Guaifenesin.Wow. That's quite a cocktail. Has he been on Mirapex for long or is this a new addition? It seems like all of the people on this board who have tried it, developed a great deal of fatigue on it after a while (though not initially).
I hear you about the need to get moving on this. Likewise I can't seem to make treatment decisions either. I also find that I can't concentrate enough to do further research. The small amount of doxepin I'm taking may be adding to the mental fog. I'm really impressed that you're able to study all of this so intensely and comprehend it.
My sister has offered to pay for me to get the rEEG analysis done. I don't know whether to take her up on it. I don't want to waste the money. (I'd also like to be able to pay her back someday but don't know if that will be possible.) Down deep I don't think that anything is really going to help. I'm also afraid that if the scans suggest my best treatment meds, that they would be something that I can't tolerate for some reason. (That would be heartbreaking.) My last concern is the way that success may be defined according to this system. Perhaps an SSRI that lifts mood a lot but doesn't help (or even decreases) motivation would be considered success. I have a friend who was happy as can be on antidepressants but he couldn't get up off of the couch to save his life! Is that "success"?
> It's a vicious circle. NMDA/glutamate over-excitibility decrease dopamine, decreased DA causes NMDA/glutamate to become more excited, which decreases DA more, which...etc.,etc.,etc. Have to break the downward spiral.
How do you know for sure that this pertains to your case? Do you take any supplements like NAC or reduced glutathione to help combat this neurotoxicity?K
Posted by franco neuro on April 9, 2005, at 11:35:19
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 9, 2005, at 0:13:37
Hello there,
> Sorry to hear that the Wellbutrin is still tiring you out. How long do you plan to trial it? (I wonder if rEEG could have predicted that response. I'm so sick of trying things that don't work out as I'm sure you are too.)
Thanks. Actually, I didn't take it this morning. I wanted to give it another week or so but it was too fatiquing. Not sure if the fEEG or Brain Mapping would predict something like that.
>Yes, I have been taking thryoid medication for a few years now. How about you?
I had been taking Braverman's "Pathroid", which is his T3/T4 formula, for about a month but I stopped the last few days on Wellbutrin. Will start again tomorrow morning.
> I didn't know that either. So you think that amisulpride is probably not any worse in this respect than any other antipsychotic?
I think it may be somewhat better. But that's only my humble opinion.
> Nope. I was thinking of hydergine. I just knew it was a "smart drug" so I associated it with Ach. (but thanks for trying to save me :-))
Sure you weren't thinking of arganine? :-)
> This may seem like a dumb question, but if you suppress glutamate do you run the risk of increasing anxiety (because glutamate eventually becomes GABA)?
I don't know. But according to Dr. Braverman's Brain Mapping I'm high in GABA. (Which should also suggest I'm high in glutamate.) You would think being high in GABA would suppress anxiety but it hasn't. It may be because a hyperglutamatergic state trumps GABA's calming effects by it's overstimulation of the NMDA receptor. Too much glutamate initially may cause too much dopamine release in stressfull situations which converts too quickly to NE than epinephrine. This is what over time causes the DA deficit. Glutamate actually does cause DA secretion, but I think it's being chronically elevated is what overstimulates the DA auoreceptors ultimately causing a decrease in dopamine release.
> Also, if you keep glutamate from stimulating dopamine autoreceptors, does that then lead to downregulation or a decrease in the number of those DA autoreceptors?
I think Dr. Goldstein is implying that without glutamate overstimulating the autoreceptors, the synapse will return to a more normal state of affairs. I.e. you would be able to secrete a "proper" amount of DA without the overexcited autoreceptor prematurely shutting down it's release from the presynaptic neuron.> Guaifenesin is the stuff in cough syrups that is supposed to loosen mucous, right? You can get that in pills? Is it over the counter? I'm very curious as to how that will work for you. Have you thought about acamprosate at all?
Yep. It's been used by that Dr. St. Amand for a while but he didn't know how it worked. Dr. Goldstein explains that it antagonizes the NMDA glycine receptor which is why it's helping some CFS FMS patients. It is over the counter. I bought it last year online after reading St. Amands book. I bought it but never bought his theory so I didn't take it. I will try it now.
> Have you thought about acamprosate at all?
No. But it's funny you mentioned it. My friend on the Lamictal is looking for the final ten or twenty percent improvement. So Dr. Braverman suggested Campral.
"Campral (acamprosate) has in vitro affinity for GABA type A and GABA type B receptors, so it's been assumed that the therapeutic effects of acamprosate are due to actions on GABA receptors. However, acamprosate does not share most of the other effects of GABA receptor modifying drugs, such as antianxiety, hypnotic, or muscle relaxant activity. It is therefore possible, perhaps likely, that the effects are mediated some other way. Acamprosate is structurally related to l-glutamic acid (l-gutamate), which is an excitatory neurotransmitter. It's been proposed that acamprosate decreases the effects of the naturally-occurring excitatory neurotransmitter glutamate in the body. Since chronic alcohol consumption disrupts this system, and the changes last many months after alcohol ingestion is stopped, it's possible that acamprosate somehow restores the glutamate system towards normal. It's thought, no matter how it acts, that Campral decreases the pleasant "high" associated with alcohol consumption, and thus decrease the frequency of relapse during abstinence."Sounds like an interesting med. I don't get that nice relaxed feeling after a couple of beers that I used to get. I just feel irritated. However, on the rare occasion when I have 7 or 8 drinks. Like my cousin's wedding a few months ago. I notice that while I have a hard time sleeping and wake up a little woozey, my body also feels better the next day and I'm very horny! I'm still trying to figure out what this means. The alcohol is obviously relieving something in my brain. I found some absracts that say at higher amounts alocohol is indeed a glutamate/NMDA antagonist. And the withdrawal effects that alcoholics have may be due to the increased glutamate/NMDA activity when the alcohol is stopped. Interesting huh?
> Yikes! 400 mg. is a lot of Lamictal, isn't it?
Not really. It is the top of the range, but if you tolerate it well enough at that dose you can cautiously go higher. Even to 600mg or more. My fiend and Dr. Braverman are considering this right now.
> Have you been diagnosed as bipolar? My doctor thinks I might have a soft bipoloar condition because I haven't responded fully to antidepressants and I have periods of more anxiety/agitation.
I was wondering about this, but was almost certain I'm not bipolar. As a matter of fact I wish I were. I haven't had anything approaching hypomania in 20 years. Dr. Barverman gives Millon psychological tests as part of his initial battery of tests. It measures all kinds of psychological problems. I scored over 100 on anxiety and dysthymia (my 2 highest scores) and 0, i repeat, 0, for bipolar. Also zero or near zero for two other bipolar markers. I also came up high for somataform disorder (reflecting physical issues) and compulsiveness. Basically, I think it was spot on. If you do turn up being somewhat bipolar it's all the more reason to try Lamictal.
> Wow. That's quite a cocktail. Has he been on Mirapex for long or is this a new addition? It seems like all of the people on this board who have tried it, developed a great deal of fatigue on it after a while (though not initially).
I need to get more info. as to what order he added them, but I'm pretty sure he took the entire cocktail for about 2 years before he started tapering. He actually gave me his phone number and said I could call him to discuss it if I wanted. As far as I know he's not selling anything and seems quite sincere. I think he's so happy he got well that he wants to help out if he can. I will call him at some point soon, but I don't want to start hounding him and scare him away. :-)
It's hard to get moving. Believe me I've spent so much money on this wild goose chase I don't even want to think about it. I'm not even woking right now. The company that I worked for for 10 years was bought by a competitor and put out of business last year. I'm living off of my savings. I really need to start working again but I'm worried that if I end up trapped in a stressful situation again it'll surely kill me. I'm so stress averse right now. I think that definitely reflect a state of low chatecholamines. I'm not sure if Dr. Goldstein's theory is my problem, but his description of the typical neurosomatic patient fits me perfectly. The genetic predisposition, the childhood stress, the broken right arm at 6 and 14 causing chronic pain (irritating the brain), etc. And how neurosomatic patients are almost incapable of becoming addicted to drugs. Which was backed up on my Millon test. How the SSRI's haven't helped.
But the fact that I did have a couple of almost "normal" days after stopping the Zoloft proved to me that I can feel good agian. And that it is all related to brain chemistry. I'm sure I'll never feel 20 again, but I'll take a healthy 39. We really have no choice but to keep on trying.
Posted by KaraS on April 10, 2005, at 19:45:57
In reply to Re: Read this before answering my previous post » KaraS, posted by franco neuro on April 9, 2005, at 11:35:19
Hello there,
> Thanks. Actually, I didn't take it this morning. I wanted to give it another week or so but it was too fatiquing. Not sure if the fEEG or Brain Mapping would predict something like that.
So you're done with the Wellbutrin completely? How about the CES? Are you usuing that more regularly? I like the idea of it being able to hit so many different neurotransmitters at once without horrible side effects. I really hope that works well.
> I had been taking Braverman's "Pathroid", which is his T3/T4 formula, for about a month but I stopped the last few days on Wellbutrin. Will start again tomorrow morning.
Yes, that's right. You mentioned that previously. What is so unique about his "Pathroid" formula? What is the percentage of T4 to T3?
> > I didn't know that either. So you think that amisulpride is probably not any worse in this respect than any other antipsychotic?
>
> I think it may be somewhat better. But that's only my humble opinion.I had written amisulpride off of my list because someone had posted about the prolactin levels. I really shouldn't have. If I cross off too many things because of some side effects that I don't even know will be a problem for me, then I'm left with very few options. If I get over my fear of APs, then I might also try Abilify. Lately I've read a couple of posts from people having really good results from very low dose of this. My pdoc likes it and was more than willing to prescribe it for me. Wish I weren't such a chicken sh*t!
Have you considered Abilify? Is that only on your list if you need to move beyond the NMDA antagonists?
> > Nope. I was thinking of hydergine. I just knew it was a "smart drug" so I associated it with Ach. (but thanks for trying to save me :-))
>
> Sure you weren't thinking of arganine? :-)Yes, that's it! Arganine. (NOT!)
> > This may seem like a dumb question, but if you suppress glutamate do you run the risk of increasing anxiety (because glutamate eventually becomes GABA)?
>
> I don't know. But according to Dr. Braverman's Brain Mapping I'm high in GABA. (Which should also suggest I'm high in glutamate.) You would think being high in GABA would suppress anxiety but it hasn't. It may be because a hyperglutamatergic state trumps GABA's calming effects by it's overstimulation of the NMDA receptor. Too much glutamate initially may cause too much dopamine release in stressfull situations which converts too quickly to NE than epinephrine. This is what over time causes the DA deficit. Glutamate actually does cause DA secretion, but I think it's being chronically elevated is what overstimulates the DA auoreceptors ultimately causing a decrease in dopamine release.Ok, sounds feasible I think.
> > Also, if you keep glutamate from stimulating dopamine autoreceptors, does that then lead to downregulation or a decrease in the number of those DA autoreceptors?
>
> I think Dr. Goldstein is implying that without glutamate overstimulating the autoreceptors, the synapse will return to a more normal state of affairs. I.e. you would be able to secrete a "proper" amount of DA without the overexcited autoreceptor prematurely shutting down it's release from the presynaptic neuron.I was under the impression that hypersensitive autoreceptors meant that the number of autoreceptors stays the same and they just start overresponding to DA in the synapse. Others here corrected me and said that hypersensitive actually meant that the autoreceptors were too dense - that more of them are created and that's what causes the overresponsiveness. So when you downregulate them, you're actually decreasing the number of autoreceptors.
> > Guaifenesin is the stuff in cough syrups that is supposed to loosen mucous, right? You can get that in pills? Is it over the counter? I'm very curious as to how that will work for you. Have you thought about acamprosate at all?
>
> Yep. It's been used by that Dr. St. Amand for a while but he didn't know how it worked. Dr. Goldstein explains that it antagonizes the NMDA glycine receptor which is why it's helping some CFS FMS patients. It is over the counter. I bought it last year online after reading St. Amands book. I bought it but never bought his theory so I didn't take it. I will try it now.Since I also have CFS I will be very interested to see how the guaifenisen works for you.
> > Have you thought about acamprosate at all?
>
> No. But it's funny you mentioned it. My friend on the Lamictal is looking for the final ten or twenty percent improvement. So Dr. Braverman suggested Campral.
> "Campral (acamprosate) has in vitro affinity for GABA type A and GABA type B receptors, so it's been assumed that the therapeutic effects of acamprosate are due to actions on GABA receptors. However, acamprosate does not share most of the other effects of GABA receptor modifying drugs, such as antianxiety, hypnotic, or muscle relaxant activity. It is therefore possible, perhaps likely, that the effects are mediated some other way. Acamprosate is structurally related to l-glutamic acid (l-gutamate), which is an excitatory neurotransmitter. It's been proposed that acamprosate decreases the effects of the naturally-occurring excitatory neurotransmitter glutamate in the body. Since chronic alcohol consumption disrupts this system, and the changes last many months after alcohol ingestion is stopped, it's possible that acamprosate somehow restores the glutamate system towards normal. It's thought, no matter how it acts, that Campral decreases the pleasant "high" associated with alcohol consumption, and thus decrease the frequency of relapse during abstinence."I will be interested to hear how your friend fares on Campral. Sounds like even if you don't get to see Braverman much while he's off trying to become a star, he does at least come up with some good suggestions.
> Sounds like an interesting med. I don't get that nice relaxed feeling after a couple of beers that I used to get. I just feel irritated. However, on the rare occasion when I have 7 or 8 drinks. Like my cousin's wedding a few months ago. I notice that while I have a hard time sleeping and wake up a little woozey, my body also feels better the next day and I'm very horny! I'm still trying to figure out what this means. The alcohol is obviously relieving something in my brain. I found some absracts that say at higher amounts alocohol is indeed a glutamate/NMDA antagonist. And the withdrawal effects that alcoholics have may be due to the increased glutamate/NMDA activity when the alcohol is stopped. Interesting huh?Yeah. Your reaction to alcohol adds to your theory.
> Not really. It is the top of the range, but if you tolerate it well enough at that dose you can cautiously go higher. Even to 600mg or more. My fiend and Dr. Braverman are considering this right now.
I don't know that much about Lamictal doses - only what I've seen people post here that they take. If your friend isn't 100% yet, then it makes sense to try increasing the Lamictal or augmenting with something else. BTW, does this friend of yours also use the CES device or any other supplements from Dr. B or does he credit his improvement solely to Lamictal?
> > Have you been diagnosed as bipolar? My doctor thinks I might have a soft bipoloar condition because I haven't responded fully to antidepressants and I have periods of more anxiety/agitation.
>
> I was wondering about this, but was almost certain I'm not bipolar. As a matter of fact I wish I were. I haven't had anything approaching hypomania in 20 years. Dr. Barverman gives Millon psychological tests as part of his initial battery of tests. It measures all kinds of psychological problems. I scored over 100 on anxiety and dysthymia (my 2 highest scores) and 0, i repeat, 0, for bipolar. Also zero or near zero for two other bipolar markers. I also came up high for somataform disorder (reflecting physical issues) and compulsiveness. Basically, I think it was spot on. If you do turn up being somewhat bipolar it's all the more reason to try Lamictal.I wonder what my tests would show. I assume that the rEEG would show if there were some bipolarity. At least it would show if I would respond well to Lamictal which would then in itself imply bipolarity. It's nothing I ever considered about myself until recently but it's worth checking out.
> > Wow. That's quite a cocktail. Has he been on Mirapex for long or is this a new addition? It seems like all of the people on this board who have tried it, developed a great deal of fatigue on it after a while (though not initially).
>
> I need to get more info. as to what order he added them, but I'm pretty sure he took the entire cocktail for about 2 years before he started tapering. He actually gave me his phone number and said I could call him to discuss it if I wanted. As far as I know he's not selling anything and seems quite sincere. I think he's so happy he got well that he wants to help out if he can. I will call him at some point soon, but I don't want to start hounding him and scare him away. :-)
Sounds like a nice guy who wants to help others in the same way that he's been helped. Now he saw a doctor who utilized Goldstein's protocols, correct? That's how he came up with that cocktail? (Just want to make sure I'm keeping my facts straight here.)
> It's hard to get moving. Believe me I've spent so much money on this wild goose chase I don't even want to think about it. I'm not even woking right now. The company that I worked for for 10 years was bought by a competitor and put out of business last year. I'm living off of my savings. I really need to start working again but I'm worried that if I end up trapped in a stressful situation again it'll surely kill me. I'm so stress averse right now. I think that definitely reflect a state of low chatecholamines. I'm not sure if Dr. Goldstein's theory is my problem, but his description of the typical neurosomatic patient fits me perfectly. The genetic predisposition, the childhood stress, the broken right arm at 6 and 14 causing chronic pain (irritating the brain), etc. And how neurosomatic patients are almost incapable of becoming addicted to drugs. Which was backed up on my Millon test. How the SSRI's haven't helped.I can totally relate. I'm out of work and was traumatized at a couple of recent jobs. That along with my predisposition to anxiety and depression really put me in a bad state. I'm literally terrified to go back to the workplace. I've been living off of my savings as well. It's not a situation. The only good thing now is that I'm taking a small amount of doxepin which has the anxiety completely under control. A few weeks ago I couldn't eat or sleep because of stress. Just taking a shower was a Herculean feat. Now I'm still quite depressed but I can handle stress and function day to day. So I guess I'm part of the way there. It sure would be nice to get rid of the depression, think clearly and have energy/motivation. It seems to far fetched to even hope for such a cure at this point. Fortunately I come here often and read about others who have had those kinds of drastic improvements. I think that as long as we keep trying to understand, we'll eventually figure it all out and find appropriate solutions.
> But the fact that I did have a couple of almost "normal" days after stopping the Zoloft proved to me that I can feel good agian. And that it is all related to brain chemistry. I'm sure I'll never feel 20 again, but I'll take a healthy 39. We really have no choice but to keep on trying.It really is related to brain chemistry and possibly other things going on in the body physiologically. It will be worth all of the searching when we find something(s) that work for us. Just imagine feeling joy in living again, jumping out of bed in the morning because we can't wait to face the new day! It can happen.
K
Posted by islandangel on April 10, 2005, at 19:52:43
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 10, 2005, at 19:45:57
Hi: I originally posted about being tired on Wellbutrin XL 150mg. I have my first prescription of SR now. My doc prescribed 150mg once a day. I took it this morning and so far so good. I'll know tonight if I am wiped out by 7:00pm. But so far, I don't feel that way. Does anyone know-- if I can split the SR pills? I thought I'd take half at breakfast and half at noon. I don't want to mess up the time release if there is any. I haven't gone to 300mg just because at that level I got very angry and aggressive when I went up to 300mg on the XL.
I appreciate everyone on this thread! :)
Posted by franco neuro on April 11, 2005, at 10:29:12
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 10, 2005, at 19:45:57
Hi Kara,
> So you're done with the Wellbutrin completely? How about the CES?
Yes I stopped the Wellbutrin. I think it might be worth trying again, but I need to get the "fight or flight" DA-NE-E reaction under control first. I do you the CES occasionally and find it somewhat relaxing. They say the more you use it the better.
> What is so unique about his "Pathroid" formula? What is the percentage of T4 to T3?
I'm not sure what the percentages are. He had it written on the prescription. I think it was 2:1 t4 to t3. I'll find out. I'm only taking 1/4 grain.
> Have you considered Abilify? Is that only on your list if you need to move beyond the NMDA antagonists?
I'll try anything at this point.
> I was under the impression that hypersensitive autoreceptors meant that the number of autoreceptors stays the same and they just start overresponding to DA in the synapse. Others here corrected me and said that hypersensitive actually meant that the autoreceptors were too dense - that more of them are created and that's what causes the overresponsiveness. So when you downregulate them, you're actually decreasing the number of autoreceptors.
I think both scenarios can occur. But as far as the autoreceptors go I think it has more to do with hypersensitivity of individual receptors. However, if the amount of neurotransmitter in the synapse is chronically low than the postsynaptic receptors often increase in number in an attempt to make up for the weak "signal". The opposite is also true. If you chronically excrete too much of a specific neurotransmitter the number of postsynaptic receptors may decrease. It's all part of the brain's attempt to maintain homeostasis. Of course for some of us with neurosomatic problems brain it seems the brain has forgotten where homeostasis is.
> Since I also have CFS I will be very interested to see how the guaifenisen works for you.
I've only just started taking it. Goldstein recommends 1200mg of time released twice per day. I don't have time released so I'm trying to spread it out 600mg 4 times per day.
> BTW, does this friend of yours also use the CES device or any other supplements from Dr. B or does he credit his improvement solely to Lamictal?
He uses the CES and likes it. It's funny but he used to be obsessed with health foods and supplements and since the Lamictal started working he doesn't worry about that stuff too much anymore.
> I will be interested to hear how your friend fares on Campral. Sounds like even if you don't get to see Braverman much while he's off trying to become a star, he does at least come up with some good suggestions.
I wish he'd come up with a few good ones for me. :-)
> I wonder what my tests would show. I assume that the rEEG would show if there were some bipolarity. At least it would show if I would respond well to Lamictal which would then in itself imply bipolarity. It's nothing I ever considered about myself until recently but it's worth checking out.
Do you see a pdoc? They should be able to give you the Millon test.
> Sounds like a nice guy who wants to help others in the same way that he's been helped. Now he saw a doctor who utilized Goldstein's protocols, correct? That's how he came up with that cocktail? (Just want to make sure I'm keeping my facts straight here.)
I think he just happened to be lucky enough to have been seeing a doc that was willing to try out Goldstein's protocol with him. He pretty much just started trying meds. Keeping the ones that helped and dropping the ones that didn't. It's best to start with Goldstein's heavy hitters. Neurontin, Lamictal, Baclofen, etc.
> I can totally relate. I'm out of work and was traumatized at a couple of recent jobs. That along with my predisposition to anxiety and depression really put me in a bad state. I'm literally terrified to go back to the workplace.
Boy do I know the feeling.
> The only good thing now is that I'm taking a small amount of doxepin which has the anxiety completely under control.
Glad to here it.
> I think that as long as we keep trying to understand, we'll eventually figure it all out and find appropriate solutions.
That's the plan.
> It really is related to brain chemistry and possibly other things going on in the body physiologically. It will be worth all of the searching when we find something(s) that work for us. Just imagine feeling joy in living again, jumping out of bed in the morning because we can't wait to face the new day! It can happen.
From your keyboard to God's ears.
You know Dr. Goldstein's most effective treatments are IV ketamine and IV lidocaine. I'd really like to give them a try. I may have found a doc who may use them. A friend of my sister's (who is having all kinds of strange physical problems) just went to see him. He's a fairly well know CFS doc in this area. I went to his website and he mentions IV ketamine and also baclofen as possible treatmens, so he's obviously aware of Goldstein's work. I may have to give him a call. I've also started taking a lot of fish oil/borage oil/flax oil to combat the inflamation in my body. Also, TMG and plenty of B vitamins to help lower my homocysteine level. Homocysteine, as I've recently found out, is glutamate/NMDA agonist. There's a lot of fixing to do.
Posted by KaraS on April 13, 2005, at 21:24:07
In reply to Re: Read this before answering my previous post » KaraS, posted by franco neuro on April 11, 2005, at 10:29:12
> Hi Franco,
> Yes I stopped the Wellbutrin. I think it might be worth trying again, but I need to get the "fight or flight" DA-NE-E reaction under control first. I do you the CES occasionally and find it somewhat relaxing. They say the more you use it the better
And not just for relaxation, right? It's also supposed to help with depression I thought.
> I'm not sure what the percentages are. He had it written on the prescription. I think it was 2:1 t4 to t3. I'll find out. I'm only taking 1/4 grain.
So to begin with he had you on Wellbutrin, "Pathroid" and the CES device. Does he have any other plans for you? Have you told him or called his office to say that you've gone off of the Wellbutrin or are you not planning on seeing him anymore?
> I think both scenarios can occur. But as far as the autoreceptors go I think it has more to do with hypersensitivity of individual receptors. However, if the amount of neurotransmitter in the synapse is chronically low than the postsynaptic receptors often increase in number in an attempt to make up for the weak "signal". The opposite is also true. If you chronically excrete too much of a specific neurotransmitter the number of postsynaptic receptors may decrease. It's all part of the brain's attempt to maintain homeostasis. Of course for some of us with neurosomatic problems brain it seems the brain has forgotten where homeostasis is.
...or perhaps for some of us homeostasis is not a healthy place to be. (Since my problems encompass my entire adulthood, I think I'm in this group.)
> I've only just started taking it. Goldstein recommends 1200mg of time released twice per day. I don't have time released so I'm trying to spread it out 600mg 4 times per day.
Any reaction yet on the guaifenisen or is it too early to tell?> He uses the CES and likes it. It's funny but he used to be obsessed with health foods and supplements and since the Lamictal started working he doesn't worry about that stuff too much anymore.
Not so funny. If you feel good then where's the need?
> Do you see a pdoc? They should be able to give you the Millon test.I had been seeing one but couldn't afford it anymore. Recently I did some intake at a free clinic but I've yet to see a doctor. I don't have high hopes though. I imagine he or she will just try to throw the latest SSRI at me or perhaps Cymbalta if I'm lucky.
What is the Millon test? Is it a written questionnaire? Does it take into account the newer definitions of bipolarity that many pdocs are using these days?
> I think he just happened to be lucky enough to have been seeing a doc that was willing to try out Goldstein's protocol with him. He pretty much just started trying meds. Keeping the ones that helped and dropping the ones that didn't. It's best to start with Goldstein's heavy hitters. Neurontin, Lamictal, Baclofen, etc.Definitely need to get a hold of that book!
> > It really is related to brain chemistry and possibly other things going on in the body physiologically. It will be worth all of the searching when we find something(s) that work for us. Just imagine feeling joy in living again, jumping out of bed in the morning because we can't wait to face the new day! It can happen.
>
> From your keyboard to God's ears.:-)
> You know Dr. Goldstein's most effective treatments are IV ketamine and IV lidocaine. I'd really like to give them a try. I may have found a doc who may use them. A friend of my sister's (who is having all kinds of strange physical problems) just went to see him. He's a fairly well know CFS doc in this area. I went to his website and he mentions IV ketamine and also baclofen as possible treatmens, so he's obviously aware of Goldstein's work. I may have to give him a call. I've also started taking a lot of fish oil/borage oil/flax oil to combat the inflamation in my body. Also, TMG and plenty of B vitamins to help lower my homocysteine level. Homocysteine, as I've recently found out, is glutamate/NMDA agonist. There's a lot of fixing to do.I hear you. I'm going to increase my fish oil intake soon. TMG is on my list also. Homocysteine is bad in so many ways. I've been a bit lax with the B vitamins. I'd better start taking them more regularly again. The latest doctor sounds encouraging. Definitely keep me posted as I also have CFS and I think I'm not that far away from you. (I only get CFS attacks periodically these days - unlike when I first was diagnosed. These days I usually get an attack when I'm run down. Now I'm having one but this is the first in a while. But I imagine the treatments you're referring to will do more than just combat the outward physical symptoms of CFS.)
Talk to you later.
K
Posted by islandangel on April 13, 2005, at 22:23:07
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 13, 2005, at 21:24:07
Okay, So here's the update on being tired on Wellbutrin XL. I made the switch to SR earlier this past week,hoping the shorter release would help my extreme tiredness. So far, it seems to be working. I just take 150mg SR in the morning. I notice within an hour after I take it I begin to get sleepy but it doesn't last all day like it did with the XL. I get over that tiredness within a couple of hours. I'm still leaving out Elavil for Fibromyalgia/Fatigue at night because I am sleeping so well I don't really need it. I've also cut out carbohydrates and for some reason it really makes me feel better physically.
Hope you are all doing well!
Posted by franco neuro on April 14, 2005, at 11:42:10
In reply to Re: Read this before answering my previous post » franco neuro, posted by KaraS on April 13, 2005, at 21:24:07
Hi Kara,
I need to use the CES device more. I really bought it for the relaxation, but I guess over time it should help depression too. I'm not sure if the $300 could have been better spent at this point, but what the heck I thought I'd get it anyway.
> So to begin with he had you on Wellbutrin, "Pathroid" and the CES device. Does he have any other plans for you? Have you told him or called his office to say that you've gone off of the Wellbutrin or are you not planning on seeing him anymore?
Actually, the Wellbutrin and thyroid were my suggestions and he just agreed with them. He really hasn't had much to offer. I wish he did because I know he's smart. He made the right call with my friend. But I have to say he pretty much told my friend that he was bipolar and Lamictal is a big bipolar med. So I still don't know if it's the bipolar effect that's helping him or the Goldstein anti-glutamate chronic fatigue stuff. Maybe it's both.
I haven't called Braverman's office. I'm just stuck. I called Dr. Podell's office and the woman said she "wasn't aware" if he was using IV ketamine or IV lidocaine. Good answer. So now I'm back to where do I go from here. Should I call the psychopharmacologist pdoc that's in the yellow pages and is located nearby? Maybe I can persuade him to let me try some of Goldstein's oral meds. Maybe not. Braverman does give IV's in his office but I think they're just vitamin drips. Maybe I can persuade him to give me a ketamine or lidocaine IV. I did find a couple of websites about IV ketamine and how it's being used for chronic pain from RSD (regional sympathetic dystrophy). The only doc I could find is in Arizona. There is a RSD support group in Bloomfield so maybe I can call and ask them. This sucks.
> ...or perhaps for some of us homeostasis is not a healthy place to be. (Since my problems encompass my entire adulthood, I think I'm in this group.)
Me too. But I think somewhere deep down our brain knows where the correct homeostasis is but it just can't get to it.
> Any reaction yet on the guaifenisen or is it too early to tell?
Well I took 1200mg in one dose the other day and I must say my brain felt a little weird. Sort of muffled if that makes sense. I'm going to try an experiment 600mg guaifenesin + 300mg lipoic acid + 1 benedryl all at the same time. They are all NMDA antagonists. I want to see how my brain feels with that combo.
> What is the Millon test? Is it a written questionnaire? Does it take into account the newer definitions of bipolarity that many pdocs are using these days?
It's another psychiatric test. The one Dr. Braverman gives is like the SAT. It's about 175 questions. I'm not sure how up to date it is. The problem is it says my two main issues are anxiety and dysthymia which it says should be treated with serotonin and GABA agonists. But the Brain Mapping says my brain serotonin and GABA are already high and dopamine is low. The dysthymia definitely comes from the chronic physical discomfort. The anxiety I think is part of the whole hypervigilent neurosomatic symptom complex. I shouldn't be anxious with all the serotonin and GABA in my head. So why am I? Back to the NMDA/glutamate theory. Which Braverman's Brain Mapping doesn't check. I don't even know if it can be tested. I'm even thinking of trying Amerge which is a serotonin antagonist considering I felt really good for the couple of days after I stopped Zoloft. I'm going to read through "Tuning the Brain" yet again and make a concise list of the major meds and what they work on.Let me leave you with this cheery tidbit from "Tuning the Brain"...it concerns mice who were bred to have overactive NMDA receptors...
"Because the activity of the NMDA receptor is associated with memory and learning, these mice are smarter than normal ("wild-type") mice but are also more sensitive to pain caused by tissue injury and inflammation."
There you have it. The same thing that's causing us to be anxious, depressed, fatigued and in pain has also made us smarter than the average mouse! A cruel twist of fate indeed...
Posted by franco neuro on April 14, 2005, at 11:43:57
In reply to Re: Tired on Wellbutrin XL followup, posted by islandangel on April 13, 2005, at 22:23:07
Hi,
Glad to hear the SR is working better for you. Keep us posted...
Posted by DumbFox on April 14, 2005, at 12:55:15
In reply to Re: Tired on Wellbutrin XL followup, posted by islandangel on April 13, 2005, at 22:23:07
I began Wellbutrin XL 150mg 2 weeks ago, increasing to 300mg after the first 4 days. I have been extremely exhausted since the first dose. I was prescribed this for ADHD and it is making me worse! I can't focus on anything because I am literally nodding off constantly.
I'm glad to hear you are doing better on the SR version. I am speaking with my doctor's nurse this afternoon and am hoping for a stimulant to add. I have not noticed any improvement in depression or my ADHD symptoms since starting WB, just the extreme fatigue.
Does anyone have a theory on why the XL is making a few of us so tired?
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