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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on October 25, 2006, at 18:41:16
In reply to Re: Lyrica left me feeling worse., posted by Crazy Horse on October 25, 2006, at 17:58:11
Hi Monte.
> Scott, I apologise for not posting earlier..I have not been to the PB website for about a week. I am sorry Lyrica didn't work for you, and now you feel even worse. Why not try ECT Scott?
I had a series of treatments in 1991.
> I had 22 treatments in 1997..and they helped me very much.
Wow. What kind? Unilateral? Bilateral? Right or left?
How many treatments did it take before you began to feel better?
How long did the improvement last for?
I actually experienced a few hours of improvement after my fifth treatment. It was very encouraging. However, I saw no further response despite ten more treatments.
I am actually beginning to consider VNS more seriously. I never thought I would. I am also hoping that rTMS will become available relatively soon. Of course, rTMS is non-invasive and would probably make more sense to wait for.
- Scott
Posted by Phillipa on October 25, 2006, at 19:40:24
In reply to Re: Lyrica left me feeling worse. » Crazy Horse, posted by SLS on October 25, 2006, at 18:41:16
Scott which meds would you take do you think if you decided on VNS? Love Jan
Posted by zeugma on October 25, 2006, at 20:13:18
In reply to Re: Lyrica left me feeling worse. » SLS, posted by Phillipa on October 25, 2006, at 19:40:24
it seems like this might be implicated in your pathology.
perhaps it would be worth learning more about this ion.
It seems that NMDA receptor activation allows Ca2+ influx, and NMDA antagonists are thought to have AD properties. I'm just thinking out loud.
-z
Posted by corafree on October 25, 2006, at 20:18:05
In reply to Re: Lyrica left me feeling worse. » corafree, posted by SLS on October 25, 2006, at 18:19:00
Tks 4 bein' nice 2 me. Don't deserve much after 'my whiney reaction' this a.m.
I've seen quite a few pain docs. I'm on Flexeril 3xday, Voltaren 2x day, oxycodone 7.5/500or325 3x a day, Soma 50mg h.s., Lyrica 75mg h.s. Then on two psych meds.
I've seen quite a few pain docs. Only trigger points are effective and I'm not a surgical candidate.
One pain doc I saw (just got folder out), I grabbed a pen when he started talking and I've written here on his flyer I brought home, amitriptyline and Keppra. I don't know anything re: Keppra. Just FYI.
As 2 Lyrica, I don't have bad side effect on 75mg h.s. But, did when increased. Tried taking during day, NOT.
Neurontin, bad side effect, can't recall, d.c.'d.; same w/ Topomax.
love, cf
Posted by zeugma on October 25, 2006, at 20:23:06
In reply to Re: Lyrica left me feeling worse. » SLS, posted by corafree on October 25, 2006, at 20:18:05
cf,
I don't know about Keppra, but amitriptyline is a potent analgesic, as is its metabolite nortriptyline.
So you'll get to see if you like the TCA's.
-z
Posted by corafree on October 25, 2006, at 20:36:39
In reply to Re: Lyrica left me feeling worse. » corafree, posted by zeugma on October 25, 2006, at 20:23:06
No Z. I'm stickin' w/ Eff-XR. I tried amitriptyline in the past and d.c.'d 4 some reason, and more recently Norpramin as didn't feel lift of mood.
love, cf
Posted by Crazy Horse on October 25, 2006, at 21:27:21
In reply to Re: Lyrica left me feeling worse. » Crazy Horse, posted by SLS on October 25, 2006, at 18:41:16
>
>
> How many treatments did it take before you began to feel better?
> I began to feel better after about the 14th treatment.
> How long did the improvement last for?
> Well the treatments were back in 1997 and since then i have never been as severely depressed as i was before the ECT treatments. After the treatments and with Paxil and other augmentation agents on board i got about 2 years of depression free living, but even now and then when i do have a depressive episode they are never as horrible as the pre ECT depression. Is that because of the treatments or the meds?..i don't know. I do know that Lyrica makes me feel better then ANY med i have ever been on..and that is a lot of dif meds. :) I'm so sorry it didn't help you.-Monte
Posted by SLS on October 26, 2006, at 8:34:46
In reply to Ca2+, posted by zeugma on October 25, 2006, at 20:13:18
> it seems like this might be implicated in your pathology.
>
> perhaps it would be worth learning more about this ion.
>
> It seems that NMDA receptor activation allows Ca2+ influx, and NMDA antagonists are thought to have AD properties. I'm just thinking out loud.
I heard you all the way from here!One time, I took 1000mg of calcium supplement. I felt horribly more depressed within 1/2 hour. I've been too afraid to repeat the experiment. Does that make any sense?
- Scott
Posted by SLS on October 26, 2006, at 8:46:06
In reply to Re: Lyrica left me feeling worse. » SLS, posted by corafree on October 25, 2006, at 20:18:05
> Tks 4 bein' nice 2 me. Don't deserve much after 'my whiney reaction' this a.m.
I was upset at the possibility that I had overlooked your previous post. It happens quite frequently that I simply don't have the mental energy to attend to them all. So, for future reference, please don't take it personally should I not respond to one of your posts. It usually means that I either missed it or that I just didn't have the additional energy to reply to it.
> I've seen quite a few pain docs.I'm sorry that I don't remember exactly what you are suffering from. Is fibromyalgia in there somewhere?
Nortriptyline is not the same as Norpramin (desipramine). Nortriptyline is the daughter drug of amitriptyline and tends to be a more pleasant drug to deal with than desipramine.
I can't believe how many drugs you are taking. No wonder you are burned-out on them.
- Scott
Posted by deniseuk190466 on October 26, 2006, at 12:13:32
In reply to Lyrica left me feeling worse., posted by SLS on October 21, 2006, at 17:06:31
Scott,
Just want to say, I'm really sorry that the Lyrica didn't work for you, I'm waiting for the day when you post on this board saying how great you feel.
I hope you feel better than you do now soon, at least you know it's the lyrica that's caused this set back so hopefully in a couple of weeks you will feel a bit better.I know what you mean about the VNS, I would seriously think about it myself but the statistics on it don't look that great. However, there are some people it really seems to have helped.
I'm not sure how bad you were feeling before trying out the Lyrica or what risks you would consider taking in order to feel really truly well. But would you consider something like Deep Brain Stimulation? I know the samples have been small so far but the results seem to be really promising.
Anyway, if you don't answer that's fine just wanted to say something as you've always been so encouraging and reassuring with me and I only seem to post on this board to whinge and moan (refer to my next post for more whinging :-))
Denise
Posted by zeugma on October 26, 2006, at 13:17:17
In reply to Re: Ca2+ » zeugma, posted by SLS on October 26, 2006, at 8:34:46
it makes perfect sense that you would not want to repeat the experiment. Calcium is an intensely aversive stimulus for you.
As to underlying pathology, I don't know. Sigma-1 agonists are theorized by some to be antidepressant, and it appears that they slow K+ efflux and speed Ca2+ efflux from cells. Have you ever noticed an effect on your mood from any other mineral (potassium especially?).Looking on notes I took last summer, it seems AMPA receptor stimulation phosphorylates Na+ and K+ channels, and NMDA stimulation phosporylayes K+ and Ca2+ channels. That's why the Polish pharmacologists (who are the main source of interest in the "NMDA hypothesis" of depression) recommend amantadine and similar drugs for augmentation.
since my computer has lost its ability to cut and [paste, i will summarize a fragment. They hypothesize that amantadine and sigma ligands synerdize with AD's chiefly via D2/D3 receptors and alpha-1 adrenoceptors. D2 signalling is thought to be responsible for attentional flexibility, as well as being anti-anhedonic/motivational. What is your cognitive phenotype? (I've been reading these articles too long.) Excessive D2 is thought to create 'flexible but unstable' representations, while excessive D1 creates an inability to process novel information due to the excessive stabilty of the cognitive representations. D1 receptors physically interact (not just colocaloze) with NMDA receptors; it seems the D1 receptors randomly drift in the cellular space until 'trapped' by NMDA receptors. This probably explains why D1 receptors couple to so many second messenger systems.
in any case, if you google 'amantadine' and 'antidepressants', you will come with a lot of this stuff :-)
But I am just trying to think of what the pattern is to your AD (or dysphoric) responses. I have a close friend who had a severely dysphoric reaction to Wellbutrin, and some researchers at Lilly found that adding bupropion to clozapine potentiated NMDA function in the PFC. Do you have OCD-like symptoms, or is it closer to the cognitive chaos of ADHD?
Sorry of these questions are too personal; feel free not to answer them. You can clearly see the perseveration in my own thought process :-)
-z
Posted by ed_uk on October 26, 2006, at 13:54:32
In reply to Re: Ca2+ » zeugma, posted by SLS on October 26, 2006, at 8:34:46
>One time, I took 1000mg of calcium supplement. I felt horribly more depressed within 1/2 hour.
Have you ever taken a magnesium supplement? How did you react?
Ed
Posted by corafree on October 26, 2006, at 13:59:18
In reply to Re: Ca2+ » zeugma, posted by SLS on October 26, 2006, at 8:34:46
Z & S:
This is 'way over my head', but if U take 1000mg calcium, u might need take double dose(?) magnesium alongside it.
Posted by zeugma on October 26, 2006, at 13:59:51
In reply to Re: Ca2+ » SLS, posted by ed_uk on October 26, 2006, at 13:54:32
Ed, you read my mind!
Personally, I reacted badly to magnesium.
But the effect could just as easily been a GI disturbance as a psychotropic effect.
-z
Posted by corafree on October 26, 2006, at 14:11:27
In reply to Re: Lyrica left me feeling worse. » corafree, posted by SLS on October 26, 2006, at 8:46:06
S - I was attacked and thrown around. C2-3, 3-4, 4-5 were damaged. Most damage @ C4-5 w/ signal on MRIs.
It's hard 2 tell if have fibromyalgia or not, as the injury occurred same time proximity as it would have onset.
I'm also on levothroid and estrogen patch.
Yep ... just dump daily pill supply out on my bed in a.m. 2 gather up my morn' cocktail.
I am doing well. Having my coffee.
I haven't forgotten nortriptyline and have 'stored in memory bank as possibility in the future'. Yes; this I've not been on b4.
Someday let me know why steer clear of Eff-XR.
4now,tksS, cf
Posted by linkadge on October 26, 2006, at 17:01:06
In reply to Re: Lyrica left me feeling worse. » SLS, posted by corafree on October 26, 2006, at 14:11:27
SLS reacts well to NRI's (?). Isn't there a intricate relationship between noradrenaline and glutamatergic function?
Some studies linked positive response to TCA's with a dramatically increased affinitity of zinc to hippocampal neurons. I found zinc to be a better antidepressant than magnesium. Both are NMDA antagonists, but magnesium decreases BDNF while zinc upregulates it. Zinc also increases BCL-2 like lithium. BCL-2 increase supposedly has antidepressant effect. Valproate also increases BCL-2, but not other mood stabilizers.
BCL-2 transgenic mice (with dramatically increased BCL-2), seem to have low anxiety. BCL-2 may be a target for anxiety disorders. The ratio of certain members of the BCL-2 antiapoptotic/apoptotic family has a big influence on apoptosis and anxonal regeneration.
Linkadge
Posted by SLS on October 26, 2006, at 23:35:04
In reply to Re: Ca2+ » SLS, posted by zeugma on October 26, 2006, at 13:17:17
> Sigma-1 agonists are theorized by some to be antidepressant, and it appears that they slow K+ efflux and speed Ca2+ efflux from cells.
I am not that familiar with sigma receptors. Where are they located and what are their function?
> Have you ever noticed an effect on your mood from any other mineral (potassium especially?).
I find magnesium calming.
> Looking on notes I took last summer, it seems AMPA receptor stimulation phosphorylates Na+ and K+ channels, and NMDA stimulation phosporylayes K+ and Ca2+ channels. That's why the Polish pharmacologists (who are the main source of interest in the "NMDA hypothesis" of depression) recommend amantadine and similar drugs for augmentation.
I responded briefly to memantine. I wish I had thought to augment it with magnesium. It would have been an interesting experiment.
> since my computer has lost its ability to cut and [paste, i will summarize a fragment. They hypothesize that amantadine and sigma ligands synerdize with AD's chiefly via D2/D3 receptors and alpha-1 adrenoceptors. D2 signalling is thought to be responsible for attentional flexibility, as well as being anti-anhedonic/motivational. What is your cognitive phenotype?
Dumb and dumber.
> (I've been reading these articles too long.) Excessive D2 is thought to create 'flexible but unstable' representations, while excessive D1 creates an inability to process novel information due to the excessive stabilty of the cognitive representations.
I would be excessive D1, then.
> in any case, if you google 'amantadine' and 'antidepressants', you will come with a lot of this stuff :-)
I still have some amantadine lying around. Maybe I'll try adding it to an MAOI. What is the "latest" as to what amantadine does physiologically?
> But I am just trying to think of what the pattern is to your AD (or dysphoric) responses. I have a close friend who had a severely dysphoric reaction to Wellbutrin,
I would characterize my reaction to Wellbutrin as being moderately dysphoric.
> and some researchers at Lilly found that adding bupropion to clozapine potentiated NMDA function in the PFC. Do you have OCD-like symptoms, or is it closer to the cognitive chaos of ADHD?
I would say the OCD.
Thanks for "perservering".
:-)
- Scott
Posted by SLS on October 26, 2006, at 23:49:30
In reply to Re: Lyrica left me feeling worse., posted by deniseuk190466 on October 26, 2006, at 12:13:32
Hi Denise.
> Just want to say, I'm really sorry that the Lyrica didn't work for you, I'm waiting for the day when you post on this board saying how great you feel.
Yeah. Won't that be cool.
> I hope you feel better than you do now soon, at least you know it's the lyrica that's caused this set back so hopefully in a couple of weeks you will feel a bit better.
Today was a little lighter than yesterday. Maybe tomorrow will be a little lighter still.
> I know what you mean about the VNS, I would seriously think about it myself but the statistics on it don't look that great. However, there are some people it really seems to have helped.
Statistics are disappointing but testimonials are compelling.
> I'm not sure how bad you were feeling before trying out the Lyrica or what risks you would consider taking in order to feel really truly well. But would you consider something like Deep Brain Stimulation?
I think I would wait a few years before going with that. From what I understand, they are starting to receive reports of adverse cognitive side effects with DBS including decreased verbal fluency, decline in executive functions, verbal learning, and memory. A friend of mine received a Biological Therapies in Psychiatry newsletter describing this.
> I know the samples have been small so far but the results seem to be really promising.
For some types of depression, I think Brodman Area 25 is the right target. I hope that they will soon find some way of testing a prospect for hyperexcitability in that area before committing them to the procedure.
> Anyway, if you don't answer that's fine just wanted to say something as you've always been so encouraging and reassuring with me and I only seem to post on this board to whinge and moan (refer to my next post for more whinging :-))
Thanks, Denise.
I look forward to your venting.
Take care.
- Scott
Posted by SLS on October 26, 2006, at 23:53:21
In reply to Re: Ca2+ » SLS, posted by ed_uk on October 26, 2006, at 13:54:32
> >One time, I took 1000mg of calcium supplement. I felt horribly more depressed within 1/2 hour.
>
> Have you ever taken a magnesium supplement? How did you react?
I found it calming and pleasant. I didn't receive an antidepressant effect from it. But then again, I didn't take it for more than a week. Maybe I should try again?
- Scott
Posted by SLS on October 27, 2006, at 0:05:08
In reply to Re: Lyrica left me feeling worse., posted by linkadge on October 26, 2006, at 17:01:06
Hi Linkadge.
> SLS reacts well to NRI's (?).
Actually, I reacted adversely to reboxetine. It exacerbated my depression severely and made me suicidal. Also, I find imipramine and nortriptyline better for me than desipramine. It seems that a mixture of 5-HT and NE reuptake inhibition produces a better effect for me than a selective NE reuptake inhibition.
> Isn't there a intricate relationship between noradrenaline and glutamatergic function?
I don't know how that works other than to characterize NE as being generally excitatory upon GLU pathways.
> Some studies linked positive response to TCA's with a dramatically increased affinitity of zinc to hippocampal neurons. I found zinc to be a better antidepressant than magnesium.
What dosage of zinc did you find helpful?
> Both are NMDA antagonists, but magnesium decreases BDNF while zinc upregulates it. Zinc also increases BCL-2 like lithium. BCL-2 increase supposedly has antidepressant effect. Valproate also increases BCL-2, but not other mood stabilizers.
Thanks for this information.
- Scott
Posted by zeugma on October 27, 2006, at 5:00:16
In reply to Re: Ca2+, posted by SLS on October 26, 2006, at 23:35:04
I had been wondering how SSRI's work on OCD when it seemed (following Robbins and Cools) that the OCD cognitive phenotype was insufficient D2 striatal stimulation. Fluvoxamine, which is also a sigma-1 agonist (Ki=36 nM) apparently leads to to a 7-10% upregulation of raclopride binding in the D2 receptors of the striatum in OCD patients.
This is very simplistic of course. But it was found that while 6-OH-dopamine lesions had no effect on the behavioral effects of NRI's, they blocked the effects of SSRI's in animal models.
I will post on the location and function of sigma-1 receptors later. The truth is that they are myststerious- sigma-knockout mice exhibited no evident abnormalities, and apparently these receptors share no homology with any other known type of receptor. Sigma-1 ligands are also famous for narrow, bell-shaped dose curves, which has probably made it difficult for these ligands to have their functions clarified.
-z
Posted by zeugma on October 27, 2006, at 17:26:05
In reply to brief note on OCD » SLS, posted by zeugma on October 27, 2006, at 5:00:16
believed to be implicated in AD effects: in the hippocampus.
-z
Posted by Phillipa on October 27, 2006, at 18:35:44
In reply to Re: brief note on sigma-1 receptors, posted by zeugma on October 27, 2006, at 17:26:05
Gee I never realized vitamins especially Calcium and Magnesium could be detrimental too. So then why do they tell people to take Calcium and magnesium in a l:2 ratio of bone health? I'm confused here. Love Phillipa
Posted by linkadge on October 28, 2006, at 7:15:12
In reply to brief note on OCD » SLS, posted by zeugma on October 27, 2006, at 5:00:16
I was under the impression that sigma-1 receptors were involved in certain forms of neurite outgrowth. Supposedly, that in the presence of NGF, sigma receptors have some neurotrophic action. Sigma agonists are "smart drugs" are they not.
Linkadge
Posted by SLS on October 28, 2006, at 7:45:33
In reply to Re: brief note on OCD, posted by linkadge on October 28, 2006, at 7:15:12
> Sigma agonists are "smart drugs" are they not.
I could use as much as I can get my hands on right now. I'm as dumb as dirt.
On a somewhat related note, my doctor decided it was time to give Emsam a try. I don't expect much from it other than a lot of irritated skin.
- Scott
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