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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by LouisianaSportsman on May 2, 2014, at 21:57:54
Hey, everybody!
I've been spending some nerdy time reading all about amantadine this afternoon, and it looks really interesting. It is an adamantane like memantine.
I loathe to copy and paste from Wikipedia, but it sums up my points so well:
"frequently used to treat the chronic fatigue often experienced by patients with multiple sclerosis. Additionally, there have been anecdotal reports and a small number of pilot studies that show low-dose amantadine as a potential treatment for ADHD. Limited data has shown that amantadine may help to relieve SSRI-induced sexual dysfunction. Some open-label uncontrolled studies have found it to possess value as an adjunct to antidepressant therapy."
^^ Not only that, amantadine might help with the weight gain from my antipsychotics because it decreases prolactin which then influences gonadal and adrenal steroids. There are are a lot of studies where it is combined with olanzapine with some success, some neutral, and some failed.
I think it might be tight: treat the chronic fatigue often experienced by patients with multiple sclerosis (don't have MS, but definitely know what chronic fatigue is for damn sure!) potential treatment for ADHD (anything helps! taking Desoxyn), relieve SSRI-induced sexual dysfunction (Brintellix sexual side effects are very mild (4/10), but I do notice one certain "issue" that is not a big deal), adjunct to antidepressant therapy (currently taking Brintellix).
The MOA:
"Amantadine is a weak antagonist of the NMDA type glutamate receptor, increases dopamine release, and blocks dopamine reuptake. The drug has many effects in the brain, including release of dopamine and norepinephrine from nerve endings. It appears to be a weak NMDA receptor antagonist as well as an anticholinergic, specifically a nicotinic alpha-7 antagonist like the similar pharmaceutical memantine.
Amantadine appears to act through several pharmacological mechanisms, but no dominant mechanism of action has been identified. It is a dopaminergic, noradrenergic and serotonergic substance, blocks monoamine oxidase A and NMDA receptors, and seems to raise beta-endorphin/beta-lipotropin levels."
From what I understand, antagonism of the NMDA receptor reduces glutamate transmission which then results in more dopaminomimetic activity which I presume is responsible in the weight loss effect?
But, it's interesting how some of the dopamine agonist drugs like ropinirole cause compulsive eating and weight gain?
I guess many people indicated for Zyprexa, unlike me, aren't indicated for schedule II stimulants or modafinil, so this is the best they can offer.
I'm currently taking methamphetamine (prescribed) with my Latuda along with 200mg. Topamax. My weight is stabilized, and I'm losing weight at a tortoise pace (1-3) pounds a month. I wouldn't mind something to help me lose weight to where I was before I began taking antipsychotics in the first place (should reach goal by end of 2014), but I like the sound of amantadine; it sounds like a weaker memantine which I'm a big fan of. Would it do many of the same thing it does, e.g. reduce amphetamine tolerance? It does the NMDA stuff, the dopamine stuff, even the nicotonic stuff-- it just doesn't seem as studied. Wikipedia didn't mention the 5-HT3 effects and it was actually hard to info about it, but I dug around on Scholar and amantadine effects 5-HT3 similarly to memantine.
Thoughts? Experiences?
Posted by Beckett on May 3, 2014, at 1:25:17
In reply to Amantadine: Any experiences?, posted by LouisianaSportsman on May 2, 2014, at 21:57:54
Blocking amphetamine tolerance is a holy grail. I wish you luck. If I remember correctly, it was Namanda that I took towards this end without success.
Posted by LouisianaSportsman on May 3, 2014, at 12:20:36
In reply to Re: Amantadine: Any experiences?, posted by Beckett on May 3, 2014, at 1:25:17
> Blocking amphetamine tolerance is a holy grail. I wish you luck. If I remember correctly, it was Namanda that I took towards this end without success.
That sucks.
I'm a little bit worried about this one too for it as it seems to be more of a dopamine reuptake inhibitor comparatively which means it competes with amphetamine's dopamine releasing MOA.
Posted by klein on May 4, 2014, at 14:58:14
In reply to Amantadine: Any experiences?, posted by LouisianaSportsman on May 2, 2014, at 21:57:54
> Hey, everybody!
>
> I've been spending some nerdy time reading all about amantadine this afternoon, and it looks really interesting. It is an adamantane like memantine.
>
> I loathe to copy and paste from Wikipedia, but it sums up my points so well:
>
> "frequently used to treat the chronic fatigue often experienced by patients with multiple sclerosis. Additionally, there have been anecdotal reports and a small number of pilot studies that show low-dose amantadine as a potential treatment for ADHD. Limited data has shown that amantadine may help to relieve SSRI-induced sexual dysfunction. Some open-label uncontrolled studies have found it to possess value as an adjunct to antidepressant therapy."
>
> ^^ Not only that, amantadine might help with the weight gain from my antipsychotics because it decreases prolactin which then influences gonadal and adrenal steroids. There are are a lot of studies where it is combined with olanzapine with some success, some neutral, and some failed.
>
> I think it might be tight: treat the chronic fatigue often experienced by patients with multiple sclerosis (don't have MS, but definitely know what chronic fatigue is for damn sure!) potential treatment for ADHD (anything helps! taking Desoxyn), relieve SSRI-induced sexual dysfunction (Brintellix sexual side effects are very mild (4/10), but I do notice one certain "issue" that is not a big deal), adjunct to antidepressant therapy (currently taking Brintellix).
>
> The MOA:
>
> "Amantadine is a weak antagonist of the NMDA type glutamate receptor, increases dopamine release, and blocks dopamine reuptake. The drug has many effects in the brain, including release of dopamine and norepinephrine from nerve endings. It appears to be a weak NMDA receptor antagonist as well as an anticholinergic, specifically a nicotinic alpha-7 antagonist like the similar pharmaceutical memantine.
>
> Amantadine appears to act through several pharmacological mechanisms, but no dominant mechanism of action has been identified. It is a dopaminergic, noradrenergic and serotonergic substance, blocks monoamine oxidase A and NMDA receptors, and seems to raise beta-endorphin/beta-lipotropin levels."
>
> From what I understand, antagonism of the NMDA receptor reduces glutamate transmission which then results in more dopaminomimetic activity which I presume is responsible in the weight loss effect?
>
> But, it's interesting how some of the dopamine agonist drugs like ropinirole cause compulsive eating and weight gain?
>
> I guess many people indicated for Zyprexa, unlike me, aren't indicated for schedule II stimulants or modafinil, so this is the best they can offer.
>
> I'm currently taking methamphetamine (prescribed) with my Latuda along with 200mg. Topamax. My weight is stabilized, and I'm losing weight at a tortoise pace (1-3) pounds a month. I wouldn't mind something to help me lose weight to where I was before I began taking antipsychotics in the first place (should reach goal by end of 2014), but I like the sound of amantadine; it sounds like a weaker memantine which I'm a big fan of. Would it do many of the same thing it does, e.g. reduce amphetamine tolerance? It does the NMDA stuff, the dopamine stuff, even the nicotonic stuff-- it just doesn't seem as studied. Wikipedia didn't mention the 5-HT3 effects and it was actually hard to info about it, but I dug around on Scholar and amantadine effects 5-HT3 similarly to memantine.
>
> Thoughts? Experiences?Hi L.,
I've tried amantadine for motivation etc. Powerful stuff and it feels very different from memantine.
Before you get excited ;) keep in mind that AAPs seem to interfere with it's MOA, which makes sense. At least that's what I experienced, they just blocked it. I think this is mentioned in the package insert too. !!!Maybe this can be used to your advantage though.
When I took it without AAPs it definitely worked, but in an unpleasant way. It gave me wicked insomnia (even my Dormicum didn't work) and some anxiety. I felt very awake but unfocused.. all over the place, really.
Uhmmmm... It definitely reversed SSRI-induced sexual dysfunction. Again, it wasn't a nice feeling, let's just say that I couldn't get enough (sorry if that's too coarse)
Now I'm thinking that a lower dose might have worked better, when I use it (it's otc where I'm living atm) I usually take 200-300mg. Maybe 50mg BID?
It worked within 2 weeks.
It has a really high toxic index, something like 800mg so you need to keep track of your dose.
I'm not sure about the NMDA thing, memantine might be a better choice in that regard.
Posted by klein on May 4, 2014, at 15:05:41
In reply to Amantadine: Any experiences?, posted by LouisianaSportsman on May 2, 2014, at 21:57:54
There's a natural (yet very powerful) option for weight loss and added energy, "yerba maté". It's a drink from South America, google it. Coffee without the jitters. Among other things, mate a *very* weak MAOI, it has a strange regulating effect on anxiety (it heightens energy yet it soothes anxiety - you can even take it before bedtime), lowers triglycerides cholesterol glu, antioxidant etc.
My doc okayed it. I drink it by the gallon for its antidepressant and anxiolytic effect. With added sweetener or sugar, it's delicious. No interactions with my meds despite it's putative action on MAO.
I'm not weight conscious (always been rail thin, though certain meds do make me gain weight) but I have noticed weight loss since I started drinking it about a year ago. I wouldn't call it an anorectic outright, it simply lowers your hunger a bit and apparently toys with your glucose blood levels.
It's readily available in the US, Celestial Seasoning's "Morning Thunder" tea has a bit of mate.
Any Qs, ask away ;)
Posted by phidippus on May 4, 2014, at 20:40:29
In reply to Amantadine: Any experiences?, posted by LouisianaSportsman on May 2, 2014, at 21:57:54
Amantadine was like a placebo for me. I didn't notice anypsychological effects. Its MOA is weak overall - doing several things but none well. Go ahead try it, but I bet you won't feel a thing.
Eric
Posted by Jeroen on May 4, 2014, at 23:25:46
In reply to Amantadine: Any experiences?, posted by LouisianaSportsman on May 2, 2014, at 21:57:54
Amantadine has an anti depressant properties
but it can give you psychosisi'm not trying to scare you but that's what my old pdoc said
Posted by Dr. Bob on May 8, 2014, at 22:16:29
In reply to Re: Amantadine: Any experiences? - weight » LouisianaSportsman, posted by klein on May 4, 2014, at 15:05:41
> There's a natural (yet very powerful) option for weight loss and added energy, "yerba maté".
There might be interest at Psycho-Babble Alternative, so I've reposted this there:
http://www.dr-bob.org/babble/alter/20131226/msgs/1065389.html
Bob
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