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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Emme on July 11, 2004, at 7:35:30
My pdoc prescribed aricept, a chonlinergic drug, to help with cognitive function and, hopefully, depression. One of the listed potential side effects of aricept is depression. I have read that increasing acetylchoine reduces mania and can induce depression. But aricept doesn't seem to be making me more depressed and may even be helping. And from what I understand, SAM-e leads to an increase in acetylcholine So I'm confused about the role of acetylcholine in depression and also in mediating stress response.
Can anyone help me out here? I'm not getting too far trying to work it out.
Thanks
Emme
Posted by linkadge on July 11, 2004, at 8:14:51
In reply to acetylcholine and depression, posted by Emme on July 11, 2004, at 7:35:30
I don't think that acetylcholine plays much role in governing the stress responce (I could be wong).
However, increasing cholinergic function can lead to depression, but I think that this is largely dependant on the level of other chemicals in the brain.
I found that when I attempted to increase acetycholine through lecetin, gingo, choline bitrate etc, it would always make me a little bit depressed. It gave me a sence of uselessness, it was almost like it revealed everything that I didn't know.This may not be the case with you.
I know of a few people that have had antidepressant effects from cognative inhancers, especially when the cognition is slightly abnormal to begin with.
Best of Luck
Posted by SLS on July 11, 2004, at 8:27:30
In reply to acetylcholine and depression, posted by Emme on July 11, 2004, at 7:35:30
Hi Emme.
> My pdoc prescribed aricept, a chonlinergic drug, to help with cognitive function and, hopefully, depression. One of the listed potential side effects of aricept is depression. I have read that increasing acetylchoine reduces mania and can induce depression. But aricept doesn't seem to be making me more depressed and may even be helping.Wonderful!!!!
> And from what I understand, SAM-e leads to an increase in acetylcholine So I'm confused about the role of acetylcholine in depression and also in mediating stress response.
> Can anyone help me out here?Not me.
> I'm not getting too far trying to work it out.
I am not surprised. Were you to, you would surely be published, and probably be eligible for a Nobel Prize.
My doctor, fully aware of the depressogenic potential of donepezil, wanted me to try it anyway. He had his reasons. He approaches neuropsychopharmacology with great sophistication and a photographic memory. The guy is brilliant and with great passion for his work. Still, he considers the brain to be mostly unexplored and poorly understood. To treat it otherwise is childish. Things are changing rapidly, though. I don't think we need to think of it as a black box anymore, but it sure is dark inside.
Keep taking you Aricept and smile.
:-)
- ScottP.S. There was some work in the late 1970s and early 1980s suggesting a cholinergic-dopaminergic balance theory for depression. Remember, it is not only *what* a drug does, but also *where* it does it.
Posted by Emme on July 11, 2004, at 11:10:06
In reply to Re: acetylcholine and depression, posted by SLS on July 11, 2004, at 8:27:30
Hi Scott,
> > My pdoc prescribed aricept, a chonlinergic drug, to help with cognitive function and, hopefully, depression. One of the listed potential side effects of aricept is depression. I have read that increasing acetylchoine reduces mania and can induce depression. But aricept doesn't seem to be making me more depressed and may even be helping.
>
> Wonderful!!!!We'll see if there's any sustained improvement. :) I think that whatever decent mood I have for a few hours is still pretty fragile - it took very little to break it the other night and send me spiraling back down for the rest of the evening.
>> > And from what I understand, SAM-e leads to an increase in acetylcholine So I'm confused about the role of acetylcholine in depression and also in mediating stress response.
>
> > I'm not getting too far trying to work it out.
>
> I am not surprised. Were you to, you would surely be published, and probably be eligible for a Nobel Prize.I always did crave internation recognition. :)
> P.S. There was some work in the late 1970s and early 1980s suggesting a cholinergic-dopaminergic balance theory for depression. Remember, it is not only *what* a drug does, but also *where* it does it.Interesting....I've suspected that I'm not going to find mood control in serotonin regulation and I get some help from things that affect dopamine (in either way, depending on my state).
I'm also taking 250 mg Lamictal, 50 mg or less of SAM-e, 12.5 mg atenolol as needed, xanax as needed, and I'm trying a dash of Keppra if I'm still edgy on top of xanax. Quite the brew, eh?
Here's Emme's current multiple hypotheses about what might be happening. Comments welcome if anything springs to mind for anyone:
1) The 1 mg or less of Aricept I'm taking isn't actually doing anything and what I'm really seeing is a delayed effect of SAM-e, which I started playing with about a month ago. OTOH, Larry Hoover thought that I might not get SAM-e benefit because I've broken the enteric coating by cutting it and it could be destroyed by stomach acid.
2) What the Aricept is doing is making me sleep better and that's providing the benefit. Traz sent me to the State of Unconsciousness, but I was hung over the next day.
3) The aricept might be helping with focus and I feel less unhappy just having a more functional brain and losing some of the really wacky depressive thinking.
4) Okay, now, my depression has made me sluggish and unmotivated, brain-dead, and lacking in any sense of pleasure. I have life circumstance to fuel this. But I've not been properly medicated either. I seem to genuinely need a good kick in the dopamine to get me functional. But it's difficult to perk me up without sending me into orbit.
Furthermore, along with this zombie state I've also been very anxious and panicked, had raw nerves, terrible insomnia (sleeping 4-5 hours a night), brain running in circles too fast to concentrate, a shifted body clock, anger up the wazoo - running into rage at times, and bad noise sensitivity. It's almost like I've had some of the aspects of a mixed state, but with way way more sluggishness. Or is this just a really really anxious depression? Or a new state - call it the Emme state? Anyway, it's hard to figure out how to medicate this. We simmered down some of the anger by increasing Lamictal. Maybe the aricept is calming down some of the symptoms in a way the xanax can't do, and without inducing brain fog. Of course that theory will become moot if I don't sustain an improvement. Updates to follow.
Emme
Posted by SLS on July 11, 2004, at 12:17:08
In reply to Re: acetylcholine and depression » SLS, posted by Emme on July 11, 2004, at 11:10:06
I would be inclined to stop the S-AMe temporarily to see if it is making you more agitated.
- Scott
Posted by Emme on July 11, 2004, at 12:46:34
In reply to Re: acetylcholine and depression, posted by SLS on July 11, 2004, at 12:17:08
> I would be inclined to stop the S-AMe temporarily to see if it is making you more agitated.
I've thought about it. I'm worried about losing the motivational "do things" effect. I've gone too long being an edgy blob and getting nothing done.
BUT, I think I will try your suggestion and drop the SAM-e for the next two days just to see how I do. I'm always hoping for the smallest number of drugs, but the only good days I ever have seem to be the result of 4 or 5 things. Stay tuned for updates. :)
In the meantime, I'm relieved to have at least some improvement. What magic!
I can't remember - did you tell us how it went trying duloxetine?
Emme
Posted by SLS on July 11, 2004, at 13:05:28
In reply to Re: acetylcholine and depression, posted by Emme on July 11, 2004, at 12:46:34
> In the meantime, I'm relieved to have at least some improvement. What magic!Maybe you ought not to change things. Perhaps your irritability is actually the beginnings of an antidepressant response. It can happen that way. I don't know. I wouldn't want you to risk your good response to whatever it is that's working right now.
I'll be seeing my doctor next week. I won't know about duloxetine until then.
- Scott
Posted by Emme on July 14, 2004, at 8:13:58
In reply to Re: acetylcholine and depression, posted by SLS on July 11, 2004, at 13:05:28
Hi Scott,
Well, my mood is holding in that the depression isn't too bad. I'm still trying aricept. But my energy mojo is going a little wonky. I'm jumping out of my skin. My instict is telling me to drop the SAM-e for the moment and up the anti-anxiety things. It's almost like I've been "toggled" into increased jitteriness. Plus, I'm having er...internal disturbances in the digestive tract. The "Emme state" is so unpredictable.
I seee from your other posts that you're feeling pretty discouraged. It's kind of you to try so hard to be responsive to everyone else even while you feel awful. All I can say is the cliched "hang in there". Even if there's a long-term course to a mood disorder and physiologic brain changes typically associated with it, that doesn't say anything about the state of *your* brain or its fate. It's not a foregone conclusion that you won't be able to ultimately thrive and achieve a good life. I always remind myself of people like Winston Churchilll, Abraham Lincoln, Kay Jamison, etc. If they can do it, there will come a day when you can do it. Okay, that's my very sappy pep talk for today.
Emme
> Maybe you ought not to change things. Perhaps your irritability is actually the beginnings of an antidepressant response. It can happen that way. I don't know. I wouldn't want you to risk your good response to whatever it is that's working right now.
>
> I'll be seeing my doctor next week. I won't know about duloxetine until then.
>
>
> - Scott
Posted by Jenbracha on May 11, 2005, at 19:43:50
In reply to SAM-e and Aricept update » SLS, posted by Emme on July 14, 2004, at 8:13:58
Emme,
Any update on the Aricept? Can you share your current experiences on it?
I have been dealing with refractory bipolar and OCD and no meds have helped (only hurt). My doc is now prescribing Aricept to help with my hypervigilent brain and OCD elements of my bipolar and also says it could help with the depression. I am trying to gather as much info as possible before I start the med.
Much thanks,
Jen
> Hi Scott,
>
> Well, my mood is holding in that the depression isn't too bad. I'm still trying aricept. But my energy mojo is going a little wonky. I'm jumping out of my skin. My instict is telling me to drop the SAM-e for the moment and up the anti-anxiety things. It's almost like I've been "toggled" into increased jitteriness. Plus, I'm having er...internal disturbances in the digestive tract. The "Emme state" is so unpredictable.
>
> I seee from your other posts that you're feeling pretty discouraged. It's kind of you to try so hard to be responsive to everyone else even while you feel awful. All I can say is the cliched "hang in there". Even if there's a long-term course to a mood disorder and physiologic brain changes typically associated with it, that doesn't say anything about the state of *your* brain or its fate. It's not a foregone conclusion that you won't be able to ultimately thrive and achieve a good life. I always remind myself of people like Winston Churchilll, Abraham Lincoln, Kay Jamison, etc. If they can do it, there will come a day when you can do it. Okay, that's my very sappy pep talk for today.
>
> Emme
>
>
>
> > Maybe you ought not to change things. Perhaps your irritability is actually the beginnings of an antidepressant response. It can happen that way. I don't know. I wouldn't want you to risk your good response to whatever it is that's working right now.
> >
> > I'll be seeing my doctor next week. I won't know about duloxetine until then.
> >
> >
> > - Scott
>
>
This is the end of the thread.
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