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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by SLS on December 9, 2006, at 14:04:24
Hi.
Riluzole did not help me at all, but...
- Scott
------------------------------------------
Biol Psychiatry. 2006 Dec 1;
[Epub ahead of print]Preliminary Evidence of Riluzole Efficacy in Antidepressant-Treated Patients with Residual Depressive Symptoms.
* Sanacora G,
* Kendell SF,
* Levin Y,
* Simen AA,
* Fenton LR,
* Coric V,
* Krystal JH.Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
BACKGROUND: Excessive glutamatergic neurotransmission may contribute to the pathophysiology of major depressive disorder (MDD). Recent evidence suggests that riluzole and other agents that target glutamate neurotransmission may show antidepressant activity. METHODS: Ten patients with treatment-resistant depression had riluzole added to their ongoing medication regimen for 6 weeks, followed by an optional 6-week continuation phase. Depression and anxiety severity were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Linear mixed models were used to test for a linear trend in HDRS and HARS scores across time with treatment. RESULTS: Subjects' HDRS and HARS scores declined significantly following the initiation of riluzole augmentation therapy. The effect of riluzole was significant at the end of the first week of treatment and persisted for the 12-week duration of the study. CONCLUSIONS: These data suggest that riluzole augmentation produces antidepressant and anxiolytic effects in patients with treatment-resistant depression.
Posted by Tom Twilight on December 9, 2006, at 18:59:20
In reply to Riluzole = glutamate release inhibitor, posted by SLS on December 9, 2006, at 14:04:24
Riluzole sounds great on paper
Unfortunatly I've heard of at least two people who didn't respond, that does included Scott!
I've heard of no one who did respond!
Posted by rovers95 on December 10, 2006, at 19:38:20
In reply to Re: Riluzole = glutamate release inhibitor, posted by Tom Twilight on December 9, 2006, at 18:59:20
> Riluzole sounds great on paper
>
> Unfortunatly I've heard of at least two people who didn't respond, that does included Scott!
> I've heard of no one who did respond!Yeah, but i wouldnt get too dissapointed about that........its so bloody expensive i dont expect many people could afford to try it!!!
however, i heard/hope that its going generic soon!!!
mark
Posted by rovers95 on December 12, 2006, at 19:17:06
In reply to Re: Riluzole = glutamate release inhibitor, posted by rovers95 on December 10, 2006, at 19:38:20
hi scott, when u tried it how much did it cost?! it would be ridiculosly expensive for me to try. I am currently 1 week into a memantine trial and doin better.
i heard there may be generic riluzole on the way, do you know anything about this??
mark
Posted by SLS on December 12, 2006, at 19:29:47
In reply to SLS - riluzole, posted by rovers95 on December 12, 2006, at 19:17:06
> hi scott, when u tried it how much did it cost?!
I don't remember. It was prohibitively expensive. I received some help from my prescription plan.
> I am currently 1 week into a memantine trial and doin better.
Wow. That's great!
> i heard there may be generic riluzole on the way, do you know anything about this??No. I would be surprised to see it go generic. I would think there would be too limited a market for it. I could be wrong, though.
- Scott
Posted by rovers95 on December 12, 2006, at 22:36:40
In reply to Re: SLS - riluzole, posted by SLS on December 12, 2006, at 19:29:47
> > hi scott, when u tried it how much did it cost?!
>
> I don't remember. It was prohibitively expensive. I received some help from my prescription plan.
>
> > I am currently 1 week into a memantine trial and doin better.
>
> Wow. That's great!
>
> > i heard there may be generic riluzole on the way, do you know anything about this??
>
> No. I would be surprised to see it go generic. I would think there would be too limited a market for it. I could be wrong, though.
>
>
> - ScottI think it might be going generic.........i found this!! Perhaps impax feel they can exploit new markets i.e. depression etc.?!
http://sanjose.bizjournals.com/sanjose/stories/2006/11/20/daily39.html?surround=lfn
Hopefully that wil mean i can try it for less!!
Do you know how its NMDA antagonistic properties compare with that of memantine?!
mark
Posted by SLS on December 13, 2006, at 7:27:40
In reply to Re: SLS - riluzole, posted by rovers95 on December 12, 2006, at 22:36:40
> Do you know how its NMDA antagonistic properties compare with that of memantine?!
Riluzole inhibits the release of glutamate so that there is less available to stimulate receptors, including NMDA receptors. Memantine directly blocks NMDA receptors from being stimulated by glutamate. Which is better? I don't know. There is the possibility that there is some importance in reducing the stimulation of the other two types of glutamate receptors (AMPA and Kainate), in which case there might be an advantage to using riluzole.
- Scott
Posted by rovers95 on December 13, 2006, at 21:19:30
In reply to Riluzole = glutamate release inhibitor, posted by SLS on December 9, 2006, at 14:04:24
> Hi.
>
> Riluzole did not help me at all, but...
>
>
> - Scott
>
>
> ------------------------------------------
>
>
> Biol Psychiatry. 2006 Dec 1;
> [Epub ahead of print]
>
> Preliminary Evidence of Riluzole Efficacy in Antidepressant-Treated Patients with Residual Depressive Symptoms.
>
> * Sanacora G,
> * Kendell SF,
> * Levin Y,
> * Simen AA,
> * Fenton LR,
> * Coric V,
> * Krystal JH.
>
> Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
>
> BACKGROUND: Excessive glutamatergic neurotransmission may contribute to the pathophysiology of major depressive disorder (MDD). Recent evidence suggests that riluzole and other agents that target glutamate neurotransmission may show antidepressant activity. METHODS: Ten patients with treatment-resistant depression had riluzole added to their ongoing medication regimen for 6 weeks, followed by an optional 6-week continuation phase. Depression and anxiety severity were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Linear mixed models were used to test for a linear trend in HDRS and HARS scores across time with treatment. RESULTS: Subjects' HDRS and HARS scores declined significantly following the initiation of riluzole augmentation therapy. The effect of riluzole was significant at the end of the first week of treatment and persisted for the 12-week duration of the study. CONCLUSIONS: These data suggest that riluzole augmentation produces antidepressant and anxiolytic effects in patients with treatment-resistant depression.
What dosage did u try? Unable to find the dosage used in the above trial but am i right in thinking
50mg is the therapeutic dosage?!mark
Posted by SLS on December 15, 2006, at 7:14:23
In reply to Re: Riluzole - SLS, posted by rovers95 on December 13, 2006, at 21:19:30
> > Hi.
> >
> > Riluzole did not help me at all, but...
> >
> >
> > - Scott
> >
> >
> > ------------------------------------------
> >
> >
> > Biol Psychiatry. 2006 Dec 1;
> > [Epub ahead of print]
> >
> > Preliminary Evidence of Riluzole Efficacy in Antidepressant-Treated Patients with Residual Depressive Symptoms.
> >
> > * Sanacora G,
> > * Kendell SF,
> > * Levin Y,
> > * Simen AA,
> > * Fenton LR,
> > * Coric V,
> > * Krystal JH.
> >
> > Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
> >
> > BACKGROUND: Excessive glutamatergic neurotransmission may contribute to the pathophysiology of major depressive disorder (MDD). Recent evidence suggests that riluzole and other agents that target glutamate neurotransmission may show antidepressant activity. METHODS: Ten patients with treatment-resistant depression had riluzole added to their ongoing medication regimen for 6 weeks, followed by an optional 6-week continuation phase. Depression and anxiety severity were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Linear mixed models were used to test for a linear trend in HDRS and HARS scores across time with treatment. RESULTS: Subjects' HDRS and HARS scores declined significantly following the initiation of riluzole augmentation therapy. The effect of riluzole was significant at the end of the first week of treatment and persisted for the 12-week duration of the study. CONCLUSIONS: These data suggest that riluzole augmentation produces antidepressant and anxiolytic effects in patients with treatment-resistant depression.
>
>
> What dosage did u try? Unable to find the dosage used in the above trial but am i right in thinking
> 50mg is the therapeutic dosage?!
I used 100mg. It made me feel somewhat worse after only 3 days. However, my case is a pretty poor representation of the average.
- Scott
-------------------------------------------------
Am J Psychiatry. 2004 Jan;161(1):171-4.An open-label trial of riluzole in patients with treatment-resistant major depression.
* Zarate CA Jr,
* Payne JL,
* Quiroz J,
* Sporn J,
* Denicoff KK,
* Luckenbaugh D,
* Charney DS,
* Manji HK.Laboratory of Molecular Pathophysiology and Experimental Therapeutics and the Pathophysiology Branch, Mood and Anxiety Disorders Program, NIMH, Department of Health and Human Services, NIH, Bethesda, MD 20892, USA. zaratec@intra.nimh.nih.gov
OBJECTIVE: This study was conducted to determine the efficacy and safety of riluzole, a glutamate-modulating agent, in patients with recurrent major depression. METHOD: After a 1-week drug-free period, subjects 18 years or older with a diagnosis of recurrent major depression and a Montgomery-Asberg Depression Rating Scale score > or = 20 received riluzole monotherapy (100-200 mg/day) openly for 6 weeks. RESULTS: Nineteen treatment-resistant depressed patients, 53% of whom were classified as having stage 2 treatment resistance or greater, received riluzole at a mean dose of 169 mg/day. Significant improvement occurred during weeks 3 through 6 for all patients and weeks 2 through 6 for completers. CONCLUSIONS: Although preliminary, these results indicate that riluzole may have antidepressant properties in some patients.
Posted by rovers95 on December 17, 2006, at 19:50:39
In reply to Re: Riluzole - SLS, posted by SLS on December 15, 2006, at 7:14:23
Did you use a benzo alongside it????? I say this as when i took klonopin with the memantine the other week i felt very depressed............perhaps a case of no glutamate and too much GABA causing CNS depression!
mark
Posted by SLS on December 21, 2006, at 6:33:15
In reply to Re: Riluzole - SLS, posted by rovers95 on December 17, 2006, at 19:50:39
> Did you use a benzo alongside it????? I say this as when i took klonopin with the memantine the other week i felt very depressed............perhaps a case of no glutamate and too much GABA causing CNS depression!
That's a good thought. How does Klonopin affect you otherwise?
When I took riluzole or memantine, I did not take a benzo along with them.
- Scott
Posted by rovers95 on December 22, 2006, at 2:20:35
In reply to Re: Riluzole - SLS, posted by SLS on December 21, 2006, at 6:33:15
> > Did you use a benzo alongside it????? I say this as when i took klonopin with the memantine the other week i felt very depressed............perhaps a case of no glutamate and too much GABA causing CNS depression!
>
> That's a good thought. How does Klonopin affect you otherwise?
>
> When I took riluzole or memantine, I did not take a benzo along with them.
>
>
> - Scott
I was fine on it before the memantine, if anything it had a v.slight AD effect on me as i did not have the racing thoughts - but memantine for me is more effective than a benzo!!On the GABA glutamate subject, seen as lamictal upregulates GABA and you would also get a similar effect from the riluzole (i.e. also through voltage sensitive sodium channel blockade!)....perhaps this could be a reason for your poor response???!
mark
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