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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Dinah on August 20, 2008, at 19:01:10
I long ago figured out that most of my problems have to do with acetylcholine. IBS, migraine, anxiety. And rhinorrhea with at least some of my sudden migraines, and also just prior to orgasm. If I look into all of these things, they are related to acetylcholine and a hair trigger parasympthetic nervous system. (Am I understanding that right? I'm no expert on neurotransmitters.) I always said that my DSM IV diagnosis should be "nervous system like an overly inbred cocker spaniel".
I'm sure I asked about this before, but have they made any inroads in this area? Any new developments?
And just as an aside, is there some link between this and my fondness for Risperdal (and Thorazine in my younger days)? I know the antipsychotics target dopamine. Is there some relationship between dopamine and acetylcholine?
I don't think I'll ever understand this stuff. But it's frustrating to see everything linked together with this one neurotransmitter - right down to the rhinorrhea that no one has ever heard of - and not be able to figure out how that understanding can help me.
Posted by SLS on August 21, 2008, at 2:05:49
In reply to Acetylcholine - Any new developments?, posted by Dinah on August 20, 2008, at 19:01:10
> I long ago figured out that most of my problems have to do with acetylcholine. IBS, migraine, anxiety. And rhinorrhea with at least some of my sudden migraines, and also just prior to orgasm. If I look into all of these things, they are related to acetylcholine and a hair trigger parasympthetic nervous system. (Am I understanding that right? I'm no expert on neurotransmitters.) I always said that my DSM IV diagnosis should be "nervous system like an overly inbred cocker spaniel".
>
> I'm sure I asked about this before, but have they made any inroads in this area? Any new developments?
>
> And just as an aside, is there some link between this and my fondness for Risperdal (and Thorazine in my younger days)? I know the antipsychotics target dopamine. Is there some relationship between dopamine and acetylcholine?
You are an incredibly smart woman. Yes, there is a delicate balance between ACh and DA, the disturbance of which has been thought to cause depression. I really don't have much more to offer you in terms of understanding your illness, but I don't doubt your intriguing conclusions will provoke more thought.The other possibility is that you have an overactive sympathetic nervous system. Fight or flight. This usually produces dry mouth, dizziness, rapid heartbeat, blurred vision, reduced peristalsis, and even headache associated with orgasm. Sex prior to orgasm involves the activation of the parasympathetic nervous system. However, orgasm itself is a sympathetic event.
I am confused at this point.
Do tricyclics make things better or worse?
- Scott
Posted by Dinah on August 21, 2008, at 9:00:46
In reply to Re: Acetylcholine - Any new developments? » Dinah, posted by SLS on August 21, 2008, at 2:05:49
Not smart enough to understand any of this. :)
I just did a search on the rhinorrhea, which lead to vascular rhinitis, which led to actylcholine, and all these health issues that I have popped up as being related. IBS, migraines, gerd, a high correlation with anxiety and depression. Then there was this interesting study.
http://www.biopsychiatry.com/acetph.htm
My psychiatrists have always ruled out borderline personality disorder with me, but I've always identified with portions of the descriptions. And I've always thought it was a sloppy diagnosis since surely it involves both an underlying physiological condition, and a characteristic way of coping with it?
The thing that throws me off a bit is that they describe the vascular rhinitis as happening after orgasm, and mine is definitely before orgasm and ends with orgasm.
As far as dopamine goes... Well, I've always been sort of annoyed that depression or anxiety is considered sufficient diagnosis. They have identified a number of different sorts of headaches, caused by different things, and requiring different treatments. The same was true of vertigo. Wouldn't it be at least as true of anxiety and depression? I know there aren't the physical tests that they have for headaches or vertigo. But surely they can find other ways of making more delicate distinctions? Things like comorbidity, or the response to different medications.
It's because of that belief on my part that I'm interested in my enormously positive reaction to antipsychotics, which affect dopamine, and my enormously negative response to norepinephrine affecting medications like Effexor, Wellbutrin, and nortriptyline. Surely this information can help narrow down what exactly is causing anxiety and depression in my case, and therefore give clues in how to treat it.
The only tricyclic I've tried is nortriptyline. I think my current psychiatrist is too conservative to consider a trial of other tricyclics, the ones with a slightly lesser effect on NE perhaps?
Unfortunately, nothing in my googling showed me that there was any treatment targeted at this. The closest is the migraine triptan treatments, but those are pretty specific. However, I understand the whole neurotransmitter stuff so little that I could probably run across the answer to all my problems and not even realize it.
Thanks Scott.
(As I posted this, I wondered whether it should have been posted to the neurotransmitter board, and it occurred to me that if Dr. Bob had adopted your definition of the board, I'd have had less trouble figuring out where it belongs. I wish he had adopted that.)
Posted by dcruik518 on August 22, 2008, at 10:04:41
In reply to Re: Acetylcholine - Any new developments? » SLS, posted by Dinah on August 21, 2008, at 9:00:46
Dinah,
Acetylcholine makes most people nervous and irritable when they have too much, even if it does help with memory. I know this personally as a few years ago I got my hands on some Aricept, which works by boosting acetylcholine and is the most popular Alzheimer's drug. I tried it for a week or two, thinking it might help with my ADD, but could not tolerate it. My guess is that if you're already nervous anything stimulating might exacerbate that, hence your reaction to NE. What might help you the most are anti-cholinergic drugs like most anti-histamines, most ot the tricyclic anti-depressants, and others. Specifically:
1. Benadryl
2. ClomimpramineThese are the most sedating/calming and would probably do the most to wipe out your anxiety.
D
Posted by dcruik518 on August 22, 2008, at 10:14:53
In reply to Re: Acetylcholine - Any new developments?, posted by dcruik518 on August 22, 2008, at 10:04:41
Benapryzine, benzhexol, orphenadrine, and bornaprine are other examples of anticholinergic drugs used alone or in combination with other medications in Parkinson's disease to improve motor function. Disturbances in dopaminergic transmissions are associated with the symptoms observed in Parkinson's disease. The beneficial effects of anticholinergics in this disease are due to the resulting imbalance between dopamine and acetylcholine ratio in neurons. These anticholinergic agents may decrease gastrointestinal movements, causing constipation; and the positive effects on motor functions vary among patients. Other classes of drugs available today that act on the pathways of dopamine and its receptors to treat Parkinson's disease, such as levodopa, tolcapone, and pramipexol, effectively increase the levels of dopamine at dopaminergic receptors in neurons.
Posted by Dinah on August 24, 2008, at 19:26:47
In reply to Re: Acetylcholine - Any new developments?, posted by dcruik518 on August 22, 2008, at 10:14:53
I think I'll bring this up with my pdoc next time I see him and see if he thinks a trial is worthwhile.
Benadryl... I'm not sure but I think Benadryl knocks me flat, even in small doses. If that's the anticholinergic effect, I suppose I won't be able to tolerate that either.
Thanks, dcruik.
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