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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by rjlockhart37 on November 30, 2012, at 15:16:08
i just found something that finally i have been searching for about the medications not taking effect. The blood brain barrier protects the brain from unknown substances, and things that could be harmful....but I also read it can stop the actions of CNS drugs... read it throughtly and also that chemo treated patients are resistant to treatment due to the brain trying to protect itself.
Is there any kinda of way to make it start working right, well its complcicated because this is difficult to understand even for me. But I am vary sure this is the case, because I had blood tests done and they showed the medications are in my system, the bloodstream but I read even when substances are in the blood they have to go through the BBB like a filter. I have resistance to alot of medication, it never takes effect...once and a while but its not the full effect.Please can someone fill me in on this...please! any doctors that can make this go away?
r
Posted by rjlockhart37 on November 30, 2012, at 15:25:03
In reply to Blood Brain Barrier - any doctors for this?, posted by rjlockhart37 on November 30, 2012, at 15:16:08
Posted by Phillipa on November 30, 2012, at 16:27:26
In reply to Blood Brain Barrier - any doctors for this?, posted by rjlockhart37 on November 30, 2012, at 15:16:08
What did you google? Phillipa
Posted by rjlockhart37 on November 30, 2012, at 16:48:22
In reply to Re: Blood Brain Barrier - any doctors for this? » rjlockhart37, posted by Phillipa on November 30, 2012, at 16:27:26
http://www.monzir-pal.net/Poisons%20and%20Drugs/Lecture%20material/Toxicokinetics%20summary.pdf
I originally was looking up GI absorbation, but then rerember I had blood tests they are in bloodstream, but then I found this....its little info but that's what made me get on google and search BBB and absorbation into the brain with CNS drugs.
r
Posted by rjlockhart37 on November 30, 2012, at 16:50:50
In reply to Re: Blood Brain Barrier - any doctors for this? » rjlockhart37, posted by Phillipa on November 30, 2012, at 16:27:26
opps...sorry that was wrong article...i got on my internet history...its another article..sorry about that...
but know this is what I found googling BBB absorbation and resistance to substances.
Posted by jono_in_adelaide on November 30, 2012, at 21:47:00
In reply to Blood Brain Barrier - any doctors for this?, posted by rjlockhart37 on November 30, 2012, at 15:16:08
RJ, drugs either cross the blood brain barrier or they dont - I find it hard to beleive that Zyprexa doesnt cross your blood brain barrier when it crosses everyone elses (and remember that episode when you stoped taking your antipsychotics, and how quickly you came back to earth when you started Zyprexa again)
I think the drugs ARE working, they just arnt completely resolving every symptom.
I think you need a second opinion from another psychiatrist about the treatment that you're on more than anything.
Posted by rjlockhart37 on November 30, 2012, at 23:20:24
In reply to Re: Blood Brain Barrier - any doctors for this?, posted by jono_in_adelaide on November 30, 2012, at 21:47:00
yes....but im finding out things that could be causing this. You don't understand...i said the medication sometimes will work, but nothing like they did before, they have lost their effect or there is something that is blocking them from working....and I found this on google...it doesnt mean its the actual situation, im trying to figure out a problem that is preventing treating other problems, depression, anxiety...mood flips.
So, I did say I put zyprexa under my tongue and it does work...somewhat, i've had to things either its the GI track malfunctioning, or bbb barrier, and ill find more things out later. There suppost to be working...people say there's nothing wrong and its overlooked and not taken into consideration, people don't take me seriously.
thanks for the suggestion
r
Posted by gilmourr on December 1, 2012, at 9:09:25
In reply to Re: Blood Brain Barrier - any doctors for this? » jono_in_adelaide, posted by rjlockhart37 on November 30, 2012, at 23:20:24
I remember while I was reading at the library I briefly glossed over the blood brain barrier section in this pharma book.
I believe certain drugs automatically cross the blood brain barrier because of something added to them that lets it permeate the BBB. So the drug itself will ALWAYS do this.
The only exception is if you have some type of genetic mutation that doesn't allow drugs to pass your BBB and that is very uncommon. I'm not even sure if you can test for it or correct it.
In summary, you may be right that your drugs are not crossing the BBB or that way less then the targeted amount is getting through. However this is unlikely if you've had a response to ANY drugs. If no drugs have ever worked, it's likely you have this issue. If they work but don't work well then they are getting through the BBB, but it may not be well. In that case you'll just have to try every single med and see which one works best.
Or do ECT, VNS, or rTMS.
I am not sure whether a BBB genetic issue can be fixed. My instinct is saying probably not
Posted by ed_uk2010 on December 3, 2012, at 18:15:58
In reply to Blood Brain Barrier - any doctors for this?, posted by rjlockhart37 on November 30, 2012, at 15:16:08
>I just found something that finally i have been searching for about the medications not taking effect. The blood brain barrier protects the brain from unknown substances, and things that could be harmful....but I also read it can stop the actions of CNS drugs...
Some drugs which do cross the blood brain barrier are pumped back out of the brain by a molecule called p-glycoprotein (also called multi-drug resistance protein). P-gp activity is controlled by genetics and can be inhibited by various drugs. Some psychiatric drugs are pumped back out of the brain by P-gp, and genetic differences in P-gp activity may partly account for why some people require higher doses of antidepressants than others. Drugs which inhibit P-gp may increase the effects of other drugs which would otherwise be pumped back out of the brain by P-gp. Certain SSRIs such as sertraline (Zoloft), paroxetine (Paxil) and to a lesser extent fluoxetine (Prozac) are believed to be P-gp inhibitors.
I think it's unlikely that the blood brain barrier has any special relevance to your reduced response to medication.
One of the main factors which reduces blood/brain levels of olanzapine (Zyprexa) is smoking. Do you smoke?
Posted by rjlockhart37 on December 3, 2012, at 21:26:53
In reply to P-glycoprotein and psychiatry » rjlockhart37, posted by ed_uk2010 on December 3, 2012, at 18:15:58
yes I smoke....i dont really care about the zyprexa its not really a vital medication to me...only when I'm thinking of spirit world too much...obsessed over it.
i still know there may be a problem with the GI track, its wierd lots of times it will have no effect, the nuvigil...like nothing at all, no wakefulness, and then couple weeks ago it totally took effect one day...and people keep telling me its in my head, its its some stupid complication my body created. It has nothing but a burden.
i've been trying to find something to find this problem, the basic tests said everything is normal, blood work scans, bowel tests....I drink red bulls and coffee....nothing...i mean ALOT of coffee, ... nothing but acid in the stomach...there's something blocking this from doing it. some people on babble doesnt have any clue what im talking about, i've posted this several times...so i've posted on other medical websites...they ask me dumb questions like what do I eat...how many times do I go to the bathroom, am i depressed, just stuff that's not the point of what im asking
if you can find something on this, what tests could be done...that would great.
r
Posted by ed_uk2010 on December 4, 2012, at 8:44:30
In reply to Re: P-glycoprotein and psychiatry, posted by rjlockhart37 on December 3, 2012, at 21:26:53
>I drink red bulls and coffee....nothing...i mean ALOT of coffee, ... nothing but acid in the stomach...there's something blocking this from doing it.
That's not unusual, not everyone gets much effect from caffeine. It doesn't mean you're not absorbing it, it just means that what caffeine does in the brain doesn't create a stimulant effect for you.
With respect to meds which used to have a stronger effect than they do now, this is not unusual either. Tolerance can occur to a variety of psych meds due to adaptations in the brain which oppose their effects. The drug still gets into the brain, but it's not able to exert such a potent effect when it gets there. Tolerance is especially common with stimulants and benzodiazepines. Also, drugs which exert a sedative effect which is partly due to antihistamine activity (eg. some antipsychotics) tend to get less sedative over time.
This is the end of the thread.
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