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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 43. This is the beginning of the thread.
Posted by SLS on January 27, 2013, at 16:37:44
I accidentally skipped taking minocycline for almost a week. I deteriorated quite a bit over the last few days. I had blamed lithium discontinuation for it. I discovered my mistake just this morning. After taking a 200 mg loading dose of minocycline early in the day, I am now feeling significantly better. Unfortunately, I can't control for the lithium discontinuation. However, I am unwilling to repeat the inadvertent experiment.
- Scott
Posted by Phillipa on January 27, 2013, at 16:44:56
In reply to Inadvertent experiment., posted by SLS on January 27, 2013, at 16:37:44
Scott do you have a pill box as pretty sure you do. So back on minocycline. And the lithium? If you were discontinuing the lithium you were in a withdrawal also weren't you. Phillipa
Posted by gadchik on January 27, 2013, at 17:04:02
In reply to Re: Inadvertent experiment. » SLS, posted by Phillipa on January 27, 2013, at 16:44:56
Scott, I am so anal about my psych meds. I would never forget them, altho I wish I could sometimes! I have never missed a day,and take it precisely at 9pm. I used to take 3 meds,now just 1.
Posted by SLS on January 27, 2013, at 17:32:32
In reply to Re: Inadvertent experiment., posted by gadchik on January 27, 2013, at 17:04:02
> Scott, I am so anal about my psych meds. I would never forget them, altho I wish I could sometimes! I have never missed a day,and take it precisely at 9pm. I used to take 3 meds,now just 1.
I know it sounds weird. I'm usually very consistent with my medication. I was taking 7 different medications totaling 21 pills a day. I simply forgot to place a new bottle of minocycline in my cabinet to replace the empty one that I had removed from the lineup of bottles. Now that I have discontinued lithium, I have two less pills to worry about. I still wish I could take lithium as a prophylactic agent against the development of Alzheimer's Dementia. Perhaps I will revisit it using a dosage of 100 mg taken at night. That won't be for a while, though. For now, I am greatly relieved that I don't need it to treat my depression.
- Scott
Posted by SLS on January 27, 2013, at 17:37:36
In reply to Re: Inadvertent experiment. » SLS, posted by Phillipa on January 27, 2013, at 16:44:56
> Scott do you have a pill box as pretty sure you do. So back on minocycline. And the lithium? If you were discontinuing the lithium you were in a withdrawal also weren't you. Phillipa
I can't be sure to what degree the discontinuation of lithium affected my mood. Maybe it still is. I am only sure that the reintroduction of minocycline produced a rapid improvement.
- Scott
Posted by Bob on January 27, 2013, at 18:51:55
In reply to Inadvertent experiment., posted by SLS on January 27, 2013, at 16:37:44
> I accidentally skipped taking minocycline for almost a week. I deteriorated quite a bit over the last few days. I had blamed lithium discontinuation for it. I discovered my mistake just this morning. After taking a 200 mg loading dose of minocycline early in the day, I am now feeling significantly better. Unfortunately, I can't control for the lithium discontinuation. However, I am unwilling to repeat the inadvertent experiment.
>
>
> - Scott
>So I gather that you don't attribute the malaise to the minocycline?
Posted by SLS on January 28, 2013, at 9:06:54
In reply to Re: Inadvertent experiment. » SLS, posted by Bob on January 27, 2013, at 18:51:55
> > I accidentally skipped taking minocycline for almost a week. I deteriorated quite a bit over the last few days. I had blamed lithium discontinuation for it. I discovered my mistake just this morning. After taking a 200 mg loading dose of minocycline early in the day, I am now feeling significantly better. Unfortunately, I can't control for the lithium discontinuation. However, I am unwilling to repeat the inadvertent experiment.
> So I gather that you don't attribute the malaise to the minocycline?I am doing better today, now that I have restarted the minocycline. It took less than 24 hours to recapture my antidepressant response to treatment. I am not experiencing any kind of malaise; amotivation and passivity have not returned since discontinuing lithium.
- Scott
Posted by jono_in_adelaide on January 28, 2013, at 17:31:50
In reply to Re: Inadvertent experiment. » Bob, posted by SLS on January 28, 2013, at 9:06:54
Glad you're back on track Scott
Posted by SLS on January 28, 2013, at 18:49:54
In reply to Re: Inadvertent experiment., posted by jono_in_adelaide on January 28, 2013, at 17:31:50
> Glad you're back on track Scott
Thanks. I appreciate it.
- Scott
Posted by jono_in_adelaide on January 28, 2013, at 19:19:11
In reply to Re: Inadvertent experiment. » jono_in_adelaide, posted by SLS on January 28, 2013, at 18:49:54
I've only ever made one major mistake with my meds..... most drugs in Australia come in blister packs, and for drugs i dont take every day, I keep them in a tupperware box..... one sunday I had a headache, so went to the box, and grabbed a loose blister pack of what i thought was ibuprofen, I awllowed two and settled down on the couch to read, next think i knew it was six hours later. I had inadvetrtantly taken 2 Mogadon sleeping pills - learned a valuable lesson.
Posted by ChicagoKat on January 29, 2013, at 7:24:59
In reply to Inadvertent experiment., posted by SLS on January 27, 2013, at 16:37:44
Glad you feel better now that you are back on your Minocycline, Scott.
Kat
Posted by ihatedrugs on January 30, 2013, at 2:50:48
In reply to Inadvertent experiment., posted by SLS on January 27, 2013, at 16:37:44
I've been following you and your progress with minocycline.
Interestingly, UF invited guest speaker, Dr. Krystal from the Department of Psychiatry at Yale University who mentioned how back in the 60's a doctor treating TB patients with depression showed a rapid onset of psychiatric benefits occurring after drug administration.
Crane G. The psychotropic effect of cycloserine: a new use of an antibiotic. Compr Psychiatry. 1961;2:51-59..
Here is the lecture: http://mediasite.video.ufl.edu/Mediasite/Play/4a46e8f9a6f84560aadacc408f77f6b51dYou can skip the first 15 minutes as it discusses glutamate in schizophrenia.
ihatedrugs
Posted by SLS on January 30, 2013, at 6:13:16
In reply to Re: Inadvertent experiment. » SLS, posted by ihatedrugs on January 30, 2013, at 2:50:48
> I've been following you and your progress with minocycline.
>
> Interestingly, UF invited guest speaker, Dr. Krystal from the Department of Psychiatry at Yale University who mentioned how back in the 60's a doctor treating TB patients with depression showed a rapid onset of psychiatric benefits occurring after drug administration.
> Crane G. The psychotropic effect of cycloserine: a new use of an antibiotic. Compr Psychiatry. 1961;2:51-59..
> Here is the lecture: http://mediasite.video.ufl.edu/Mediasite/Play/4a46e8f9a6f84560aadacc408f77f6b51d
>
> You can skip the first 15 minutes as it discusses glutamate in schizophrenia.
>
> ihatedrugs
Brilliant. Brilliant. Brilliant.Thanks!
My main rationale for using minocycline is that it is anti-glutamatergic and may act in synergy with Lamictal, another anti-glutamatergic drug. I think the anti-inflammatory properties of minocycline are helpful, but probably not sufficient.
- Scott
Posted by ihatedrugs on January 30, 2013, at 15:00:50
In reply to Re: Inadvertent experiment. » ihatedrugs, posted by SLS on January 30, 2013, at 6:13:16
Posted by ihatedrugs on January 30, 2013, at 15:05:44
In reply to Re: Inadvertent experiment. » ihatedrugs, posted by SLS on January 30, 2013, at 6:13:16
Posted by alchemy on January 30, 2013, at 16:43:56
In reply to At least they're up to something (new?) (nm) » SLS, posted by ihatedrugs on January 30, 2013, at 15:05:44
Scott,
I have an apt tomorrow with my pdoc who basically said we have reached the end of the road. Have you found minocycline to help very much? What could I tell my dr to convince him?
Thanks
Posted by rovers95 on January 30, 2013, at 17:55:08
In reply to Re: Inadvertent experiment. » SLS, posted by ihatedrugs on January 30, 2013, at 2:50:48
http://www.ncbi.nlm.nih.gov/pubmed/16677714
Had to jump in with this study on cycloserine here, a very small sample but checked it out because I thought cycloserine might be worth a go.
I tried minocycline and I'm not sure it did anything after a while, perhaps the brain adapts to these drugs as well?
cheers
Rover
Posted by SLS on January 31, 2013, at 10:26:40
In reply to question on minocycline, posted by alchemy on January 30, 2013, at 16:43:56
> Scott,
> I have an apt tomorrow with my pdoc who basically said we have reached the end of the road. Have you found minocycline to help very much? What could I tell my dr to convince him?
> ThanksMinocycline:
1. Is neuroprotective.
2. Reduces brain inflammation
3. Reduces the number of glutamate receptors.
4. Demonstrates antidepressant properties in mouse models of depression.
5. Is reported to act synergistically with noradrenergic antidepressants to treat depression - desipramine (but not fluoxetine).
6. Is reported to act synergistically with NMDA antagonists.
7. Reduces glutamate excitotoxicity by reducing the formation of quinolic acid, a NMDA agonist.
8. Reduces mitochondrial release of cytochrome C.
9. Modulates several signaling pathways.
10. Reduces microglial activation.
11. Has been reported anecdotally to successively treat depression.
12. Reduces the expression of lipopolysaccharide-induced pro-inflammation cytokines, an effect that acts as an antidepressant in animal models.
13. Increases neurite growth in response to nerve growth factor (NGF).
14. Inhibits high levels of PKC and GSK-3 alpha;
15. Decreases nitric oxide synthetase, thereby reducing free radicals which damage neurons and glia.
16. Reduces glutamate release.It has been suggested that minocycline might act synergistically with Lamictal to reduce glutamate activity and improve depression.
The following article contains a review of the rationale for using minocycline to treat mood disorders:
http://bmjopen.bmj.com/content/2/1/e000643.full
- Scott
Posted by alchemy on January 31, 2013, at 13:02:21
In reply to Re: question on minocycline » alchemy, posted by SLS on January 31, 2013, at 10:26:40
Wow, thanks Scott! Almost sounds too good to be true. I know that you have had some success with it. About how much do you think it has helped you and when did you start noticing its effects? Did you also notice that it helped with motivation or anhedonia? Sometimes it feels like it hurts my brain just to think!
Posted by SLS on January 31, 2013, at 15:09:26
In reply to Re: question on minocycline, posted by alchemy on January 31, 2013, at 13:02:21
> Wow, thanks Scott! Almost sounds too good to be true. I know that you have had some success with it. About how much do you think it has helped you and when did you start noticing its effects? Did you also notice that it helped with motivation or anhedonia? Sometimes it feels like it hurts my brain just to think!
I and one other person experienced an improvement within the first week. It is important to take note that we both are also taking Lamictal and Abilify. The other person achieved full remission within two weeks. I am not quite so lucky, but, from what I understand, it can take a full year for some people. I figure it is worth the wait. I would say that motivation and anhedonia are significantly improved in me. Although I have had brief "blip" improvements in the past that have been more robust, I have not felt this well consistently in 25 years. If I do get stuck, I would consider TMS or ketamine treatments to move things along.
To summarize, minocycline:
1. Reduces glutamate hyperactivity.
2. Reduces glutamate excitotoxicity (neuroprotective).
3. Reduces brain inflammation.
4. Increases neuroplasticity by enhancing the neurite growth produced by nerve growth factor (NGF).Of these, I believe that it is #1 that is the most important for the acute improvement that occurs early in treatment. If so, then one might pursue the idea of adding an antiglutamatergic agent to enhance the effects of minocycline. Lamictal is an obvious choice. Memantine would be another drug to look at as well as N-acetylcysteine (NAC). I believe that #4 would also contribute to the acute therapeutic effect. It may be that the anti-inflammatory properties of minocycline become important to produce a sustained therapeutic effect. Interestingly, in animal models, adding minocycline to the TCA, desipramine, produced a greater antidepressant effect than desipramine alone. I am currently taking nortriptyline, another TCA.
The most important side effect of minocycline to screen for is brain swelling (pseudotumor cerebri). It is rare, but dangerous.
http://www.mayoclinic.com/health/pseudotumor-cerebri/DS00851/DSECTION=symptoms
Symptoms include:
* Moderate to severe headaches that may originate behind the eyes
* Ringing in the ears that pulses in time with your heartbeat
* Nausea, vomiting or dizziness
* Blurred or dimmed vision
* Brief episodes of blindness, lasting only a few seconds and affecting one or both eyes (visual obscurations)
* Difficulty seeing to the side
* Double vision (diplopia)
* Seeing light flashes (photopsia)
* Neck, shoulder or back pain
- Scott
Posted by ihatedrugs on January 31, 2013, at 16:27:56
In reply to Re: question on minocycline » alchemy, posted by SLS on January 31, 2013, at 15:09:26
> > Wow, thanks Scott! Almost sounds too good to be true. I know that you have had some success with it. About how much do you think it has helped you and when did you start noticing its effects? Did you also notice that it helped with motivation or anhedonia? Sometimes it feels like it hurts my brain just to think!
>
> I and one other person experienced an improvement within the first week. It is important to take note that we both are also taking Lamictal and Abilify. The other person achieved full remission within two weeks. I am not quite so lucky, but, from what I understand, it can take a full year for some people. I figure it is worth the wait. I would say that motivation and anhedonia are significantly improved in me. Although I have had brief "blip" improvements in the past that have been more robust, I have not felt this well consistently in 25 years. If I do get stuck, I would consider TMS or ketamine treatments to move things along.
>
> To summarize, minocycline:
>
> 1. Reduces glutamate hyperactivity.
> 2. Reduces glutamate excitotoxicity (neuroprotective).
> 3. Reduces brain inflammation.
> 4. Increases neuroplasticity by enhancing the neurite growth produced by nerve growth factor (NGF).
>
> Of these, I believe that it is #1 that is the most important for the acute improvement that occurs early in treatment. If so, then one might pursue the idea of adding an antiglutamatergic agent to enhance the effects of minocycline. Lamictal is an obvious choice. Memantine would be another drug to look at as well as N-acetylcysteine (NAC). I believe that #4 would also contribute to the acute therapeutic effect. It may be that the anti-inflammatory properties of minocycline become important to produce a sustained therapeutic effect. Interestingly, in animal models, adding minocycline to the TCA, desipramine, produced a greater antidepressant effect than desipramine alone. I am currently taking nortriptyline, another TCA.
>
> The most important side effect of minocycline to screen for is brain swelling (pseudotumor cerebri). It is rare, but dangerous.
>
> http://www.mayoclinic.com/health/pseudotumor-cerebri/DS00851/DSECTION=symptoms
>
> Symptoms include:
>
> * Moderate to severe headaches that may originate behind the eyes
>
> * Ringing in the ears that pulses in time with your heartbeat
>
> * Nausea, vomiting or dizziness
>
> * Blurred or dimmed vision
>
> * Brief episodes of blindness, lasting only a few seconds and affecting one or both eyes (visual obscurations)
>
> * Difficulty seeing to the side
>
> * Double vision (diplopia)
>
> * Seeing light flashes (photopsia)
>
> * Neck, shoulder or back pain
>
>
> - ScottAre there too many risks associated with taking antibiotics for so long?
ihatedrugs
Posted by Bob on January 31, 2013, at 16:32:23
In reply to Re: question on minocycline » SLS, posted by ihatedrugs on January 31, 2013, at 16:27:56
> > > Wow, thanks Scott! Almost sounds too good to be true. I know that you have had some success with it. About how much do you think it has helped you and when did you start noticing its effects? Did you also notice that it helped with motivation or anhedonia? Sometimes it feels like it hurts my brain just to think!
> >
> > I and one other person experienced an improvement within the first week. It is important to take note that we both are also taking Lamictal and Abilify. The other person achieved full remission within two weeks. I am not quite so lucky, but, from what I understand, it can take a full year for some people. I figure it is worth the wait. I would say that motivation and anhedonia are significantly improved in me. Although I have had brief "blip" improvements in the past that have been more robust, I have not felt this well consistently in 25 years. If I do get stuck, I would consider TMS or ketamine treatments to move things along.
> >
> > To summarize, minocycline:
> >
> > 1. Reduces glutamate hyperactivity.
> > 2. Reduces glutamate excitotoxicity (neuroprotective).
> > 3. Reduces brain inflammation.
> > 4. Increases neuroplasticity by enhancing the neurite growth produced by nerve growth factor (NGF).
> >
> > Of these, I believe that it is #1 that is the most important for the acute improvement that occurs early in treatment. If so, then one might pursue the idea of adding an antiglutamatergic agent to enhance the effects of minocycline. Lamictal is an obvious choice. Memantine would be another drug to look at as well as N-acetylcysteine (NAC). I believe that #4 would also contribute to the acute therapeutic effect. It may be that the anti-inflammatory properties of minocycline become important to produce a sustained therapeutic effect. Interestingly, in animal models, adding minocycline to the TCA, desipramine, produced a greater antidepressant effect than desipramine alone. I am currently taking nortriptyline, another TCA.
> >
> > The most important side effect of minocycline to screen for is brain swelling (pseudotumor cerebri). It is rare, but dangerous.
> >
> > http://www.mayoclinic.com/health/pseudotumor-cerebri/DS00851/DSECTION=symptoms
> >
> > Symptoms include:
> >
> > * Moderate to severe headaches that may originate behind the eyes
> >
> > * Ringing in the ears that pulses in time with your heartbeat
> >
> > * Nausea, vomiting or dizziness
> >
> > * Blurred or dimmed vision
> >
> > * Brief episodes of blindness, lasting only a few seconds and affecting one or both eyes (visual obscurations)
> >
> > * Difficulty seeing to the side
> >
> > * Double vision (diplopia)
> >
> > * Seeing light flashes (photopsia)
> >
> > * Neck, shoulder or back pain
> >
> >
> > - Scott
>
> Are there too many risks associated with taking antibiotics for so long?
>
>
> ihatedrugs
My question is along these lines as well. Is the intention to take these antibiotics indefinitely if they seem to help? Obviously if some are responding after a year or so then they are on this for quite a long time.Bob
Posted by alchemy on January 31, 2013, at 16:46:48
In reply to Re: question on minocycline » alchemy, posted by SLS on January 31, 2013, at 15:09:26
> > Wow, thanks Scott! Almost sounds too good to be true. I know that you have had some success with it. About how much do you think it has helped you and when did you start noticing its effects? Did you also notice that it helped with motivation or anhedonia? Sometimes it feels like it hurts my brain just to think!
>
> I and one other person experienced an improvement within the first week. It is important to take note that we both are also taking Lamictal and Abilify. The other person achieved full remission within two weeks. I am not quite so lucky, but, from what I understand, it can take a full year for some people. I figure it is worth the wait. I would say that motivation and anhedonia are significantly improved in me. Although I have had brief "blip" improvements in the past that have been more robust, I have not felt this well consistently in 25 years. If I do get stuck, I would consider TMS or ketamine treatments to move things along.
>
> To summarize, minocycline:
>
> 1. Reduces glutamate hyperactivity.
> 2. Reduces glutamate excitotoxicity (neuroprotective).
> 3. Reduces brain inflammation.
> 4. Increases neuroplasticity by enhancing the neurite growth produced by nerve growth factor (NGF).
>
> Of these, I believe that it is #1 that is the most important for the acute improvement that occurs early in treatment. If so, then one might pursue the idea of adding an antiglutamatergic agent to enhance the effects of minocycline. Lamictal is an obvious choice. Memantine would be another drug to look at as well as N-acetylcysteine (NAC). I believe that #4 would also contribute to the acute therapeutic effect. It may be that the anti-inflammatory properties of minocycline become important to produce a sustained therapeutic effect. Interestingly, in animal models, adding minocycline to the TCA, desipramine, produced a greater antidepressant effect than desipramine alone. I am currently taking nortriptyline, another TCA.I also take Lamictal, although I think the only benefit it gives me is help with agitation. Abilify makes me more depressed. I also try and take NAC daily. I have tried desipramine found it neutral except for side effects (at least it didn't worsen my mood).
Unfortunately, TMS did not really help me. I have been trying to figure out how to try ketamine. I failed the requirements for a trial and know that it is expensive. So far I haven't found any doctors who administer it for depression. And then there is the question of long-term use back-firing on me.
Posted by SLS on January 31, 2013, at 16:54:06
In reply to Re: question on minocycline » SLS, posted by ihatedrugs on January 31, 2013, at 16:27:56
> Are there too many risks associated with taking antibiotics for so long?
I'm not aware of any with minocycline.
- Scott
Posted by alchemy on February 1, 2013, at 15:41:21
In reply to Re: question on minocycline » ihatedrugs, posted by Bob on January 31, 2013, at 16:32:23
He was again basically saying we have reached the end of the road. After I asked to try minocycline he was hesitant and said that this is not usually how he practices. He looked up some research info and gave me a script. So here we go. At least it won't make me worse and i have something else to try to give me some hope!
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