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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by mogger on November 6, 2014, at 21:59:53
My doctor mentioned to me today that Campral could benefit me as I reacted so well to Riluzole and have tolerated Lamictal for years which has helped. Riluzole unfortunately caused me to not be able to put a sentence together so I had to discontinue it however I have never had such a powerful anti depressant response as well as a decrease in anxiety. I tried namenda but that made my depression much worse. Lamictal is a solid piece of my medication cocktail. I am on 3 anti depressants, buspar 90mg, zoloft 150mg and remeron 60mg and am a non responder.
We were discussing the theory that my ocd/depression is a result of excitatory neurotransmitters needing to be quelled rather than a depletion of neurotransmitters that I need more of a supply of. Just a theory of course. My depression/ocd is such crippling anxiety that it causes my mood to plummet. I genuinely think in that what came first the chicken or the egg term, in this case ocd/anxiety came first and the depression was a by product.
My question is does anyone have experience with Campral and if so what side effects occurred? I see a side effect is depression which terrifies me. Penny for your thoughts.
mogger
Posted by Phillipa on November 7, 2014, at 9:14:21
In reply to Campral: NMDA antagonist, Glutamate Modulator..., posted by mogger on November 6, 2014, at 21:59:53
No experience with campral. Just wanted to say that I totally agree that the OCD anxiety causes depression and great fears. So far nothing but a benzo at night to recharge my batteries from the constant ruminations does a thing for me. OCD causes me to feel anything I do different will cause something bad to happen. Or that if I do something for me the same will happen. So I do nothing for me. Afraid of any type of change. And that includes meds. Phillipa
Posted by Christ_empowered on November 7, 2014, at 16:00:14
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » mogger, posted by Phillipa on November 7, 2014, at 9:14:21
I have a friend on Campral. Nothing much to report...his mood seems better, but that could be other stuff. Isn't campral related chemically to taurine? Or...not?
Posted by mogger on November 8, 2014, at 14:03:06
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » mogger, posted by Phillipa on November 7, 2014, at 9:14:21
I hear you Phillipa,
I am the same way. So frustrating.
mogger
Posted by mogger on November 8, 2014, at 14:05:26
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator..., posted by Christ_empowered on November 7, 2014, at 16:00:14
Interesting,
I see a couple of anecdotal reports of it being used for anxiety but not much else. Didn't know about the taurine aspect of it. He also mentioned Namenda as being potentially helpful but we tried it already and it caused a wicked worsening of mood.
mogger
Posted by phidippus on November 10, 2014, at 18:20:41
In reply to Campral: NMDA antagonist, Glutamate Modulator..., posted by mogger on November 6, 2014, at 21:59:53
> Lamictal is a solid piece of my medication cocktail.
I hate to bring this up but some case studies show Lamictal worsens OCD symptoms in patients who are also bipolar.
>I am on 3 anti depressants, buspar 90mg, zoloft 150mg and remeron 60mg and am a non responder.
You're on more than enough antidepressants to combat the OCD effectively. Perhaps you need to try different antidepressants.
>my ocd/depression is a result of excitatory neurotransmitters needing to be quelled rather than a depletion of neurotransmitters
Its probably a case of both.
>ocd/anxiety came first and the depression was a by product.
Than you need to focus on getting the OCD under control.
1. Add a low dose of an atypical antipsychotic - there is often an excess of dopamine in the nucleus accumbens of OCD sufferers.
2. Add a glutamate antagonist - Topomax, Keppra, Lyrica, Gabapentin, etc. Riluzole is a glutamate antagonist.
3. There are other medicines which have shown efficacy in treating OCD: dextroamphetamine, Pindolol, Ondansetron, etc.
Campral was effective for general anxiety but didn't help much with my OCD. It did cause me depression-its a gaba a agonist which tend to carry the side effect ofg depression.
Eric
Posted by mogger on November 11, 2014, at 14:41:24
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » mogger, posted by phidippus on November 10, 2014, at 18:20:41
>I hate to bring this up but some case studies show Lamictal worsens OCD symptoms in patients who are also bipolar.
Thanks Eric. Worsening OCD/depression can be the case with almost all anti convulsants and AAPs. Thankfully in my case Lamictal does the opposite.
>You're on more than enough antidepressants to combat the OCD effectively. Perhaps you need to try different antidepressants.
Could be true but in order to try Brintellix or Viibryd I'd have to come off some of my ADs which I don't feel strong enough to do right now. My pdoc is not a fan of pindolol's effectiveness. Riluzole has been the most powerful anti depressant/anti OCD medicine I have tried however I couldn't put a sentence together while I was on it unfortunately.
I have been on lithium for the 3 weeks now and added 5 mgs of zyprexa (always helped with anxiety not so much with depression) they seem to be having an anti depressant response so I am keeping my fingers crossed it will hold.
Posted by phidippus on November 11, 2014, at 16:04:55
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » phidippus, posted by mogger on November 11, 2014, at 14:41:24
>I'd have to come off some of my ADs which I don't feel strong enough to do right now.
Do a cross taper between the Zoloft and the Brintellix. I don't think its going to matter if you drop the Mirtazapine-one of those two ADs is dead weight and I'm betting its the Mirtazapine.
Riluzole is a glutamate antagonist and Lamictal is a glutamate antagonist. You claim both help with your OCD, so it might do you some good to explore other antiglutamatergic drugs such as Gabapentin, Lyrica, Keppra and Tompamax. Keppra is probably the most powerful of the four and did wonders for my OCD.
Eric
Posted by mogger on November 11, 2014, at 16:21:39
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » mogger, posted by phidippus on November 11, 2014, at 16:04:55
Thanks Eric. My doctor thought the positive response to riluzole was a combination of glutamate modulation and riluzole being a strongish NMDA antagonist. Wouldn't I have to vome off buspar too for Brintellix? That's good to know about Keppra. I shall ask my doctor about it. I see a side effect is depression but glad to hear you didn't. Why did you discontinue?
Posted by phidippus on November 11, 2014, at 16:46:36
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » phidippus, posted by mogger on November 11, 2014, at 16:21:39
>riluzole was a combination of glutamate modulation and riluzole being a strongish NMDA antagonist
Riluzole preferentially blocks TTX-sensitive sodium channels, which are associated with damaged neurons. Riluzole has also been reported to directly inhibit the kainate and NMDA receptors, however this property has not been confirmed. The action of riluzole on glutamate receptors has been controversial, as no binding of the drug to any known sites has been shown for them. In addition, as its antiglutamatergic action is still detectable in the presence of sodium channel blockers, it is also uncertain whether or not it acts via this way. Rather, its ability to stimulate glutamate uptake seems to mediate many of its effects. In addition to its role in accelerating glutamate clearance from the synapse, Riluzole may also prevent glutamate release from presynaptic terminals. These effects combined could significantly reduce glutamate signaling and cause indirect antagonism without acting at glutamate receptors themselves.
>Wouldn't I have to vome off buspar too for Brintellix?
No. Buspar is just a partial agonist of the 5ht1a receptor. If anything it will act synergistically with the Brintellix.
>Why did you discontinue?
I didn't. I still take 1000 mg a day.
Depression doesn't happen all that often with Keppra.
Besides you're on so many ADs(lithium, lamictal, zoloft, mirtazapine, buspar...geez) I find it hard to believe it would make you depressed
Eric
Posted by mogger on November 11, 2014, at 16:53:14
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » mogger, posted by phidippus on November 11, 2014, at 16:46:36
Good to know. Gabapentin, Namenda and Tegretol all made my depression considerably worse. I dont believe other ADs would offset an anti convulsant induced depression but good to know it is rare with Keppra. You should read Dr. Chris Pittenger's piece in his research on riluzole, n-acetyl cysteine and lamictal for ocd.
Posted by mogger on November 11, 2014, at 17:42:33
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » mogger, posted by phidippus on November 11, 2014, at 16:46:36
Eric,
One more thing. Have you tried sarcosine? Tastes delicious and I had a response to it a while ago. I am going to start that up again as I remember it helped. Energy booster as well.
Joseph
Posted by phidippus on November 13, 2014, at 13:31:00
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » phidippus, posted by mogger on November 11, 2014, at 17:42:33
What is sarcosine?
Eric
Posted by mogger on November 13, 2014, at 14:46:46
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » mogger, posted by phidippus on November 13, 2014, at 13:31:00
Eric,
Perhaps after reading these studies you can tell us what it does as you are much more knowledgeable about meds/supplements than me. I think it is a glycine reuptake inhibitor. I took it for a week and it was powerful but focused on another med with my doctor so haven't tried it since. Here are a couple of studies on it.
http://www.ncbi.nlm.nih.gov/m/pubmed/23562005/?i=18&from=glycine%20anxiety
In the article below there is a paragraph dedicated to Sarcosine for OCD on page 15.
http://ocfoundation.org/uploadedFiles/Pages%20from%20Vol%2027%20Issue%203%20Summer%202013.pdf
http://www.ncbi.nlm.nih.gov/pubmed/21508860
You can buy it relatively cheap. It is in powder form and tastes delicious I must say!
Posted by phidippus on November 15, 2014, at 16:44:40
In reply to Sarcosine for depression/ocd » phidippus, posted by mogger on November 13, 2014, at 14:46:46
The NMDA receptor is an ionotropic receptor that allows for the transfer of electrical signals between neurons in the brain and in the spinal column. For electrical signals to pass, the NMDA receptor must be open. To remain open, glutamate and glycine must bind to the NMDA receptor. An NMDA receptor that has glycine and glutamate bound to it and has an open ion channel is called "activated."
What I can't figure out is why a Glycine agonist would work to treat OCD/depression. In treating OCD/depression we want to antagonize the NMDA receptor and Sarcosine is not doing that-quite the opposite, actually. It could be that inhibition of glycine reuptake may modulate glutamate transmission in ways that will be therapeutic in OCD/depression. I'm thinking Glycine effects the way glutamate binds to the NMDA receptor causing it to decay quicker. Glycine remains intact in the receptor and without glutamate, the NMDA receptor remains inactive. Just a theory anyway.
Eric
Eric
Posted by Mogger on November 15, 2014, at 20:28:48
In reply to Re: Sarcosine for depression/ocd » mogger, posted by phidippus on November 15, 2014, at 16:44:40
I am blonde Eric so most of this went over my head but I trust your knowledge. The time I used it it gave me tremendous energy but I discontinued due to a med change. I am going to check with my doctor to see if I can restart it. Thanks for explaining it,
Joseph
Posted by phidippus on November 18, 2014, at 17:13:50
In reply to Re: Sarcosine for depression/ocd » phidippus, posted by Mogger on November 15, 2014, at 20:28:48
Most of what I've read indicates its an effective therapy and I don't think you have to worry too much about drug interactions. Go for it.
Eric
Posted by orochi on November 23, 2014, at 16:45:05
In reply to Re: Campral: NMDA antagonist, Glutamate Modulator... » mogger, posted by phidippus on November 13, 2014, at 13:31:00
Hi everyone,
can someone tell me how dangerous Lamictal is?
Doesn't it really some major side effects like steve johnson's syndrome? I'd be interested in trying another glutamate antagonist (memantine didn't work for me, lyrica made me forgetful) but if a drug has too scary side effects I don't dare to take it.
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