Psycho-Babble Medication Thread 1095035

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Thoughts on this medicaton combination?

Posted by farshad on September 17, 2017, at 16:30:52

Wellbutrin + Abilify + Memantine or guanfacine?

So how did I come up with this combo? well First of the Abilify To increase or should I say Balance Dopamine levels.

Second Wellbutrin to Increase Norepinephrine.
(Wellbutrin is a weak Dopamine med btw thats why I added abilify)

and Third med the most important one.. Well let me explain something. I belive I have some sort of mutation which makes my brain or body produce too much serotonin and all the excess Serotonin goes to other parts in the brain to avoid serotonin syndrome. So one special place it goes to is the Amygdala it goes to. When too much Serotonin goes to the amygdala it will put my amygdala in an overactive state and with this comes loads of side effects. Constant alert , Constant stress, and it never gets better unless I can somehow decrease the activity of my amygdala which I found memantine or guanfacine can do. I dont know which one is better but thats why im here for. Maybe I should combine the two?

So now that I have my dopamine in check. Norepinephrine in check. Amygdala in check.
last part is my Serotonin levels.. Will these meds all together be enough to get rid of the excess serotonin or do I need some sort of Serotonin antagonist? I have been looking at Zyprexa and risperdal but I dont know for sure if they do decrease serotonin or if there is a better med for this? thanks for any answears and if I am missing any important neurontransmitters or anything else let me know.

 

Re: Thoughts on this medicaton combination?

Posted by Lamdage22 on September 18, 2017, at 2:07:53

In reply to Thoughts on this medicaton combination?, posted by farshad on September 17, 2017, at 16:30:52

Thats cute your theory...

 

Re: Thoughts on this medicaton combination?

Posted by farshad on September 18, 2017, at 4:40:19

In reply to Re: Thoughts on this medicaton combination?, posted by Lamdage22 on September 18, 2017, at 2:07:53

> Thats cute your theory...

okay... So what do you think? Say its all true would it work?

 

Re: Thoughts on this medicaton combination?

Posted by linkadge on September 19, 2017, at 7:57:35

In reply to Thoughts on this medicaton combination?, posted by farshad on September 17, 2017, at 16:30:52

What is the mutation (if you don't mind me asking)? Some of the preliminary genetic testing only offers a partial picture of what may be occurring inside the brain.

In reality, it is virtually impossible to determine what is really going on in your mind.

I've gone through that phase where I want to select meds based on my brains conceptualization of my own brain, but it rarely works long term (for me at least).

Take the meds that work for you.

That being said, abilify will likely do more than the other meds (via 5-ht2a antagonism) to decrease serotonin activated amygdala function.

Linkadge

 

Re: Thoughts on this medicaton combination?

Posted by Lamdage22 on September 19, 2017, at 8:48:01

In reply to Re: Thoughts on this medicaton combination?, posted by linkadge on September 19, 2017, at 7:57:35

> I've gone through that phase where I want to select meds based on my brains conceptualization of my own brain, but it rarely works long term (for me at least).
>
> Take the meds that work for you.

Not even the "real" scientists really know whats going on. So your chance of knowing is minimal.

I would say dont take meds, but i am not asked and i realize that i cant and maybe shouldnt stop people here from doing that. This is a personal decision and it is based on what you do or do not believe. So i just chime in when i think i can help.

My roommate gets hallucinations from Lorazepam and Zopiclone. There is no way of telling.

Good luck!

 

Re: Thoughts on this medicaton combination?

Posted by farshad on September 19, 2017, at 9:58:43

In reply to Re: Thoughts on this medicaton combination?, posted by linkadge on September 19, 2017, at 7:57:35

> What is the mutation (if you don't mind me asking)? Some of the preliminary genetic testing only offers a partial picture of what may be occurring inside the brain.
>
> In reality, it is virtually impossible to determine what is really going on in your mind.
>
> I've gone through that phase where I want to select meds based on my brains conceptualization of my own brain, but it rarely works long term (for me at least).
>
> Take the meds that work for you.
>
> That being said, abilify will likely do more than the other meds (via 5-ht2a antagonism) to decrease serotonin activated amygdala function.
>
>
>
> Linkadge
>

I dont know what mutation it is this is just what I think based on trail and error.
now im just thinking of trying agomelatine and memantine . Since agomelatine does what both wellbutrin and abilify do.

 

Re: Thoughts on this medicaton combination?

Posted by linkadge on September 19, 2017, at 11:30:00

In reply to Re: Thoughts on this medicaton combination?, posted by farshad on September 19, 2017, at 9:58:43

I would mainly go by which medications (or classes of medications) seem to help you the most.

Medications affecting gaba have the most beneficial effect on me. I also benefit (to some extent) from mood stabilizers and intracellular stuff (like magnesium). I also benefit from meds which reduce inflammation.

When I am depressed, dopaminergics help the most.

SSRIs used to work for me (mainly citalopram and sertraline). But at some point, they just started to increase anxiety, instability and apathy.

Linkadge

 

Re: Thoughts on this medicaton combination? linkadge

Posted by porkpiehat on October 2, 2017, at 14:26:12

In reply to Re: Thoughts on this medicaton combination?, posted by linkadge on September 19, 2017, at 11:30:00

> I would mainly go by which medications (or classes of medications) seem to help you the most.
>
> Medications affecting gaba have the most beneficial effect on me. I also benefit (to some extent) from mood stabilizers and intracellular stuff (like magnesium).
>
> Can you be more specific about your reactions to gabaminergic drugs?
>
> Times when I have felt most like "myself" have been the day after drinking, when I would take a full .5mgs klonopin at night before bed, and when I first tried gabapentin. These all included low doses of AD's to keep me out of the depths.

regardling SSRI's I found HUGELY different reactions to celexa, zoloft, and effexor (low dose). Prozac and celexa were similar. Agree with weird instability after time with Celexa.

 

Re: Thoughts on this medicaton combination?

Posted by farshad on October 2, 2017, at 15:53:31

In reply to Re: Thoughts on this medicaton combination? linkadge, posted by porkpiehat on October 2, 2017, at 14:26:12

> > I would mainly go by which medications (or classes of medications) seem to help you the most.
> >
> > Medications affecting gaba have the most beneficial effect on me. I also benefit (to some extent) from mood stabilizers and intracellular stuff (like magnesium).
> >
> > Can you be more specific about your reactions to gabaminergic drugs?
> >
> > Times when I have felt most like "myself" have been the day after drinking, when I would take a full .5mgs klonopin at night before bed, and when I first tried gabapentin. These all included low doses of AD's to keep me out of the depths.
>
> regardling SSRI's I found HUGELY different reactions to celexa, zoloft, and effexor (low dose). Prozac and celexa were similar. Agree with weird instability after time with Celexa.
>

i have tried like 30 meds and the only 2 that worked were zyprexa and diazepam no idea why.

 

Re: Thoughts on this medicaton combination?

Posted by farshad on October 2, 2017, at 15:54:07

In reply to Re: Thoughts on this medicaton combination?, posted by farshad on October 2, 2017, at 15:53:31

> > > I would mainly go by which medications (or classes of medications) seem to help you the most.
> > >
> > > Medications affecting gaba have the most beneficial effect on me. I also benefit (to some extent) from mood stabilizers and intracellular stuff (like magnesium).
> > >
> > > Can you be more specific about your reactions to gabaminergic drugs?
> > >
> > > Times when I have felt most like "myself" have been the day after drinking, when I would take a full .5mgs klonopin at night before bed, and when I first tried gabapentin. These all included low doses of AD's to keep me out of the depths.
> >
> > regardling SSRI's I found HUGELY different reactions to celexa, zoloft, and effexor (low dose). Prozac and celexa were similar. Agree with weird instability after time with Celexa.
> >
>
> i have tried like 30 meds and the only 2 that worked were zyprexa and diazepam no idea why.

ops just saw the reply wasnt to me sorry about that.

 

Re: Thoughts on this medicaton combination?

Posted by phidippus on October 7, 2017, at 17:59:42

In reply to Thoughts on this medicaton combination?, posted by farshad on September 17, 2017, at 16:30:52

serotonin deactivates the amygdala...sorry to crush your theory.

Eric

 

Re: Thoughts on this medicaton combination?

Posted by farshad on October 8, 2017, at 9:26:18

In reply to Re: Thoughts on this medicaton combination?, posted by phidippus on October 7, 2017, at 17:59:42

> serotonin deactivates the amygdala...sorry to crush your theory.
>
> Eric

no it does not. it makes the amygdala more active and thus more time to learn fear .http://www.uu.se/en/media/news/article/?id=4918

 

Re: Thoughts on this medicaton combination?

Posted by phidippus on October 8, 2017, at 10:16:12

In reply to Re: Thoughts on this medicaton combination?, posted by farshad on October 8, 2017, at 9:26:18

Confusion abounds about how antidepressants work in anxiety disorders.

SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin norepinephrine reuptake inhibitors) are antidepressant medications that are also used to treat anxiety disorders in addition to depression.

A recent article in Forbes (DiSalvo, 2015) highlights the confusion regarding how SSRIs and SNRIs work in anxiety disorders. This article highlighted a study which found that serotonin was increased in the amygdala in subjects with anxiety (Frick et al., 2015).

So this study has led people to question how SSRIs and SNRIs can help for anxiety as these medications seemingly increase serotonin in the brain. But if increased serotonin was found in the amygdala of subjects with anxiety, then how do these antidepressants work?

To clarify the confusion, its not a simple matter of a chemical imbalance and the antidepressant correcting that imbalance.

Focusing only on the neurotransmitters and the receptors in the synapse (the space and connection between neurons) is so 1990s and 2000s.

Psychopharmacology has advanced to the point where the neurobiology of anxiety is understood at what happens downstream from the synapse, neurotransmitters and receptors.

It is now about post-synaptic 2nd-messenger systems activated by the binding of neurotransmitters to post-synaptic receptors.

It is about how anxiety is mediated by fear circuits made up of neuronal bundles connecting the amygdala to different parts of the brain.

It is about how the activation of the amygdala triggers the sympathetic nervous system and the HPA axis (hypothalamic-pituitary-adrenal axis) to manifest the fight or flight response and how the subsequent release of stress hormones from the adrenal glands interacts with the brain and fear circuits to further mediate the anxiety response.

It is no longer sufficient to focus only on the synapse, neurotransmitter, and receptors to explain how these medications work for the treatment of anxiety disorders. It is now about post-synaptic 2nd-mesenger systems, brain circuits, and whole body responses. This is how we do things now in the 2010s and beyond.

So we have to discuss the neurobiology of anxiety to really understand how SSRIs and SNRIs work. In the brain, serotonergic neurons project from the raphe nuclei, located in the brainstem, to the amygdala, located in the temporal lobes bilaterally.

So these serotonergic neurons project to the amygdala, and have an inhibitory effect on the amygdala. The inhibitory effect comes about as the serotonin (5HT) receptors located post-synaptically bind to 5HT and are inhibitory when Gi is activated and there is a reduction of adenylate cyclase activity (Ressler and Nemeroff, 2000).

So this 2nd messenger system is inhibitory downstream after the serotonin binds to the post-synaptic receptor.

When you are exposed to a stressor, danger, or feared object/situation, your amygdala becomes activated and it causes your fear circuits to be overactive. When your fear circuits that are based on the amygdala become overactive, then this triggers the fight or flight response, which manifest as the physical symptoms of anxiety.

If you want to reduce the anxiety caused by the stressor, then you can take an SSRI or an SNRI, which acts on the serotonergic neurons that are projecting from the raphe nuclei to the amygdala.

The SSRI/SNRI will block the reuptake of serotonin in the synapse, and this effectively will increase the concentration of serotonin, which then binds more to the postsynaptic serotonin receptors and then has an inhibitory effect downstream, and ultimately reduces the overactivity of the amygdala.

Thus, serotonergic agents such as SSRIs and SNRIs reduce anxiety by increasing serotonin input to the amygdala.

In summary, its not as simple as high or low levels of serotonin causing anxiety or how SSRIs/SNRIs correct that chemical imbalance. It is about the complex interactions of different brain and body systems as discussed above. Dont be swayed by pop psychology and amateur explanations of complex brain phenomenon for explaining SSRIs, serotonin and anxiety.

 

Re: Thoughts on this medicaton combination?

Posted by farshad on October 8, 2017, at 10:39:44

In reply to Re: Thoughts on this medicaton combination?, posted by phidippus on October 8, 2017, at 10:16:12

> Confusion abounds about how antidepressants work in anxiety disorders.
>
> SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin norepinephrine reuptake inhibitors) are antidepressant medications that are also used to treat anxiety disorders in addition to depression.
>
> A recent article in Forbes (DiSalvo, 2015) highlights the confusion regarding how SSRIs and SNRIs work in anxiety disorders. This article highlighted a study which found that serotonin was increased in the amygdala in subjects with anxiety (Frick et al., 2015).
>
> So this study has led people to question how SSRIs and SNRIs can help for anxiety as these medications seemingly increase serotonin in the brain. But if increased serotonin was found in the amygdala of subjects with anxiety, then how do these antidepressants work?
>
> To clarify the confusion, its not a simple matter of a chemical imbalance and the antidepressant correcting that imbalance.
>
> Focusing only on the neurotransmitters and the receptors in the synapse (the space and connection between neurons) is so 1990s and 2000s.
>
> Psychopharmacology has advanced to the point where the neurobiology of anxiety is understood at what happens downstream from the synapse, neurotransmitters and receptors.
>
> It is now about post-synaptic 2nd-messenger systems activated by the binding of neurotransmitters to post-synaptic receptors.
>
> It is about how anxiety is mediated by fear circuits made up of neuronal bundles connecting the amygdala to different parts of the brain.
>
> It is about how the activation of the amygdala triggers the sympathetic nervous system and the HPA axis (hypothalamic-pituitary-adrenal axis) to manifest the fight or flight response and how the subsequent release of stress hormones from the adrenal glands interacts with the brain and fear circuits to further mediate the anxiety response.
>
> It is no longer sufficient to focus only on the synapse, neurotransmitter, and receptors to explain how these medications work for the treatment of anxiety disorders. It is now about post-synaptic 2nd-mesenger systems, brain circuits, and whole body responses. This is how we do things now in the 2010s and beyond.
>
> So we have to discuss the neurobiology of anxiety to really understand how SSRIs and SNRIs work. In the brain, serotonergic neurons project from the raphe nuclei, located in the brainstem, to the amygdala, located in the temporal lobes bilaterally.
>
> So these serotonergic neurons project to the amygdala, and have an inhibitory effect on the amygdala. The inhibitory effect comes about as the serotonin (5HT) receptors located post-synaptically bind to 5HT and are inhibitory when Gi is activated and there is a reduction of adenylate cyclase activity (Ressler and Nemeroff, 2000).
>
> So this 2nd messenger system is inhibitory downstream after the serotonin binds to the post-synaptic receptor.
>
> When you are exposed to a stressor, danger, or feared object/situation, your amygdala becomes activated and it causes your fear circuits to be overactive. When your fear circuits that are based on the amygdala become overactive, then this triggers the fight or flight response, which manifest as the physical symptoms of anxiety.
>
> If you want to reduce the anxiety caused by the stressor, then you can take an SSRI or an SNRI, which acts on the serotonergic neurons that are projecting from the raphe nuclei to the amygdala.
>
> The SSRI/SNRI will block the reuptake of serotonin in the synapse, and this effectively will increase the concentration of serotonin, which then binds more to the postsynaptic serotonin receptors and then has an inhibitory effect downstream, and ultimately reduces the overactivity of the amygdala.
>
> Thus, serotonergic agents such as SSRIs and SNRIs reduce anxiety by increasing serotonin input to the amygdala.
>
> In summary, its not as simple as high or low levels of serotonin causing anxiety or how SSRIs/SNRIs correct that chemical imbalance. It is about the complex interactions of different brain and body systems as discussed above. Dont be swayed by pop psychology and amateur explanations of complex brain phenomenon for explaining SSRIs, serotonin and anxiety.

I tried SSRI and snri and they did not work so obviously you are not 100% correct. What did work for me was diazepam and zyprexa which I belive is because of their action on the amygdala.

 

Re: Thoughts on this medicaton combination?

Posted by phidippus on October 8, 2017, at 10:58:48

In reply to Re: Thoughts on this medicaton combination?, posted by farshad on October 8, 2017, at 10:39:44

Are you bipolar, unipolar depressed? You have social anxiety, but what else?

Eric

 

Re: Thoughts on this medicaton combination?

Posted by farshad on October 8, 2017, at 11:10:28

In reply to Re: Thoughts on this medicaton combination?, posted by phidippus on October 8, 2017, at 10:58:48

> Are you bipolar, unipolar depressed? You have social anxiety, but what else?
>
> Eric

no idea what all those is i have depression , social anxiety and ocd

 

Re: Thoughts on this medicaton combination? farshad

Posted by phidippus on October 8, 2017, at 11:19:28

In reply to Re: Thoughts on this medicaton combination?, posted by farshad on October 8, 2017, at 11:10:28

It's too bad you're not responding to SSRIs and SNRIs. They are usually the frontline against depresion and anxiety. Zyprexa might be working well for you because it is a strong 5ht2a antagonist.

Have you tried Abilify with an antidepressant?

A medication you may not have considered but has shown efficacy in treating both social anxiety and OCD is Topomax. You can also try dextroamphetamine...

Eric

 

Re: Thoughts on this medicaton combination?

Posted by farshad on October 8, 2017, at 11:51:54

In reply to Re: Thoughts on this medicaton combination? farshad, posted by phidippus on October 8, 2017, at 11:19:28

> It's too bad you're not responding to SSRIs and SNRIs. They are usually the frontline against depresion and anxiety. Zyprexa might be working well for you because it is a strong 5ht2a antagonist.
>
> Have you tried Abilify with an antidepressant?
>
> A medication you may not have considered but has shown efficacy in treating both social anxiety and OCD is Topomax. You can also try dextroamphetamine...
>
> Eric

I have tried cyproheptadine which is also potent on that but did not work and I have tried Metergoline which is also a potent serotonin antagonist on 1 ,2 6 and 7 did not work so obviously its not the mechanism of zyprexas antagonist on 5ht2a that made it work so well.
what is topomox? how does it work? i have heard about it but i have no idea how it works.

 

Re: Thoughts on this medicaton combination?

Posted by phidippus on October 8, 2017, at 12:16:05

In reply to Re: Thoughts on this medicaton combination?, posted by farshad on October 8, 2017, at 11:51:54

Several cellular targets have been proposed to be relevant to the therapeutic activity of topiramate. These include (1) voltage-gated sodium channels; (2) high-voltage-activated calcium channels; (3) GABA-A receptors; (4) AMPA/kainate receptors; and (5) carbonic anhydrase isoenzymes.

Lots of anti-glutamatergice action...

Eric

 

Re: Thoughts on this medicaton combination? farshad

Posted by MightyKondrian on October 14, 2017, at 15:56:54

In reply to Thoughts on this medicaton combination?, posted by farshad on September 17, 2017, at 16:30:52

Only because you mention Memantine which is used for Alzheimer's, would Piracetam be of any help?
I'm just throwing this in as curiosity.

MightyKondrian


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