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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by linkadge on January 5, 2018, at 17:02:49
It seems that, lately, I am only responding to meds / supplements that increase gaba.
I'm a bit concerned, however, because one of the supplements I use (picamilion) is now pulled from the market.
Ian
Posted by rjlockhart37 on January 5, 2018, at 17:14:02
In reply to GABA, posted by linkadge on January 5, 2018, at 17:02:49
there's this med called Gabitril which is a GABA reuptake inhibitor, but its mainly for epilepsy, used sometimes off label but not much, not sure if doctor would approve
Posted by Christ_empowered on January 5, 2018, at 20:30:58
In reply to Re: GABA, posted by rjlockhart37 on January 5, 2018, at 17:14:02
i had a friend on gabitril back in the day. I think she's on neurontin now.
maybe high dose niacin and/or niacinamide? I didn't know picamilon had been taken off the market. what happened?
but...yeah...I do the Orthomolecular routine. I take 6 grams niacinamide and 20 grams vitamin c, plus b-complex tablets and other stuff. I seem to get more mileage out of my abilify and lamictal, plus I'm far, far less agitated, anxious, etc. I even sleep reasonably well, no sedatives required.
Posted by SLS on January 6, 2018, at 11:57:21
In reply to GABA, posted by linkadge on January 5, 2018, at 17:02:49
> It seems that, lately, I am only responding to meds / supplements that increase gaba.
>
> I'm a bit concerned, however, because one of the supplements I use (picamilion) is now pulled from the market.
>
> IanDo you think an anti-glutamatergic drug like Lamictal would serve as a substitute for a pro-GABAergic drug? I don't know. Gabitril (tiagabine) is rather unpredictable. It sometimes produces agitation, anxiety, and insomnia. Other times, it works as an anxiolytic and hypnotic. I don't know of any way to predict one's reaction to Gabitril. I did not react well to it.
- Scott
Posted by linkadge on January 6, 2018, at 15:04:26
In reply to Re: GABA, posted by Christ_empowered on January 5, 2018, at 20:30:58
Not sure why. I think its related to the fact that it is a prescription drug in Russia.
Linkadge
Posted by Tony P on January 17, 2018, at 19:57:04
In reply to Re: GABA, posted by SLS on January 6, 2018, at 11:57:21
I found Lamotrigine a moderately good anti-depressant, but NOT good for anxiety. In fact, each time I tried it, when my dose was titrated up to 100 mg/day, I experienced severe anxiety and required benzos. YMMV!
Posted by Tony P on January 17, 2018, at 20:05:05
In reply to Re: GABA, posted by rjlockhart37 on January 5, 2018, at 17:14:02
There's another recent thread mentioning Lyrica (pregabalin) as a more effective alternative to Gabapentin for GABA-related anxiety. However, it does look as though it is more dose-sensitive and has more side-effects than GP.
I myself recently had some gabapentin from a friend and found it very helpful with anxiety and withdrawal effects from a muscle-relaxant (Robaxin), whereas diazepam was not helping much at all. Unfortunately, my GP was NOT pleased that I had self-medicated, and may be reluctant to prescribe any of these.
Posted by rjlockhart37 on January 18, 2018, at 23:27:15
In reply to Re: GABA » rjlockhart37, posted by Tony P on January 17, 2018, at 20:05:05
lyrica i've been on once, for a while i was resistant to medications for years, but till a few years ago after long prayer, it went away.....but lyrica is more potent than gabapentin, it's more direct and has lower doses. gabapentin is good for shakes and anxiety, it usally calms the nerves, i've been on it in 2009-2010 while at a previous doctor
going in to my sessions, i just say im doing great, because not really much they will do, no point in talking about it. Come in, hey yup doing great, see you soon....deal with all the rest of anxiety and trauma on my own, found other treatments, it sucks but ... that's just the way it is
Posted by Tony P on January 19, 2018, at 0:25:18
In reply to Re: GABA, posted by rjlockhart37 on January 18, 2018, at 23:27:15
Thanks for your input ... how well did Lyrica work for you? I'm having shakes & anxiety from OTC muscle-relaxant withdrawal, anxiety/panic attacks when my depression makes it hard to meet a commitment, and alternating insomnia and hypersomnia -- often get my day & night reversed.
Did I mention thank the god of the Polynesians for Kava-Kava? Except I've taken so much I've used up the entire Canadian supply ;-) there's now a manufacturer's shortage until February.
Posted by rjlockhart37 on January 19, 2018, at 1:19:58
In reply to Re: GABA » rjlockhart37, posted by Tony P on January 19, 2018, at 0:25:18
lyrica was just more direct, it's more noticeable, for anxiety....nuerotin does work, just depends
there's some raw supplements like magnesium, and valerian root that good for anxiety, but there not a med to treat them. l-theanine is a supplement, it is good for anxiety
when i have anxiety i worry, and think about things too much, can't go sleep at night so just surf the web, but part of anixety is that i'm always feared ill mess up, or do something at a job, or even with friends, i mean....anxiety sometimes keeps me balance to keep going and be alert, i feel if don't anxiety i would not be able to keep up....impairments on things that i have to be on my feet and be ready for
Posted by Tony P on January 19, 2018, at 9:06:51
In reply to Re: GABA, posted by rjlockhart37 on January 19, 2018, at 1:19:58
Me too. And putting things off --> guilt --> more anxiety!
Posted by SLS on January 19, 2018, at 10:38:02
In reply to Re: GABA » rjlockhart37, posted by Tony P on January 19, 2018, at 0:25:18
> My Meds
-----------
Escitalopram 20 mg
Bupropion XR 75 mg
Diazepam 5 mg tid - weaning
Propranolol 20 mg tid
Robaxin - non-prescribed; weaning
Kava - non-Rx, prn-----------------------------------------
If you still have residual depression:
Why are you not taking bupropion at 300 mg/day?
I am big on combining Effexor (venlafaxine) 300 mg/day or Pristiq (desvenlafaxine) 100 m/day with bupropion 300 mg/day.
Effexor is indicated to treat generalized anxiety disorder (GAD) and seems to be robustly effective. I don't know that escitalopram has been as closely studied for anxiety disorders.
GABA concentration of CMS [chronic mild stress]
rats was increased significantly by leptin and/or
venlafaxine.Full text PDF:
http://www.lifescienceglobal.com/pms/index.php/ijbwi/article/download/853/542
- Scott
Posted by Tony P on January 19, 2018, at 18:20:34
In reply to Re: GABA » Tony P, posted by SLS on January 19, 2018, at 10:38:02
Hi Scott (and anyone else who wants to wade through my extended babble),
I appreciate your taking an interest; I've always greatly valued your posts.
As background, I have tended towards anxiety all my life; depression, if it wasn't late developing, was certainly late being diagnosed (mid-40s). By the same token, I have a high tolerance for sedatives and very low tolerance for stimulants _including_ serotonin. I am an early-onset alcoholic and addict. I also have had sleep disturbances most of my life, although they have varied between insomnia, hypersomnia, delayed sleep phase disorder (DSPD) and some occasional fairly weird parasomnias. I do need a balance of the big 3 (SE, NE, DA) to be moderately sane. To complicate things, I got myself addicted to benzos, barbs & other sleeping pills, as well as alcohol, in the 60s & 70s, so I have long-term GABA-receptor problems that are not easily resolved at age 71.
When it seemed that I just _might_ be MDD as well as an addict, after a year or so good sobriety in 1992-93, I was briefly on Paxil (too many side effects, anxiety, sweats, shakes), then discovered an ad for the then new Serzone in my mother's medical journal; it seemed like the perfect fit to my symptoms, which included some pretty bad sleep disturbances at that time. Serzone plus Buspar was perfect for several years, but started to poop out shortly before Serzone got banned in Canada. That was how I came to be on bupropion the first time around. This was back in about 2000-2002.
I was on the full 300 mg bupropion-SR/day for months as my only antidepressant; I was happy, even euphoric, although also quite anxious, hyper, shaky & and insomniac, and consuming a lot of OTC, Kava & benzos to try to level out & cope with the anxiety. I thought I was OK, but my work performance was falling off drastically and my family intervened when I hit borderline manic. The pdoc I saw after that took me right off the bupropion, said it was "disahstrous" for anyone with addiction disorder & switched me to Celexa, which proved even more "disahstrous"; I was so anxious I was dissociating, and developed liver pains from the combination with trazodone. I can't remember what A/D (if anything) I switched to at that point, may have been nothing but Buspar -- I was in a treatment centre, safe supportive & busy environment, difficult to be depressed!
Incidentally, I took some Serzone (150 mg?) one night when I was still on bupropion to try to get some sleep; instead wound up with moderate Serotonin Syndrome, awake all night, feverish, with my mind churning; posting incessantly right here -- nobody else was on the board until about 6 AM, but posting kept me sort of sane (I'm sure those posts are all still in the archives - 2002?). So I've ever after been very cautious about bupropion, I'm clearly about 2-4 times as sensitive to it as the average person. And Rx.com gives a red warning about mixing bupropion with escitalopram; via the CyP enzymes, bupropion synergizes with S-citalopram, resulting in higher serotonin levels.
I couldn't understand at the earlier time how a pure DNRI (bupropion) could react so violently with a pure SRI (nefazodone). Now I know more about the CyP enzyme interactions I can understand it (I spent 2 years on an MSc in microbiology & biochem.). But it seemed at the time the bupropion had made a (semi-)permanent change in my reaction to Serzone; I could never take Serzone again, even without bupropion, without becoming agitated. Explored several alternatives, Lamotrigine, Remeron, etc. I was on tianeptine which I imported from UK -- then one week my shipment simply failed to arrive, probably seized by Customs/Health Canada. So I needed to switch to something that would work quickly, and my pdoc prescribed escitalopram, new at the time, saying it had 95% of the A/D effect of Celexa (which had driven me literally crazy) and only 5% of the side-effects. It certainly worked that way for me. But S-citalopram or any SRI by itself leaves me anhedonic, anxious & not coping. Effexor made me _extremely_ anxious; almost as bad as Celexa; intolerable. Cymbalta strangely did NOT make me anxious, and worked very well for me, virtually no side-effects. But it wasn't (and isn't) covered by my govt. drug plan; evidently Effexor's marketing/lobbying team is more efficient. I got free samples for a while. I'll spare you the full rant, but that is how I eventually wound up on an odd mixture of 5 meds instead of one effective one. Argghhh! And, based on both my history and this past year's experience, I'm right to be cautious with my bupropion; if there is such a thing as BP III, I'm it!
The final series of blows were that first my pdoc went on long-term disability and eventually early retirement _right_ after he prescribed the bupropion with the escitalopram, so I was on my own trying to find the right dose - no spare staff/budget for a locum. They lost further staff, did an across-the-board triage, and I missed the cut, even though I was suicidally depressed at the time, because my addiction had flared up again. (Bupropion really, really is risky for me as a trigger). Then finally, my GP, who had been carrying about 3x the patient load of most practitioners, retired a year ago. My new GP is swamped, booking a month or more ahead for 10 minute appointments, and I'm in a vicious circle, missing half my appointments because of my sleep-disorders, GAD, depression & agoraphobia, and my sedative addiction, which has been running rampant for 9 months; so I don't have the opportunity to discuss the issues at length with my GP, and no pdoc wants to see me if I'm in active addiction; but since my prescribed meds aren't properly balanced, I go back to my drugs-of-choice to at least minimally cope; I am too depressed/anxious/stoned/sleep-deprived to get to outpatient addiction services or peer-groups, and around I go again!
As the Frenchman said, I apologize for the length of this post, but I didn't have time to write a short one! I guess I badly needed to write it all out for myself, the history and the frustration. I've been isolating and not seriously talking to anyone, professional or sane & sober peer, for 18 months. Perhaps I'll keep a copy of this post and FAX it to my new GP, see if she has time to read it (under our government system, she doesn't get paid for a lot of services like Rx refills, FAX's & telephone consultations, let alone reading patients' babbles - another rant successfully cut short). We've never had a chance to really sit down and spend time on my history since our first meeting a year ago.
I am feeling well today (coffee helps), & I hope you are continuing to improve.
Cheers,
Tony
Posted by SLS on January 20, 2018, at 6:47:57
In reply to Re: GABA » SLS, posted by Tony P on January 19, 2018, at 18:20:34
"As the Frenchman said, I apologize for the length of this post, but I didn't have time to write a short one!"
I totally get that!
Wellbutrin + Lamictal + Abilify + N-acetylcysteine (NAC)?
- Scott
Posted by Tony P on January 25, 2018, at 20:14:44
In reply to Re: GABA » Tony P, posted by SLS on January 20, 2018, at 6:47:57
> Wellbutrin + Lamictal + Abilify + N-acetylcysteine (NAC)?
>
>
> - ScottLamictal didn't work particularly well for me, and (once again) due to the vagaries of the BC govt. drug plan, is not supported unless one has already been on lithium & valproate.
Abilify - don't really know much about this, but I don't generally react well to antipsychotics.
NAC - I keep this around in case I take too much acetaminophen, and recently it's been highly recommended as an antioxidant - should be taking it regularly, but I've got so darned amny supplements; hadn't heard of its use in depression.
This is the end of the thread.
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