Psycho-Babble Medication Thread 1100299

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Re: carbamazepine (tegretol) for social anxiety

Posted by linkadge on August 14, 2018, at 10:35:29

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by Christ_empowered on August 13, 2018, at 21:33:23

If antidepressants haven't worked for anxiety, then using something like a benzodazapine or an anticonvulsant seems rational.

Linkadge

 

Re: carbamazepine (tegretol) for social anxiety

Posted by rjlockhart37 on August 14, 2018, at 12:51:43

In reply to carbamazepine (tegretol) for social anxiety, posted by farshad on August 13, 2018, at 19:48:05

tegretol reduces firing of neurotransmitters that are related with excess, regulates the voltage, but not sure hows with anxiety

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 14, 2018, at 16:18:16

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by rjlockhart37 on August 14, 2018, at 12:51:43

> tegretol reduces firing of neurotransmitters that are related with excess, regulates the voltage, but not sure hows with anxiety

''Although CBZ has been shown to inhibit hypothalamic CRH secretion in vitro''
https://www.researchgate.net/publication/308668997_Effects_of_carbamazepine_on_pituitary-adrenal_function_in_healthy_volunteers

im sure you know what CRH is .

 

Re: carbamazepine (tegretol) for social anxiety

Posted by KathrynLex on August 14, 2018, at 16:38:13

In reply to carbamazepine (tegretol) for social anxiety, posted by farshad on August 13, 2018, at 19:48:05

To me, one of the more amusing things about medications is that it's often developed for one thing, and then it turns out to work for other issues. I take Klonopin on a regular basis (right now I'm up to 1 mg 3x per day), and it started out as a medication to help with seizures. It does amazing things for anxiety, and I'm grateful for it.

Fun side note: Viagra was initially developed to lower blood pressure. Point being, there are lots of drugs out there that are created for one thing, but work for others too.

 

Re: carbamazepine (tegretol) for social anxiety

Posted by linkadge on August 14, 2018, at 17:27:29

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by KathrynLex on August 14, 2018, at 16:38:13

Tegregol can help anxiety. Give it a try. I liked it.

Linkadge

 

Re: carbamazepine (tegretol) for social anxiety

Posted by rjlockhart37 on August 16, 2018, at 22:22:06

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 14, 2018, at 16:18:16

ok, yes i didnt research, next time further research should be done, no more no-brainer answers....carbamazepine is known to cause adrenal insufficiency, and all that ordeal thing with CYP3A4 enzyme activity

http://dr-bob.org/babble/20091127/msgs/927685.html

obviously it's used well for anxiety, but i admit i don't know much about it, know more about lamotrigine than carbamazepine

 

Re: carbamazepine (tegretol) for social anxiety

Posted by rjlockhart37 on August 16, 2018, at 22:25:41

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by rjlockhart37 on August 16, 2018, at 22:22:06

carbamazepine also slightly increases serotonin, don't have a direct source but i know it boosts some serotonin levels which could be why it has a semi-anxiety relief also

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 17, 2018, at 0:46:01

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by rjlockhart37 on August 16, 2018, at 22:22:06

> ok, yes i didnt research, next time further research should be done, no more no-brainer answers....carbamazepine is known to cause adrenal insufficiency, and all that ordeal thing with CYP3A4 enzyme activity
>
> http://dr-bob.org/babble/20091127/msgs/927685.html
>
> obviously it's used well for anxiety, but i admit i don't know much about it, know more about lamotrigine than carbamazepine
>
>

yeah im just looking for any experiences people might have with CBZ if it helpt anxiety .

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 19, 2018, at 10:17:59

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by linkadge on August 14, 2018, at 17:27:29

> Tegregol can help anxiety. Give it a try. I liked it.
>
> Linkadge

Linkadge how did you manage to get prescribed Tegregol? I dunno what to tell my doctor. This isnt usually prescribed for anxiety is it? it is used for epilepsy, alchol withdrawals and some face pain , were I live. It also can be used off laber for other things but i dunno what that could be. I might just tell my doc and pretend like I have pain in my face to get it prescribed. I cant say nothing about me having anxiety or for to get it presribed for some bipolar /mood disorders, becuase then they will just refer me to psychiatry which they refuse to give me medication only therapy.

 

Re: carbamazepine (tegretol) for social anxiety

Posted by linkadge on August 22, 2018, at 14:11:29

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 19, 2018, at 10:17:59

Hey,

Not sure what to say. Tegregol is primarily used for epilepsy. However, it has other off label uses like bipolar or pain. The problem is that it is not a first line treatment for those off label uses, meaning that if you present with those symptoms you'd likely be prescribed something else instead.

It really depends on what your current diagnosis is. If it is anxiety, you might need to try a handful of traditional meds before trying an alternative.

I know you're not too keen on taking a serotonin booster. However, you may need to 'go through the motions' on a few of these meds befor trying something else. If the doctor prescribes this, take a very low dose and see how it goes.
If your anxiety gets worse, let him/her know this and see if you can try something else.

If you're not reacting well to antidepressants for anxiety, the doctor should be open to trying different classes of meds.

Many doctors don't like you to self diagnose / reccomend the first drug off the bat. However, if they see you've made a genuine attempt at traditional meds, they may be ok with trying an alternative.

You might be honest and just ask "do you ever use mood stabilizers for anxiety?" Tegretol may be a good option. Lamotrigine may also help. Keep in mind, these meds have side effects of their own.
You want to make sure you're keeping an open mind.

Do you have any relatives who take mood stabilizers (or have other diagnosis - like say bipolar)? If so, you might suggest that a relative did well on (such and such).
I have found that, honesty usually is the best policy. I've also learned that meds that I don't think will work, can sometimes work.

For example. The fist time I was given a script for tegretol I ripped up the script and threw it in the garbage (because I was looking for something else). A few days later I fished it out, taped it back together and took it to the pharmacy. Long story short, a med that I was dead against, ended up working.

Linkadge

 

Re: carbamazepine (tegretol) for social anxiety

Posted by linkadge on August 22, 2018, at 14:15:47

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 19, 2018, at 10:17:59

Just to add...

Lyrica and Gabapentin are approved for anxiety in Europe. Have you considered / tried either of these meds? They are anticonvulsants and likely have a bit more efficacy in anxiety.

Not sure if you've tried penibut (a supplement). It operates via the same mechanism as lyrica / gabapentin. If you haven't tried phenibut, you might order / try this to see if it helps your anixety. If it does, there is a decent chance that lyrica or gapapentin will help anxiety.
If I could chose between lyrica or tegretol for anxiety, I would chose lyrica. If there was a mood disorder (i.e. bipolar) with it, then I'd go for tegretol.

Linkadge

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 22, 2018, at 16:19:11

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by linkadge on August 22, 2018, at 14:15:47

> Just to add...
>
> Lyrica and Gabapentin are approved for anxiety in Europe. Have you considered / tried either of these meds? They are anticonvulsants and likely have a bit more efficacy in anxiety.
>
> Not sure if you've tried penibut (a supplement). It operates via the same mechanism as lyrica / gabapentin. If you haven't tried phenibut, you might order / try this to see if it helps your anixety. If it does, there is a decent chance that lyrica or gapapentin will help anxiety.
> If I could chose between lyrica or tegretol for anxiety, I would chose lyrica. If there was a mood disorder (i.e. bipolar) with it, then I'd go for tegretol.
>
> Linkadge

i have tried lyrica and it just made me sleepy. not much for anxiety tbh. phenibut didn't help anxiety either.
lyrica I think it is in same class as carbamazepine , lamictal etc

the only difference is carbamazepine from these other it happens to inhibit CRH in the hypothalamus straight from the source! You know what CRH is right? and its role in anxiety is huge!!!!!
valproate I think decreases CRH also.

but lyrica,gabapentin, lamictal etc no effect on CRH itself.

Im over the serotonin part by the way, I have found out my anxiety is caused by excess CRH-CRHR1 signaling.
high CRH causes high serotonin release especially high 5h3 signaling which explains why I feel dizzy all the time.

the only time I think my anxiety was at the lowest was when I took a low dose of zyprexa, it happens to inhibit CRH in the hippocampus, so i think there is a connection here and I have found it.

I havent started carbamazepine yet but it should be avalibale soon for me to buy.

people just look on the outside, yeah SSRI approved for anxiety cause it increases serotonin, meanwhile one important aspect of a ssri like Prozac is it increases allopregnenolone *neurosteroid which is responsible mostly for its anti anxiety effect, my point being you have to go trough studies on each drug and see what fits you the most what you think your problem is. in my case high CRH*CRHR1,rare case, not many solutions , but i found it.
carbazmepine structure is similar to imipramine and i heard that drug is good for anxiety and it inhibits crh too in the PVN!

 

Re: carbamazepine (tegretol) for social anxiety

Posted by Christ_empowered on August 23, 2018, at 6:24:28

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by linkadge on August 22, 2018, at 14:15:47

i dont know how it is where you live, but 'round here...oxcarbazepine (trileptal, etc.) would probably be prescribed 1st. less blood work, less toxic.

have you looked at the research on oxcarbazepine? I used to take it, and it was OK. Kinda mind numbing at higher doses, but that's to be expected. I seem to recall people around me being given relatively low doses for agitation and intense anxiety.

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 23, 2018, at 6:53:00

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by Christ_empowered on August 23, 2018, at 6:24:28

> i dont know how it is where you live, but 'round here...oxcarbazepine (trileptal, etc.) would probably be prescribed 1st. less blood work, less toxic.
>
> have you looked at the research on oxcarbazepine? I used to take it, and it was OK. Kinda mind numbing at higher doses, but that's to be expected. I seem to recall people around me being given relatively low doses for agitation and intense anxiety.

carbamazepine isnt toxic at all .oxcarbazepine doesent inhibit crh like tegretol that i know of. neither does lyrica etc.

 

Re: carbamazepine (tegretol) for social anxiety » farshad

Posted by linkadge on August 23, 2018, at 7:53:37

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 23, 2018, at 6:53:00

The HPA axis is very complicated. Both high and low cortisol have been associated with anxiety. It is difficult to know, without a series of blood tests, whether one has abnormal cortisol.

Even if one has high cortisol, it is difficult to know the source. High cortisol can cause anxiety, but high anxiety can also cause high cortisol. High cortisol may not be the initial imbalance. For example, if other monoamines were out of wack (i.e. serotonin, gaba, norepinpehrine etc) this could cause cortisol to be out of control.


Many antidepressants and anxiolytics (especially the TCAs) will normalize the HPA axis (i.e. CRH) over time. For exampe, escitalopram (even though it increases serotonin) has been shown to normalize the HPA axis. Benzodiazapines inhibit cortisol.

Tegrol does have side effects and toxicities. It can affect white blood cells. It can impact the liver. It may also negatively impact neurogenesis and cell function (you can do a pubmed search). Tegretol is less 'clean' than gabapentin / lyrica. It can certainly make you feel tired, or weak. As a mood stabilier, it can also flatten out your mood / emotions. Like all anticonvulsants, it can also dampen cognition / thinking skills and motor co-ordination.


Valproate can also help anxiety, but it is a heavy medication. It can cause drowsiness, impaired co-ordination and cognition. This is the disadvantage of all the anticonvulsants.

I'm not saying don't try tegretol. I'm just saying that if you get tunnel vision one one mechanism, you can often miss the big picture. I.e. tegretol may inhibit CRH (i.e. and hence reduce an overactive HPA axis) but so can many other medications. Tegretol, for you, may have fewer side effects, or more side effects. Who knows.


Linkadge

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 23, 2018, at 8:16:19

In reply to Re: carbamazepine (tegretol) for social anxiety » farshad, posted by linkadge on August 23, 2018, at 7:53:37

> The HPA axis is very complicated. Both high and low cortisol have been associated with anxiety. It is difficult to know, without a series of blood tests, whether one has abnormal cortisol.
>
> Even if one has high cortisol, it is difficult to know the source. High cortisol can cause anxiety, but high anxiety can also cause high cortisol. High cortisol may not be the initial imbalance. For example, if other monoamines were out of wack (i.e. serotonin, gaba, norepinpehrine etc) this could cause cortisol to be out of control.
>
>
> Many antidepressants and anxiolytics (especially the TCAs) will normalize the HPA axis (i.e. CRH) over time. For exampe, escitalopram (even though it increases serotonin) has been shown to normalize the HPA axis. Benzodiazapines inhibit cortisol.
>
> Tegrol does have side effects and toxicities. It can affect white blood cells. It can impact the liver. It may also negatively impact neurogenesis and cell function (you can do a pubmed search). Tegretol is less 'clean' than gabapentin / lyrica. It can certainly make you feel tired, or weak. As a mood stabilier, it can also flatten out your mood / emotions. Like all anticonvulsants, it can also dampen cognition / thinking skills and motor co-ordination.
>
>
> Valproate can also help anxiety, but it is a heavy medication. It can cause drowsiness, impaired co-ordination and cognition. This is the disadvantage of all the anticonvulsants.
>
> I'm not saying don't try tegretol. I'm just saying that if you get tunnel vision one one mechanism, you can often miss the big picture. I.e. tegretol may inhibit CRH (i.e. and hence reduce an overactive HPA axis) but so can many other medications. Tegretol, for you, may have fewer side effects, or more side effects. Who knows.
>
>
> Linkadge
>
>
>
>
>
>
>
>

I think I have been trough every possible thing that could cause anxiety, last left is the crh-crhr1 system, btw crh is not cortisol it is Corticotropin-releasing hormone ''corticotropin'' not same as cortisol but I think you know that already.

most drugs in my experience has no direct effect on reducing crh , i guess there is no way to know but try carbamazepine and see if it works, I will let you guys know how things go if anyone cares, should have the drug soon about 2-3 weeks.
Valproate decrease CRH release also but it dosen't say where, it is important that it decreases in the hypothalamus becuase thats were crh is created.

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 23, 2018, at 8:30:58

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 23, 2018, at 8:16:19

but my theroy is good tho right . carbamazepine inhibiting crh secretion from hypothalamus ..

 

Re: carbamazepine (tegretol) for social anxiety » farshad

Posted by linkadge on August 23, 2018, at 14:18:07

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 23, 2018, at 8:16:19

>last left is the crh-crhr1 system

Not really. The brain has neurotransmitters / neuromodulators that we don't even know about yet!
There are literally thousands of signaling molecules in the brain that could get out of whack in depression. Endocannabinoids, PEA, trace amines, CCK, substance P, TREK, NPY, neurohormones, neurotrophins (BDNF, GDNF, NGF, NT-3) protein kinases, GSK3, AMPA, NMDA, Ion channels (sodium, calcium, potassium), 2nd messengers, IP3, opioid (sigma, delta, kappa, mu), sigma receptors (sig1/2), monoamine oxidases, individual receptor dysregulation, plus a kazillion more that I can't list (or that we don't have drugs that directly target).

We know, perhaps, 1% of the mechanisms and targets of the medications we take. The medications were discovered by their effects, not their mechanisms. It is only after the fact, that we try and pin down the effects. We may discover one target or another, but, in many ways, we have a very incomplete picture of how the drugs actually work.

For example, it was only discovered a few years ago that amitriptyline acts as a direct trk-b agonist. This is despite several decades of clinical use as a very effective antidepressant. We knew it worked as an antidepressant, but didn't fully know (and still don't fully know) how.

Why is nortriptyline (a NRI) a very effective antidepressant, yet atomoxetine (a NRI) not? On paper, they should both work the same, but they don't.

CRH blockers have been developed and tested as treatments for anxiety and/or depression. However, despite much clinical research, they don't show much effect vs. placebo.

There are feedback loops for the CRH - ACTH - cortisol system. ACTH itself, for example, can suppress CRH. Also, ACTH stimulates DHEA release. DHEA tends to be low in depression. DHEA promotes neurogenesis, has antidepressant effects (through sigma-1r) and may itself help regulate cortisol.

Effective treatments for anxiety / depression can strengthen this feedback loop without directly supressing CRH. In other words, you're not supressing the whole system, as cortisol is critical for regulating energy and its release can actually help extinguish fears.

Again, I'm not saying don't try carbamazepine. It may work well. I'm just saying that you can't just focus on one target of the drug and use process of elimination. We don't know all the targets of the drugs. We don't know all the causes of depression / anxiety. It's not like you can go through a checklist (serotonin, norepinephrine, dopamine, gaba, CRH, etc. etc. to find what is wrong). This process *may* work for some, but again, most drugs are not selective.

When you change serotonin, you change everything. An SSRI indirectly affects norepinephinre, dopemine, cortisol, melatonin, glutamate, gaba, you name it. Likely everything changes. Is it the serotonin, or is it a downstream effect? Who knows. Perhaps somebody had high glutamte, or hight norepinephrine (not low serotonin) and the SSRI helped lower these, leading to improvement.

Linkadge




 

Re: carbamazepine (tegretol) for social anxiety

Posted by linkadge on August 23, 2018, at 14:27:32

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 23, 2018, at 8:30:58

>but my theroy is good tho right . carbamazepine
>inhibiting crh secretion from hypothalamus ..

In theory yes. Reducing CRH would reduce cortisol release. But, you might find that the primary targets of the drug (i.e. sodium / calcium channel inhibition) offset this benefit.

For example, cyproheptadine is a powerful regulator of cortisol. It is given to people with cushings disease (very high cortisol). However, if you have taken it, you may find that it can be a heavy medication - leaving you feel a bit yucky with long term use. In other words, other effects of the drug, outweight the anticortisol benefits, for treating anxiety disorders.

Linkadge

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 24, 2018, at 9:03:40

In reply to carbamazepine (tegretol) for social anxiety, posted by farshad on August 13, 2018, at 19:48:05

If anyone knows any other drugs besides carbamazepine that inhibits CRH in the hypothalamus PVN let me know.

so far I know: desipramine/imipramine,valproic acid,xanax and most Antipsychotic drugs.


from what I can tell my best choices are: valproate, carbamazepine or one of the imipramine drugs.


valproate very heavy side effects and short(ish) half life. 9-16 hours

imipramine 20 hour half life, I assume this drug has a lot of side effects and is difficult to get. It is a TCA.

that leaves carbamazepine. long half life 30 hours, not as much side effects and easy to get and does practically what imipramine does, inhibits CRH in the hypothalamus, in studies it says imipramine inhibits CRH in the PVN but for carbamazepine it only say hypothalamus but i assume it also inhibits in the PVN becuase of they are structually ssimilar drugs

 

Re: carbamazepine (tegretol) for social anxiety » farshad

Posted by ed_uk2010 on August 24, 2018, at 13:53:26

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 24, 2018, at 9:03:40

Imipramine shouldn't be difficult to get unless it's not sold in your country.

Imipramine is effective for various forms of anxiety and depression. It undoubtedly works. Side effects can be a bit troublesome initially but it's a much more established treatment for anxiety and depression than carbamazepine.

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 24, 2018, at 14:04:53

In reply to Re: carbamazepine (tegretol) for social anxiety » farshad, posted by ed_uk2010 on August 24, 2018, at 13:53:26

> Imipramine shouldn't be difficult to get unless it's not sold in your country.
>
> Imipramine is effective for various forms of anxiety and depression. It undoubtedly works. Side effects can be a bit troublesome initially but it's a much more established treatment for anxiety and depression than carbamazepine.

nop imipramine not available were I live (sweden). But I assume it can be bought in ? previously I had gotten nardil and i had to go to the pharmacy and they had to like order it? i assume same thing can be for imipramine .
im just gonna go for carbamazepine.

 

Re: carbamazepine (tegretol) for social anxiety

Posted by linkadge on August 24, 2018, at 16:31:58

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 24, 2018, at 14:04:53

I would think that most of the TCAs have a similar effect on the HPA / CRH / Cortisol system. Imipramine is simply the most studied, but all are structurally related.

Linkadge

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 24, 2018, at 17:54:37

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by linkadge on August 24, 2018, at 16:31:58

> I would think that most of the TCAs have a similar effect on the HPA / CRH / Cortisol system. Imipramine is simply the most studied, but all are structurally related.
>
> Linkadge

maybe but im mostly looking for drugs that have Direct effect on CRH.

I think mianserin & amitryptyline inhibit CRH not sure tho.

https://www.ncbi.nlm.nih.gov/pubmed/14735130

 

Re: carbamazepine (tegretol) for social anxiety

Posted by farshad on August 26, 2018, at 8:45:56

In reply to Re: carbamazepine (tegretol) for social anxiety, posted by farshad on August 24, 2018, at 17:54:37

we have clomipramine in sweden.
it is made from imipramine and so is
desipramine.


https://www.ncbi.nlm.nih.gov/pubmed/15214866

it was found that clomipramine lowers CRH mRNA expression in the PVN by 74%, regardless of stressor conditions.


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