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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Jay2112 on December 18, 2021, at 21:31:18
Just going over some of the excellent free tutorials
at psychopharmacology.com (donation/membership funded...no drug companies/no scientologists...etc)Lithium, and lamotragine as well, are initially agonists at glutamate receptors and they stimulate the NMDA receptor (actually, a sub-receptor of glutamate). But, the chronic administration of both lithium and lamotragine down-regulates the glutamate receptor and it's sub-type. In a way, like the SRI's are proposed to do to serotonin.
The dose is proportional, meaning smaller doses may not quite downregulate NMDA as much as higher doses. I read that the small amount of lithium many take with an antidepressant may stimulate glutamate mildly, and help slightly lift depression. (Again, it is all likely much more complicated, but is a theory we must consider.)Just think, if we stomped out glutamate to extremely low levels, we must remember glutamate *does* serve a function in arousing many brain functions. Many, like I, find that low doses of lithium has a very profound antidepressant effect, but I cannot tolerate high doses. Same goes with lamotragine. I have also had a positive response to the pro-glutamate stimulant provigil. Too much, though, and I become unstable. But, in another twist, glutamate is responsible in production of the inhibitory, calming NT GABA. On an interesting note, I think that the combination of the pro-GABA effects of Nardil with it's MAOI-A properties are why Nardil is so effective in treatment of both anxiety and depression.
My pointing out of things such as this, and my paradoxical (depressive) response to magnesium, demonstrate (yes, this is subjective, but with some research and knowledge behind it) that all-or-nothing thinking and theory is not always 100 percent applicable to every person that takes said drug.
One of the most common theories that the general public seems to hold is that, simply, antidepressants "increase" serotonin, when (as most of you know) the science behind it is much, much more complex and intricate.
Check out the above website, if you haven't. It is geared towards pdocs getting CMA credits, but for those of us with at least some psychopharmalogical
knowledge, it is quite interesting.I am currently experimenting with mild pro-cholinergic substances, mild glutamate agonists, to help with usual 5-HT and dopamine antagonists/agonists. To me, I don't think the we look to establishing some sort of balance in psychopharmacology, and we are finding micro-dosing of numerous psych meds with unique properties can have very interesting, efficacious responses in relieving various forms of depression and anxiety.
I am trying to use this knowledge in working with clients in addictions and mental health. (Concurrent Disorders.) Many of these poor folks are simply offered an antidepressant in treating these disorders (and lucky if they can get on/afford methadone or suboxone). Psychiatrists are very highly reluctant to prescribe benzo's and stims because of the so-called 'abuse' potential...sorry, but this kind of conservative thinking leaves out highly efficacious relief from torturous psychiatric conditions.
Just, IMHO, YMMV, etc...
Thoughts, please?? :)
Jay
Posted by Lamdage22 on December 19, 2021, at 4:08:33
In reply to Lithium is a glutamate agonist/NMDA stimulator, posted by Jay2112 on December 18, 2021, at 21:31:18
I agree with you. I microdose 5-HTP, Trazodone and Lithium. Very helpful. The stress is on microdose, so don't do anything stupid... Serotonergic antidepressant with 5-HTP may lead to serious trouble.
Fortunately my doctor is open minded. Many others would say microdosing is useless. Because their guidelines are their religion.
Posted by undopaminergic on December 19, 2021, at 5:59:11
In reply to Lithium is a glutamate agonist/NMDA stimulator, posted by Jay2112 on December 18, 2021, at 21:31:18
> glutamate is responsible in production of the inhibitory, calming NT GABA.
I think you mean glutamine, not glutamate. Glutamine is used to synthesise both GABA and glutamate. If I recall correctly.
-undopaminergic
Posted by undopaminergic on December 19, 2021, at 6:01:55
In reply to Re: Lithium is a glutamate agonist/NMDA stimulator, posted by Lamdage22 on December 19, 2021, at 4:08:33
> I agree with you. I microdose 5-HTP, Trazodone and Lithium. Very helpful. The stress is on microdose, so don't do anything stupid... Serotonergic antidepressant with 5-HTP may lead to serious trouble.
>
> Fortunately my doctor is open minded. Many others would say microdosing is useless. Because their guidelines are their religion.
>I thought you took 225 mg of lithium? That is not a "micro" dose.
-undopaminergic
Posted by Lamdage22 on December 19, 2021, at 7:12:37
In reply to Re: Lithium is a glutamate agonist/NMDA stimulator, posted by undopaminergic on December 19, 2021, at 6:01:55
Ok low dose Trazodone and Lithium, micro dose 5-htp.
Posted by SLS on December 19, 2021, at 12:35:45
In reply to Lithium is a glutamate agonist/NMDA stimulator, posted by Jay2112 on December 18, 2021, at 21:31:18
...at higher dosages known to squash mania.
The effects of lithium seem to be bimodal with respect to glutamate activity.
At lower dosages, lithium does the reverse of what it does at higher dosages. It stimulates glutamate activity in the brain. At higher dosages, lithium inhibits it. The dosages of lithium necessary to treat mania usually ranges between 900-1500 mg/day, which produce blood levels of 0.8 to 1.2 mmol/L.
For me, Lithium has an antidepressant effect at 300 mg/day, although mild. At 450 mg/day and higher, lithium exacerbates my depressive state. Intrestingly, a study of the *clinical* effects of lithium also demonstrates a bimodal distribution with respect to dosage. If true, this would probably explain the effects I observe in myself.At low dosages of lithium, blood tests serve little purpose in arriving at an effective dosage to treat depression. It must be done clinically. At 300 mg/day and less, there is almost no liability to damage to thyroid and kidneys.
"Bimodal Effect of Lithium Plasma Levels on Hippocampal Glutamate Concentrations in Bipolar II Depression: A Pilot Study"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438538/908
- Scott
Posted by linkadge on December 19, 2021, at 14:45:15
In reply to Lithium is a glutamate agonist/NMDA stimulator, posted by Jay2112 on December 18, 2021, at 21:31:18
Yes, your brain requires glutamate to function. If glutamate becomes too low, neuroplasticity is adversely effected.
There is evidence that (for example) glutamate must rise for ketamine to function properly in enhancing neuroplasticity.
Linkadge
Posted by Lamdage22 on December 20, 2021, at 2:17:25
In reply to Re: Lithium is a glutamate agonist/NMDA stimulator, posted by linkadge on December 19, 2021, at 14:45:15
I feel that in quenches suicidal urges. Not 100% but 85%. And the dosage needed isn't high.
Posted by Lamdage22 on December 20, 2021, at 2:23:36
In reply to Re: Lithium is a glutamate agonist/NMDA stimulator, posted by Lamdage22 on December 20, 2021, at 2:17:25
Its basically a mineral.
This is the end of the thread.
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