Posted by PaulB on August 23, 2001, at 15:29:35
In reply to Re: SP Cocktail - Your Questions+Surprise Enhancer (?) » rick_number1001@yahoo.com, posted by Rick on August 19, 2001, at 16:26:43
> This post was far too long I though for me to try and continue it and for others to then make sense of it so I decided to reflect on it instead and all the issues, and there are alot which I thought were very interesting.
The issue of Klonopin and memory impairment came up again. It can certainly be a problem. I raised the issue myself a while back and at the time Mr Richelson was answering questions at PB.[ http://www.dr-bob.org/babble/20010411/msgs/59594.html ] I wondered if there were any selctive GABA antogonists that could be used to eliminate not only the memory impairment induced by Klonopin but also the annoying cognitive impairment. Looking back I realise I should have asked whether there were any selective bz 'omega' antagonists. His response was that he was not aware of any such drugs available or in clinical trials but there were drugs that were specific only for the bz receptor that regulates anxiety. Pagoclone is a forerunner. However, there is actually an 'inverse agonist', selective for the bz receptor that regulates memory and cogntive function! It is being developed by Neurogen, has just entered phase 2 trials, is indicated for Alzheimers disease and is curreently referred to as NGD 97-1. Neurogen really has their finger on the pulse when it comes to the understanding of and development of new GABA drugs. A trip to their website will reveal more.
Other psycho-babblers suggested Xanax(Judy1) and Provigil(AndrewB). From my experience there is a difference in the level of cognitive impairment and memory problems induced by these two drugs. Xanax causes fewer problems and it is a marked difference. I was less enthusiastic about Provigil for two reasons. Firstly it seemed an approach that would attempt to correct the problem by stimulating the brain with increased catecholamine activity. I didnt think this was very practical and secondly Provigil has potent effect on Glutamate. I thought this may interfere with the effectiveness of Klonopin or Klonopin's activity.
It was mentioned that discontinuation of Serzone seemed to attenuate the memory impairment of Klonopin. This doesnt surprise me. I believe Serzone would have a much greater impact on plasma levels of Klonopin than Klonopin alone, if you take in mind that Klonopin is metabolised by the isoenzyme CYP3A4 and Serzone potently inhibits this enzyme in the liver.
On Klonopin and serotonin, I agree that it could increase or decrease its levels. One metabolite of Klonopin is serotenergic but then Klonopin, via its enhancment of GABAA activity suppresses serotonin activity, although this is probably regionally specific. This is why I believe Klonopin shouldnt be viewed as a drug that is always likely to cause a depression.
PaulB
poster:PaulB
thread:36517
URL: http://www.dr-bob.org/babble/20010822/msgs/76149.html