Posted by Emme on August 8, 2002, at 7:03:13
In reply to Re: Anyone had lowered WBC count?, posted by Shawn. T. on August 6, 2002, at 23:36:22
I was not of the opinion that WBC counts would *explain* my problems, but rather that it was either a *result* of a drug or a result of some other cause.
I was looking for responses from people who might have had *personal* experience in this, and what their doctors thought of it.
In the past I have taken an SSRI for an extended period without any blood abnormalities. Although I cannot take the time to look at every article you have looked at, my experience and those of the many people I know who've been on SSRI's for long periods of time are inconsistent with what you say - that is, no blood abnormalities.
The hematologist I just saw thought that based on clinical experience as well as it's pharmacologic properties, Neurontin was the most likely culprit. Lamictal would be considered as a second possibility, but that remains to be seen. She did not feel there is currently any danger as every other blood parameter is normal and I don't have any other suspicious symptoms such as swollen lymph nodes, fevers, sweats. She did not order any involved or unusal blood tests - just monitoring CBC over the next several weeks and seeing how it goes for the time being.
She is a reputable and experienced specialist at a teaching institution. She is not symplifying a complicated system, but has the experience and wisdom to plan a reasonable and sensible approach without unncessary testing - until appropriately indicated.
I will not be posting on this board for at least the next several months. Anyone who wishes to know why can see Psycho Babble Administration.
> Based on all of that information, my guess is that your IL-6 levels are high. White blood cell counts won't explain your problems. I apologize if the following isn't in layman's terms; we're not exactly dealing with simple material (some people would like to think everything is as simple as increasing serotonin levels, that is anything but true). Lamictal is probably the culprit (I'm basing that on the pharmacology of each of the drugs that you are taking). You could also see about having your TNF-alpha, TNF-gamma, IL-1Ra, IL-2, IL-10, and IL-4 levels checked if you really want to be thorough (I don't know how much something like that costs). IL stands for interleukin and TNF stands for tumor necrosis factor. IL-2 would probably be the most important interleukin to get checked out besides IL-6. IL-6 is involved in the production of B lymphoctyes (B cells), which are responsible for making antibodies. High levels of IL-6 cause a problem because they attracts inflammatory cells (even in the brain). Dr. Michael Maes has done a large amount of work on the involvement between IL-6 and psychological stress. He has also shown that after chronic serotonin reuptake inhibition in vivo, IL-6 levels are significantly increased. In vitro studies have shown otherwise, but such studies only imply that the people conducting them do not understand long-term in vivo serotonin reuptake inhibition pharmacology. Serotonin has been implicated in the proliferation of IL-6 cells, and Lamictal, among other things, is a serotonin reuptake inhibitor. That leads to increased extracellular serotonin levels and increased numbers of IL-6 cells. I am of the opinion that serotonin receptor 5-HT2a is mostly responsible for serotonin's effects upon IL-6 levels in the body. I am somewhat tempted to say that it may be IL-2 levels instead, but I can't say for sure (IL-6 seems more likely based on the description of your problems). Chronic tricyclic antidepressant (amitryptiline) administration has been shown to increase IL-2 levels, and that might be a better comparison drug due to its ability to inhibit noradrenaline. IL-2 causes T-cells to proliferate. Amitryptiline has a number of effects besides serotonin and noradrenaline reuptake inhibition, so it's hard to say.
>
> http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=29720049
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> http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=16410965
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> http://www4.infotrieve.com/search/databases/detailsNew.asp?artID=7154585
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> http://biopsychiatry.com/cytokine.htm
>
> Shawn
poster:Emme
thread:115406
URL: http://www.dr-bob.org/babble/20020807/msgs/115646.html