Posted by avid abulia on June 11, 2003, at 19:36:55
In reply to Re: Depression and Tourettes, posted by LostBoyinNC1 on June 15, 2002, at 11:26:13
mecamylamine was the first oral antihypertensive agent to be developed, and is no longer in use for this indication very often because of severe side effects. i have the severe kind of tourette`s requiring treatment, but i can`t use antipsychotics because i also have a seizure disorder. clonidine and tenex were only marginally useful and the effect faded very fast.
mecamylamine (sold under the trade name Inversine) is a nicotinic acetylcholine antagonist that preferentially acts on the CNS as opposed to skeletal muscle. because it is an antagonist, it is sort of the oral equivalent to a nicotine patch--nicotine is a partial agonist, so a real quick dose like from a cigarette acts as more on an agonist most of the time, whereas a slower form of ingestion like transcutaneous patches or transmucosal gum act more as a modulator... some people with tourettes who respond poorly to the patch (like me) do well on inversine because it has little stimulating qualities. it works mostly in the subset of touretters with depression, and score on depression scales positively correlates with improvement on mecamylamine in general. it has some effect on tics, but is primarily a potentiator or antipsychotics in that regard... but it does do a lot for mood. it is being investigated now for bipolar disorder and chronic fatigue syndrome, among other conditions, now.
because it is a nicotinic ACh antagonist, it lowers cortisol levels by inhibiting stimulation of release of corticotropin-releasing factor by acetylcholine, as well as noradrenaline and dopamine. i have not had time to find what, if any, effects it has on other hormones, second-messengers, and other neurotransmitters besides ACh, DA, and NA.
the effective dose for tourette`s is about 1/10 that normally used to lower blood pressure. (2.5-6.25 mg per day). it has a half-life at normal ph of 12 hrs; like nicotine, increases in ph will increase half-life and vice-versa.
yeah, i know, old thread, but here you go.
poster:avid abulia
thread:109920
URL: http://www.dr-bob.org/babble/20030609/msgs/233285.html