Posted by Ritch on December 2, 2004, at 1:25:59
In reply to Re: Anyone wanna take a stab at my woes today? » Ritch, posted by Mr.Scott on December 1, 2004, at 20:20:50
> Mitch-
>
> I can tell that these symptoms are dopaminergic. That is I believe from reading others research that the ssris put a squeeze on dopamine in the nigra striatal region of the brain and doing so causes these symptoms. By putting a squeeze on dopamine one might encouter systoms directly related to dopamine reduction such as lack of motivation, poor concentration, fatigue, flat affect. Also since dopamine inhibits acetycholine, the effect of reducing dopamine throws the acetylcholine system into overdrive and thats what I believe causes the restlessness, agitation, muscle twitching spasm, and tension. I have 50+ pages citing many articles/studies/etc. that indicate some folks will have EPS (akathisia/dystonia/myoclonus/muscle tension/rigidity/etc.) My doc has not believed me for years and pretty much had me convinced I was bipolar. I'm seeing a doc who is both a neurologist/psychiatrist in January and I'm hoping he will be able to shed some light on why this happens and how if at all possible I can get around it.
>
> The poster above is correct about using an anticholinergic to help and indeed benztropine or even benadryl is helpul in alleviating it. Problem is that the anticholinergics have there own host of side effects, and I want to be reasonably sure that I won't develop Tardive Dyskinesia by simply covering up the problem with an anticholinergic drug.
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> Was that you who said you'd used nortriptyline with good results?
>
> Scott
Scott, I've been living with for real rapid-cycling bipolar for a long long time so I'm not disputing *my* dx. I know I need to take a mood stabilizer of some kind.. and anticonvulsants WORK the BEST as antimanic/anticylics in my case. I know that stims, WB, Strat, etc. WORK for the bipolar depression and the SRI's either don't work or tend to worsen everything. The trouble is the anxiolytic to use? Benzos are depressogenic, no doubt about it (for me), and SRI's work well, but set off worsening cycling. So I can effectively control mania and depression (for the most part) with an AC and a NE/DA AD or stim, but have cognitive flattening with the AC as a side effect or worsened anxiety with those ADs/stim. I am at the point where I feel I need to ditch the SRI's permanently because of the EPS issues and find alternatives for the anxiety. Nortriptyline yes did work well for anx. in the past. There was a time where I was taking Celexa+Wellbutrin midwinter and was getting a good AD response, but was very anxious, and adding nortiptyline to that (at just 10mg/day), caused a great reduction in anxiety.---Mitch
poster:Ritch
thread:422420
URL: http://www.dr-bob.org/babble/20041201/msgs/423238.html