Posted by Chairman_MAO on May 12, 2005, at 20:53:39
In reply to Re: Clonidine for anxiety?, posted by sdb on May 11, 2005, at 13:54:39
Yohimbine has been used to POTENTIATE phobic responses or recall of trauma in order to desensitize the patient to the noxious stimuli/thoughts. I believe that sort of therapy has had some success.
A2 antagonists increase emotionally-based recall of memories, and can serve--as you found out--as a probe to find out if one is especially vulnerable to panic attacks. It's fascinating stuff.
I am not sure that a2 agonists have any utility in treating panic disorder, though.
This whole picture is complicated by the imidazoline receptor system, which clonidine also affects (I think). The endogenous "clonidine displacing substance", agmatine (decarboxylated l-arginine), is fascinating: it attenuates opioid tolerance/dependence, is slightly hypotensive (like clonidine), is an NMDA receptor antagonist, regulates Ca2+ influx, inhibits neural nitric oxide synthase, and more. I have tried this stuff (in the sulfate form), and it does potentiate the buprenorphine I am on at a dose of 500mg.
While there is certainly promise for more metabolically stable agmatine analogs to be used therapeutically, the therapeutic use of clonidine is limited due to concerns of inducing depression, which I think it can do even in people without a history of depression. Its beneficial effectgs also may be subject to tolerance, but I am not sure about that.
Moral of the story: Use a beta blocker or a benzo. Wait for agmatine-mimetics, use gaunfacine, or take a benzo. Clonidine is interesting for research but not too practical clinically.
poster:Chairman_MAO
thread:496383
URL: http://www.dr-bob.org/babble/20050510/msgs/497057.html