Posted by linkadge on June 30, 2005, at 23:28:50
In reply to Re: Trileptal is pooping-out on me. » linkadge, posted by SLS on June 30, 2005, at 17:32:15
You're like my mother indeed. Antidepressant induced mania. Most of Dr. Manji's work shows that certain family history of unremitting bipolar depression is associated with some pretty hefty shrinkage in the subgenual prefrontal cortex. Proper prefronal cortex activity is *key* to maintaining an anhedonia free life. Manji's work seemd to show that lithium/depakote (even when used it what seemd to be almost homeopathic doses) protected, and revered many prefrtal cortex shrinkage. Unfortunately carbamazapine had no effect. It is good on the temporal lobes, but not as neurotrophic/neurorestorative as lithium/depakote.
One idea of mine was to increase NGF, and BDNF content in the frontal cortex. Lithium & Depakote increased frontal cortex NGF and BDNF, unfortunately carbamazapine did not share this effect. Again, single injects of BDNF and NGF will grow new brain cells in this region.
Get vitamin D ! It increases NGF/NT-3 in the frontal cortex and hippocampus. Omega 3/vitamin D show some nice synergy in reviving frontal cortex activity.
Mifesteprone *may* help, but are cortisol issues a biggie for you right now? This drug seemed to help AD's work better when cortisol was an issue, but didn't seem to help in other circumstances.Nortryptaline seems like a good choice. Bipolars with prefronal issues seem to repsond well to Nortryptaline. I read a study that shows that it does have a nice frontal cortex catecholamine effect. (probably aided by its 2a blockade)
>Nardil produces more of a mood-brightening >effect than does Parnate. However, it does poop-out.
> I have a **million** other cool ideas,
For my last doctors visit, I was really trying to find a "focus on the frontal cortex" approach to helping myself.People with anhedonia and apathy show lots of prefronal hypofunction. It just keeps turning off, for various reasons. For any AD treatment to produce a result, there needs to be an activation of the frontal cortex.
First I wanted to have the right circutry, so I was going to take a low dose of depakote, and augment that with loads of fish oil, which has great activity in the frontal cortexs' dopamine/serotonin networks. Infact, a high intake of omega 3 in lab rats doubled their frontal cortex serotonin/dopamine content in a month.
After I worked on the circutry, I wanted to maximize activity there through all available means. Which would include 5-hta/c antagonism which increase frontal neurotransmitter output, plus 5-ht1a agonism (frontal cortex loaded with 5-ht1a receptors), some direct/indirect noradrenergic activity.
I was thinking (for my case)Remeron, Buspar, Fish Oil, depakote, and maybe
a little celexa.Doctor wouldn't hear of it.
-------------------------------------------------
Other combinations I have thought of are. Although the following are more just interest than anything else.
Buspar + Pindolol:
Lithium + Pindolol:
-------------------
(dual 5-ht1a/b autoreceptor
antagonism for a most robust
serotonin releaseBuspar + Mirapex:
-----------------
Clean, sweet, dopaminergic and
serotogenic stimulation.Stimulant + Periactin:
----------------------
Coffee + Periactin has
a powerful anti-anhedonia
effect.Remeron + Buspar:
-----------------
More intrinsic 5-ht1a a
5-ht1a agonism. Perhaps
more agression.Depakote + Selegeline + Omega 3
-------------------------------
Frontal cortex repair and activationSelegeline + Omega 3
--------------------
Frontal cortexAlphaLipoic Acid +
Acetyl-L-Carnatine +
Selegeline
-------------------
Live forever, feel good too.
Rebust mitochondial repairation.
Buspar + Selegeline
-------------------
Pharmachological KAVA KAVA
Ie MAO-B + 5-ht1a agonist.Pindolol + Amisulpride + Yohimbine
----------------------------------
5-ht,NE,DE autoreceptor
antagonism. No mans landSelegeline + Periactin:
-----------------------
Anti-anhedonia.Buspar + periactin
------------------
5-ht1a agonistm, 5-hta/c
antagonism.-----------------------------------------
Try more trileptal if you think it will help. Don't loose hope if it doesn't. Focus on the frontal cortex, thats how to beat bipolar depression IMHO.
Linkadge
poster:linkadge
thread:520955
URL: http://www.dr-bob.org/babble/20050627/msgs/521791.html