Posted by utopizen on June 4, 2006, at 17:05:24
In reply to Re: One year on Aricept- ADD augmenter, sleep booster » utopizen, posted by stan on June 1, 2006, at 2:14:19
> have you ever tried exelon or razadyne, and if so, did you experience a similar response? how about namenda (which of course has a different mechanism of action than the pro-cholinergics just mentioned). also, do you think it's possible that your response may be due as much to the evoxac as the aricept? both are pro-cholinergics.....what's the difference supposed to be?
>
> stan
stan,thank you for your thoughtful comments =)
yes, you're right-- Evoxac is certainly a drug that is a cholinergic. However, Aricept works in a completely different mechanism of action. Pretty much all drugs are either cholinergic or anti-cholinergic, so, the only real interest anyone would have on focusing on this attribute of the drug is really an urologist, if you happen to find a drug causing you urinary problems. If so, they'd give you a drug that is on the opposite end of something like Evoxac (which increases saliva, etc.) by prescribing you something that would dry you up (and certainly, likely discontinue your Evoxac first)
As for Aricept, it's so selective on the brain, and complicated, I wouldn't suggest coorelations between it and Evoxac.
I am aware, in rats, one researcher claims in an abstract (available on MedLine) Evoxac is a neuroprotective.
This probably has to do with very unique properties for Evoxac... I would be careful not to make too many loose connections here.
That hypothesis I believe came from the connection that it's basically similiar in effect to pilocarpine, a drug that's been known for about 100 years to increase saliva and tears in Sjorgen's Syndrome.
The likelihood Evoxac has, even in augmentation with another drug, any psychotropic properties that effect behavior in any way is relatively unrealistic. It's been around for a few years now, and its sister drug, Pilocarpine, really isn't much different (Salagen).
I'm aware, as you point out, and I pointed out in making the distinction in my presentation of how an NMDA antagonist is not the same as an anticholinterase inhibitor...But, my days of switching to similiar drugs for the heck of it are over. Aricept works, and, the reality is, I'm probably not going to notice much of a noticable difference with any other similiar drug, or even an NMDA antagonist.
"If it ain't broke, don't fix it" was even said to me by a doc once. With every med change, there should be a very clear basis and rationale.
If I'm doing fine on Aricept, no need to switch, just like no need to switch to different stimulants, since really the belief that different stimulants will radically change how you work is unrealistic.
As for cognitive behaviorial therapy:43folders.com is a good place to get some common sense Podcasts and advice on how to do time management, etc.
and, try to follow this:
"Don't duck the most difficult problems.That just insures that the hardest part will be left when you're most tired.
Get the big one done--
It's downhill from then on.
---Norman Vincent Pearle
utopizen
poster:utopizen
thread:648509
URL: http://www.dr-bob.org/babble/20060604/msgs/652869.html