Posted by linkadge on July 31, 2007, at 13:19:55
In reply to Final Final Note, posted by dewdropinn on July 31, 2007, at 11:55:52
>As you are probably well aware, all anti->convulsants have proven effective augmentors of >antidepressants, with the exception of Zonegran >and Keppra (both of which are so new that I >don't believe any studies have occured yet -- >and I feel truly sorry for those depressives who >participate in the Keppra study -- it reduced me >to a raging, blubbering blob.)
In some studies yes. But again, it probably depends on the exact underlying biochemical abnormalties. Some depression may be a result of hyperactive limbic glutamatergic function, but some may be a result of hypofunction. SSRI's antidepressants and anticonvulsants may have effect where there is some sort of underlying gabaergic dysfunction. Lithium, for instance, doesn't really augment everybody's antidepressant. Lithium is also an atypical augmentor in that it probably enhances the serotonergic function of antidepressants via 5-ht1b. So lithium is actually has intracellular and monoaminergic functions. Lithium aside though, there is really only limited evidence of augmentation capability of anticonvulsants. Tegretol, and depakote have some, lamotrigine has some too, but thats about all.
Its funny, because you can go on the GSK website (where they have decided to disclose all clinical trial data). You will see a registry of trials lamotrigine. There are like 20 or so trials. I would say more than 90% of those trials are negative. These were studies of bipolar, unipolar, and schizophrenia augmentation. Yet, based on 1 out of 10 sucessfull trials lamotrigine has such a reputation? This is unwarranted in my opinion.
>So, even if you proceed with the unipolar >depression hypothesis, there's good reason to >believe you will benefit from the addition of an >anti-convulsant.
>keep in mind that almost all anti-convulsants >make a bad first impression and only become your >friends after you get to know them -- which >usually takes 2-4 weeks.You'd think then that they would be my friends after a year or so (?)
P.S. I don't mean to be pessimistic. I certainly appreciate your effort, but my web of negative bias goes far too deep.
Linkadge
poster:linkadge
thread:772375
URL: http://www.dr-bob.org/babble/20070730/msgs/773107.html