Posted by SLS on May 21, 2009, at 6:41:14
In reply to Re: Breaking through the wall. » SLS, posted by jedi on May 18, 2009, at 20:29:25
> Hi Scott,
> How is your anxiety level?
Pretty low. Most of the health care professionals have a hard time believing it. To make a long story short, after I was informed by one of my more brilliant doctors that anxiety would prevent me from responding well to treatment and increase the liability for relapse, I have been using CBT to keep stress to a minimum. It took a few years of practice, but CBT really did the trick.
> Lately I've felt my depression start to return which is normal for me after several weeks off Nardil. This time I'm going to add back in the clonazepam and try to stay off Nardil for as long as I can. I'm hoping that by increasing GABA I may be able to hold off the major depression, since anxiety is a major trigger of my depression.
What about Xanax (alprazolam)? It has proven antidepressant properties. A sister drug, adinazolam is used specifically for anxious depression. I tried this during an open label investigation. It is a very "clean" drug. I felt like I was taking nothing. Unfortunately, my depression felt the same way, but a significant number of people are helped by this drug.
> Does the Lamictal increase GABA for you enough to help with anxiety?
It is hard to say. It does more for depression than anxiety. Lamictal seems to work by inhibiting the release of glutamate rather than act directly on GABAergic neurons. I guess GABA is potentiated because Lamictal is also a sodium channel blocker.
> I've never used Lamictal but I have used gabapentin in the past. Any ideas for me on how to increase GABA without going back to the benzos on a daily basis?
1. Depakote - some people find this drug mildly depressing.
2. Lyrica - a variant of Neurontin.* TCAs - doxepin, trimipramine, amitriptyline don't work on GABA directly, but are known to reduce anxiety along with depression.
* Seroquel
> There were times, while coming off clonazepam where it got pretty dicey.
I can imagine. I've been there myself. I particularly hated the brain "lightning" that I experienced. They felt different from SRI withdrawal brain "zaps".
> If it were not for the memory impairment, I would just go on high dose clonazepam and relax.
Hmm. Does Xanax do the same thing?
> I'm not bipolar, but I have had hypomanic episodes when first starting Nardil. My depression is atypical and IMHO this disease lies somewhere on the bipolar spectrum.
I agree.
> maybe a mood stabililer such as Lamictal would be good for me. Thoughts?
Definitely. It is a personal theory of mine that Lamictal works to increase dopaminergic activity downstream in the nucleus accumbens through a process known as disinhibition. I guess I do find Lamictal calming. It helps take away the anxious part of an agitated depression.
> Good Luck Scott,
Much appreciated, Jedi.
- Scott
poster:SLS
thread:896403
URL: http://www.dr-bob.org/babble/20090515/msgs/896947.html