Posted by uncouth on October 28, 2011, at 11:25:31
In reply to Re: Latest riluzole rilutek thoughts....trying next wk » Uncouth, posted by SLS on October 28, 2011, at 7:53:01
well honestly i'd rather take lamotrigine at a high dose but i definitely felt some cognitive issues on it. i think i'm just hoping riluzole has a similar efficacy but without the cognitive and motivational issues. rilutek seems a lot more broad spectrum too in its effects on glutamate regulation, affecting both glutamate release and uptake and metabolic cycling. pretty crazy how it does all those things at once, it seems magical. they seem to really like it at the NIMH. there is a great study going on: acute ketamine followed by longer term riluzole for TRD, would be interesteing when results come out.
however, i will say that the last two times i tried it (granted, it was for a very short time at lower doses and while i was on a shitload of other stuff) i didnt' feel like it solved my problems. but right now i am dealing with obsessiveness as well as bipolar depression, and the only other option is an SSRI (i'm coming off of paxil which was intolerable) and i'd just rather not go down that route, hoping rilutek gives me antidepressant and antiobsessional effects without causing anhedonia and also helping to support my brain neurotrophically. i think it's as highly neurotrophic of a substance as lithium or the like. it may have direct bioenergetic effects on mitochondria, so i could imagine it would synergize well with n-acetyl-cysteine which i'm also on.
but yeah of you're already on lamotrigine, i can't believe your doctor hasn't pushed the dose higher? there is not much in terms of clinical studies but from my experience the pdocs in rehab and my pdoc at home both have heard via the pdoc rumor mill that lamotrigine can really kick in and do some amazing things at higher doses, and that 200mg is really the bare minimum dose, as long as side effects don't get bad. you can probably increase quicker too, 100mg every week or so instead of by 50mg.
honestly, that should be your first step. seems like you are still feeling bad and vilazadone wasn't all that great? how do you feel scale of 0-10 wth 10 being the best? i have bipolar 2 mostly depression too but I have been feeling the best I have in over a year (and a year ago i was basically high) on this crazy cocktail:
Bupropion 600mg
Mirapex ER 1.5mg
Vyvanse 50mg
Saphris 10mg at night (really would like to decrease or d/c, but can't sleep without an AAP)
Paxil CR 25mg (discontinuing)
Cerefolin 600mg
Low dose naltrexone 3.5mg nightly (felt definite improvement after first night, and do feel a positive difference I think though it could be placebo. negligible side effects at this dose and using it as i'm using it i think, helps to upregulate endorphins etc.)
and a bunch of supplements including:
additional NAC, magnesium, zinc, chromium picolinate, alpha lipoic acid, lithium orotate, multivitamin, b-vitamins, melatonin, DLPA, D3, fish oil). this is actually down from a lot more, which is good progress. i basically believe that the supplements i'm on are really the bare minimum at least I with my mood condition and history should be on for supporting general brain health. i also eat a few tablespoons of coconut oil daily for the high quality saturated fat which is important too.anyway let me know what your pdoc says about pushing the lamotrigine as high as it needs to go to see some change, either positive or negative. i'm no doctor but given your resistance i think it's nuts that that hasn't been tried yet for you...or find a doctor that will prescribe low dose buprenorphine, which i'm looking into among bay area doctors right now too.
poster:uncouth
thread:999389
URL: http://www.dr-bob.org/babble/20111027/msgs/1001053.html