![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 28 to 52 of 93. Go back in thread:
Posted by brynb on August 19, 2012, at 8:11:46
In reply to Re: Starting minocycline. » brynb, posted by SLS on August 17, 2012, at 15:21:14
> > Scott-
> >
> > I find this so interesting. I have an Rx for minocycline from my dermatologist (for breakouts). It's 100mg capsules. I'm thinking of adding it to my current regimen. What's the proper dosage for treating depression/inflammation?
> >
> > -b
>
> Most studies of minocycline to treat psychiatric illness have used 100 - 150 mg/day. I would start at 50 mg once per day for a few days, then 50 mg twice per day thereafter. I really don't have a "feel" for the behavior of this drug in other people yet. However, some people might be too sensitive to starting minocycline at 100 mg/day.
>
> If it turns out that I am currently experiencing the beginnings of an antidepressant response to minocycline, then it is apparent to me that some people will experience an improvement within the first week. I have seen this before with this drug. However, it is important to note that I am taking other psychotropic drugs, including Lamictal and Abilify. Lamictal, in particular, might act in concert with minocycline to disinhibit mesolimbinc dopamine release by reducing glutamate activity in the VTA. The result is increased dopamine activity. I'm sure it's not that simple, though.
>
>
> - Scott
Thanks, and I'm curious to hear how it goes for you.Also, are you in NY? I thought I saw you mention NYU in one of your posts. I started w/ a new pdoc about 2 months or so ago, and I like him (at least at the moment!), but I'm always open to new docs/clinics/etc. with expertise in mood disorders.
-b
Posted by SLS on August 19, 2012, at 17:27:43
In reply to Re: Starting minocycline. » SLS, posted by brynb on August 19, 2012, at 8:11:46
> Also, are you in NY? I thought I saw you mention NYU in one of your posts.
It takes me about an hour to get to NYC. I have been seen by doctors at Columbia, NYU, and Beth Israel. You might be better off going to NYC for a consultation rather than switching doctors. Patrick McGrath at Columbia is pretty good. I saw him about 10 years ago.
http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=pjm5&DepAffil=Psychiatry
- Scott
Posted by brynb on August 19, 2012, at 19:21:25
In reply to Re: Starting minocycline. » brynb, posted by SLS on August 19, 2012, at 17:27:43
> > Also, are you in NY? I thought I saw you mention NYU in one of your posts.
>
> It takes me about an hour to get to NYC. I have been seen by doctors at Columbia, NYU, and Beth Israel. You might be better off going to NYC for a consultation rather than switching doctors. Patrick McGrath at Columbia is pretty good. I saw him about 10 years ago.
>
> http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=pjm5&DepAffil=Psychiatry
>
>
> - ScottThanks so much! I live in NYC and it's been so hard to find a good pdoc here (weird, right?). My current doc seems good, so I'm staying with him for now, but I always want backups just in case.
-b
Posted by SLS on August 20, 2012, at 17:38:17
In reply to Re: Starting minocycline. » SLS, posted by brynb on August 19, 2012, at 19:21:25
> > > Also, are you in NY? I thought I saw you mention NYU in one of your posts.
> >
> > It takes me about an hour to get to NYC. I have been seen by doctors at Columbia, NYU, and Beth Israel. You might be better off going to NYC for a consultation rather than switching doctors. Patrick McGrath at Columbia is pretty good. I saw him about 10 years ago.
> >
> > http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=pjm5&DepAffil=Psychiatry
> >
> >
> > - Scott
>
> Thanks so much! I live in NYC and it's been so hard to find a good pdoc here (weird, right?). My current doc seems good, so I'm staying with him for now, but I always want backups just in case.
>
> -b
If you do go for a consultation, ask the doctor for some referrals. You might not ever want to leave your current doctor, but it is nice to have alternatives ready should you need them.
- Scott
Posted by SLS on August 20, 2012, at 17:58:29
In reply to Re: Starting minocycline. » brynb, posted by SLS on August 20, 2012, at 17:38:17
Feeling better...
- Scott
Posted by Phillipa on August 20, 2012, at 21:23:10
In reply to Re: Starting minocycline., posted by SLS on August 20, 2012, at 17:58:29
Great and taking twice a day. Phillipa
Posted by Slabicki on August 20, 2012, at 23:25:16
In reply to Re: Starting minocycline., posted by SLS on August 20, 2012, at 17:58:29
> Feeling better...
>
>
> - ScottThat's a good news.
Scott, did you experience any side effects?
I've read that Minocycline can cause anxiety, or depression.
Did you experience any anxiety?Slabicki
Posted by SLS on August 21, 2012, at 6:37:01
In reply to Re: Starting minocycline SLS, posted by Slabicki on August 20, 2012, at 23:25:16
> > Feeling better...
> That's a good news.
> Scott, did you experience any side effects?
> I've read that Minocycline can cause anxiety, or depression.Let's review the the sources of this information. Can you provide any URL links?
I have not seen it written in the medical literature that minocycline produces depression as an adverse effect. I didn't see it appear on the manufacturer's label. I don't doubt that it has happened, though. If it does, it must do so very infrequently. I would guess that minocycline has less potential to produce depression as an adverse reaction than standard antidepressants.
So far, the only effect from minocylcine that I can ascertain is an improvement in depression. I have no side effects yet. Others have noted experiencing an uncomfortable activating effect after taking the first few doses. I don't know if this indicates that a dosage reduction is required or that it passes with continued treatment. Either way, it seems to disappear.
The dosage range of minocycline currently being used to treat depression (both MDD and BD) is 100 - 200 mg/day given in divided doses.
I have no reluctance in recommending to someone that they talk to their doctor about using minocycline to treat depression. For now, I am leaning in the direction that minocycline is more effective as an augmenting agent than it is as monotherapy. I suspect that, for me, minocycline is particularly effective when combined with Lamictal (lamotrigine), a glutamate release inhibitor (anti-glutamatergic). Minocycline is being studied as monotherapy, though. One study indicates that minocycline works better with desipramine than with Prozac (fluoxetine). It is perhaps more effective when using a noradrenergic (NE) antidepressant than a serotonergic (5-HT) antidepressant. There are reports of minocycline producing a therapeutic effect in the absence of antidepessants. There is some thought that minocycline would work in combination with other anti-glutamatergic drugs like glutamate receptor inhibitors.
http://www.sciencedirect.com/science/article/pii/S0165017309000691
I am currently tapering the prazosin I have been taking. For me, it has been a difficult drug to dose and it abolishes my sex-drive. If I feel significantly worse, I will simply restart it and perhaps replace it with the longer acting agent, doxazosin.
Abilify is another drug that I would like to jettison. However, I am not so convinced that I can do without it. My motivations to do this are that I have gained a large amount of weight and my triglycerides are very high.
I have yet to establish the optimal dosage of minocycline. I am not inclined to raise the dosage this week, though. However, since a Harvard study used 200 mg/day, I am happy to know that there is room to work with.
- Scott
Posted by Phillipa on August 21, 2012, at 21:54:48
In reply to Re: Starting minocycline SLS » Slabicki, posted by SLS on August 21, 2012, at 6:37:01
My only concern is this is an antibiotic. I want it to work as then will take mine again also. Philllipa
Posted by Slabicki on August 21, 2012, at 22:42:47
In reply to Re: Starting minocycline SLS » Slabicki, posted by SLS on August 21, 2012, at 6:37:01
Hi Scott,
Thank you for replaying, that was helpful.
I guess you didn't experience any anxiety as a side effect.
You have mentioned the activating effect.
I'm a little bit concerned to try it as my depression isn't the anergic one. I have mostly mental depression and I'm proned to anxiety.
On the other hand, it can be a life saver.
My main concern is anxiety as a side effect.
I have to research the anxiety meds options as my
back-up.
Emme in her thread has mentioned the anxiety as a side effect, and that she takes a Xanax with Minocycline.Slabicki
Posted by SLS on August 22, 2012, at 4:55:28
In reply to Re: Starting minocycline SLS, posted by Slabicki on August 21, 2012, at 22:42:47
Hi.
> Emme in her thread has mentioned the anxiety as a side effect, and that she takes a Xanax with Minocycline.
One's reaction to the introduction of minocycline is probably variable. I experienced no anxiety at all. I need no benzodiazepines for anxiety nor sleep. My depression initially presented with anxiety, particularly social anxiety. CBT helped a great deal.
I hope I don't have to increase the dosage of minocycline. It is hard to be patient. Many studies of minocycline for use in psychiatric illnesses go up to 200 mg/day. I now take 100 mg/day. I feel like it is helping, though. I am weaning off of prazosin 12 mg/day due to dosing difficulties and side effects. I am currently at 6 mg/day. A few weeks ago, I would have deteriorated at that dosage. I seem to be okay so far. I am cautiously optimistic.
- Scott
Posted by Phillipa on August 22, 2012, at 20:41:38
In reply to Re: Starting minocycline SLS » Slabicki, posted by SLS on August 22, 2012, at 4:55:28
Scott why off the prizosin? Did it lower BP too much? Phillipa
Posted by SLS on August 23, 2012, at 20:33:23
In reply to Re: Starting minocycline SLS » SLS, posted by Phillipa on August 22, 2012, at 20:41:38
> Scott why off the prizosin? Did it lower BP too much? Phillipa
I have had difficulties finessing the dosage of prazosin with its 3 hour half-life. I also experienced a loss of sex drive. I am testing the necessity of being on prazosin as the minocycline might be responsible for inducing the improvement I am currently experiencing. Even in combination with Parnate, prazosin did not produce an unacceptable decrease in BP, although hypotension was a passing startup effect.
- Scott
Posted by SLS on August 23, 2012, at 20:34:43
In reply to Re: Starting minocycline., posted by SLS on August 20, 2012, at 17:58:29
> Feeling better.
Feeling even better...
- Scott
Posted by Phillipa on August 23, 2012, at 21:44:53
In reply to Re: Starting minocycline., posted by SLS on August 23, 2012, at 20:34:43
Since crosses the bloodbrain barrier could mean that mental illness is indeed an illness caused by some type of bacteria? Will you up the dose soon? No dizziness? No headache? As that is what I had. On a positive note not to be graphic night after taking it had normal stools first time in many years. IBS. Phillipa
Posted by Emme_v2 on August 23, 2012, at 22:13:17
In reply to Re: Starting minocycline., posted by SLS on August 23, 2012, at 20:34:43
> > Feeling better.
>
> Feeling even better...
>
>
> - ScottIt's magic!
Excellent!
Posted by SLS on August 24, 2012, at 1:48:00
In reply to Re: Starting minocycline. » SLS, posted by Phillipa on August 23, 2012, at 21:44:53
> Since crosses the bloodbrain barrier could mean that mental illness is indeed an illness caused by some type of bacteria? Will you up the dose soon? No dizziness? No headache? As that is what I had. On a positive note not to be graphic night after taking it had normal stools first time in many years. IBS. Phillipa
I cannot stress enough that minocycline is a single molecule having many diverse and unrelated properties, only one of which is antibiotic. I listed some of these properties at the beginning of this thread.
- Scott
Posted by Slabicki on August 24, 2012, at 14:55:56
In reply to Re: Starting minocycline. » Phillipa, posted by SLS on August 24, 2012, at 1:48:00
Hi Scott,
I'm really glad to hear that Minocycline helps you!!!
Could you describe what kind of effect the Minocycline has on you?
Does it help depressive thoughts, or improves the energy?
I don't know why I'm affraid to try it right now.
I have depression and mood switches.
I wonder if I should try to do the ECT first to get rid of mood cycling, and then try Minocycline for depression.
I just don't know how I will respond.
I took tons of medications in the past, but I never had mood cycling before.
Also, when I did my ECT six years ago, it didn't really have the antidepressant effect, I just had a motor slow down, and ECT has helped with that.
So I really hope that Minocycline can help with depression this time.
I know that everybody responds differently.
What are your thoughts?Slabicki
Posted by Phillipa on August 24, 2012, at 20:27:52
In reply to Starting minocycline., posted by SLS on August 14, 2012, at 9:23:51
Yes you listed them but added with lamictal so does this mean it only does these things with lamictal. I know that inflammation would occurr with both so to me inflammation & cytokines means illness. phillipa
Posted by SLS on August 25, 2012, at 6:11:56
In reply to Re: Starting minocyclineSLS, posted by Slabicki on August 24, 2012, at 14:55:56
> Hi Scott,
Hi Slabicki.
> I'm really glad to hear that Minocycline helps you!!!
Thanks. It's a little premature to declare victory, though. I have been taking minocycline for less than two weeks. I very often begin to respond extremely well to a new medication early in treatment, only to relapse a few days later. I still have my doubts about the long-term effectiveness of minocyline for me.
> Could you describe what kind of effect the Minocycline has on you?
> Does it help depressive thoughts, or improves the energy?Minocycline has improved anergia, anhedonia, interest in activities, motivation to initiate activities, thought speed, memory, clarity of thought, reading, learning, senses of taste and smell, social anxiety, talkativeness, gregariousness, and negative thoughts to name a few. In other words, for me, it is a high-quality antidepressant response which effectively treats the whole illness.
> I don't know why I'm affraid to try it right now.
Are you afraid that minocycline might launch you into a manic episode? Do you ever become psychotic? Minocycline is currently being studied to treat the negative symptoms of schizophrenia, but I don't know of anyone who has tried it for bipolar mania.
> I have depression and mood switches.
Can you describe what you experience during mood switches?
> I wonder if I should try to do the ECT first to get rid of mood cycling, and then try Minocycline for depression.
That is a difficult question to address. I don't know if any doctor has had enough experience with minocycline to know how it affects people in variable mood states and rapid-cycling. You would be a guinea pig of sorts.
> I took tons of medications in the past, but I never had mood cycling before.
What triggered the cycling?
> So I really hope that Minocycline can help with depression this time.
The two people I know who have responded to minocycline are currently taking Lamictal and Abilify along with it. It is thought that minocycline might work better when combined with Lamictal or other drugs that reduce glutamate activity. I am beginning to think that the net result of combining Lamictal and minocycline is to modulate dopamine activity.
What drugs are you currently taking? Have you ever tried Lamictal? Which antipsychotics have you tried?
> What are your thoughts?
I am reluctant to recommend minocycline to anyone because I don't think its clinical profile in treating depression and bipolar disorder is well-characterized. However, you can certainly decide for yourself if you would like to try it based upon your observations of other people. I hope Emme keeps posting. It would be nice to track the progress of two different people on minocycline.
So far, I am encouraged by my response to minocycline. It should be noted that my depression is bipolar. I am currently taking 100 mg/day. I might need to raise the dosage to 150 mg/day. I'll have a better idea if this is necessary when I see my doctor in a few weeks. One of the current studies of the use of minocycline to treat bipolar depression will be using a dosage range of 100 - 300 mg for 8 weeks.
http://clinicaltrials.gov/ct2/show/NCT01514422
- Scott
Posted by Slabicki on August 25, 2012, at 11:34:31
In reply to Re: Starting minocycline » Slabicki, posted by SLS on August 25, 2012, at 6:11:56
> > Hi Scott,
>
> Hi Slabicki.
>
> > I'm really glad to hear that Minocycline helps you!!!
>
> Thanks. It's a little premature to declare victory, though. I have been taking minocycline for less than two weeks. I very often begin to respond extremely well to a new medication early in treatment, only to relapse a few days later. I still have my doubts about the long-term effectiveness of minocyline for me.
>
> > Could you describe what kind of effect the Minocycline has on you?
> > Does it help depressive thoughts, or improves the energy?
>
> Minocycline has improved anergia, anhedonia, interest in activities, motivation to initiate activities, thought speed, memory, clarity of thought, reading, learning, senses of taste and smell, social anxiety, talkativeness, gregariousness, and negative thoughts to name a few. In other words, for me, it is a high-quality antidepressant response which effectively treats the whole illness.
>
> > I don't know why I'm affraid to try it right now.
>
> Are you afraid that minocycline might launch you into a manic episode? Do you ever become psychotic? Minocycline is currently being studied to treat the negative symptoms of schizophrenia, but I don't know of anyone who has tried it for bipolar mania.
>
> > I have depression and mood switches.
>
> Can you describe what you experience during mood switches?
>
> > I wonder if I should try to do the ECT first to get rid of mood cycling, and then try Minocycline for depression.
>
> That is a difficult question to address. I don't know if any doctor has had enough experience with minocycline to know how it affects people in variable mood states and rapid-cycling. You would be a guinea pig of sorts.
>
> > I took tons of medications in the past, but I never had mood cycling before.
>
> What triggered the cycling?
>
> > So I really hope that Minocycline can help with depression this time.
>
> The two people I know who have responded to minocycline are currently taking Lamictal and Abilify along with it. It is thought that minocycline might work better when combined with Lamictal or other drugs that reduce glutamate activity. I am beginning to think that the net result of combining Lamictal and minocycline is to modulate dopamine activity.
>
> What drugs are you currently taking? Have you ever tried Lamictal? Which antipsychotics have you tried?
>
> > What are your thoughts?
>
> I am reluctant to recommend minocycline to anyone because I don't think its clinical profile in treating depression and bipolar disorder is well-characterized. However, you can certainly decide for yourself if you would like to try it based upon your observations of other people. I hope Emme keeps posting. It would be nice to track the progress of two different people on minocycline.
>
> So far, I am encouraged by my response to minocycline. It should be noted that my depression is bipolar. I am currently taking 100 mg/day. I might need to raise the dosage to 150 mg/day. I'll have a better idea if this is necessary when I see my doctor in a few weeks. One of the current studies of the use of minocycline to treat bipolar depression will be using a dosage range of 100 - 300 mg for 8 weeks.
>
> http://clinicaltrials.gov/ct2/show/NCT01514422
>
>
> - ScottHi Scott,
Thank you for responding. That really helps.
I'm in mental pain this morning and I can't really desribe it.I have the chemical imbalance and I used to respond very well to medications.
I don't have mania or psychosis tendencies.
My mood switches are just different degree of depression.
It was triggered by Ketaconazole as you may remember from my previous thread.
Posted by Iansf on August 25, 2012, at 13:59:35
In reply to Re: Starting minocycline » Slabicki, posted by SLS on August 25, 2012, at 6:11:56
One thing I'm not clear on is whether minocycline is meant to be taken continuously as with antidepressants or if it's a one-time intervention. I don't mean one dose, of course, but one period of use. Is the theory that there is an underlying systemic infection that needs to be cleared up? Or is it that the characteristics of minocycline happen to affect brain chemistry apart from its antibiotic properties?
Posted by Jeroen on August 25, 2012, at 14:17:21
In reply to Re: Starting minocycline » SLS, posted by Iansf on August 25, 2012, at 13:59:35
i'm dying to try this med.....
not dying but suffering
Posted by SLS on August 25, 2012, at 17:15:23
In reply to Re: Starting minocycline » SLS, posted by Iansf on August 25, 2012, at 13:59:35
> One thing I'm not clear on is whether minocycline is meant to be taken continuously as with antidepressants or if it's a one-time intervention.
I would guess that we are looking at using minocycline as a long-term treatment. I have not encountered anything that would indicate otherwise. Currently, there is a study of minocycline in the treatment of bipolar depression using dosages between 100 - 300 mg/day for 8 weeks. I can only hope that they coadminister Lamictal to some of the participants.
http://clinicaltrials.gov/ct2/show/NCT01514422
> Is the theory that there is an underlying systemic infection that needs to be cleared up?
No.
> Or is it that the characteristics of minocycline happen to affect brain chemistry apart from its antibiotic properties?
Yes. I listed some of them in the following post:
http://www.dr-bob.org/babble/20120803/msgs/1023257.html
I am impatient. I am tempted to increase my dosage of minocycline from 100 mg to 150 mg, but I haven't spoken to my doctor about this. I'm just curious to see how much better I can feel at the higher dosage. I don't want to get stuck if I remain underdosed for months.
- Scott
Posted by SLS on August 25, 2012, at 17:21:18
In reply to i'm dying to try this med....., posted by Jeroen on August 25, 2012, at 14:17:21
> i'm dying to try this med.....
>
> not dying but sufferingWhat is it about minocycline that you feel is important to treat your case in particular?
I'm sorry you are suffering so much. It's not fair.
- Scott
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.