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Dr. Bob is Robert Hsiung, MD,
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Posted by SLS on September 4, 2012, at 14:02:15
In reply to Re: Starting minocycline. » SLS, posted by Tomatheus on September 4, 2012, at 13:45:00
> Good luck, Scott. I really hope that you get the kinds of benefits that you're hoping for from your dose increase.
>
> Tomatheus
Thanks for being so supportive. It is VERY much appreciated.I will continue to post of my progress - good or bad.
- Scott
Posted by Phillipa on September 4, 2012, at 21:10:49
In reply to Re: Starting minocycline., posted by SLS on September 4, 2012, at 13:15:57
Scott congrats and don't be afraid remember how Ron Hill finally found the right combo? Phillipa
Posted by SLS on September 5, 2012, at 7:15:10
In reply to Re: Starting minocycline. » Tomatheus, posted by SLS on September 4, 2012, at 14:02:15
My initial reaction to the higher dosage (200 mg/day) of minocycline has been a mixture of good and bad. I feel somewhat more depressed. My affect is flat. However, my cognitive impairments are less severe. My memory is better and my thinking is not as slow. Hopefully, this is a prelude to a more robust antidepressant response.
- Scott
Posted by SLS on September 9, 2012, at 3:00:56
In reply to Re: Starting minocycline., posted by SLS on September 5, 2012, at 7:15:10
> My initial reaction to the higher dosage (200 mg/day) of minocycline has been a mixture of good and bad. I feel somewhat more depressed. My affect is flat. However, my cognitive impairments are less severe. My memory is better and my thinking is not as slow. Hopefully, this is a prelude to a more robust antidepressant response.
I had a couple of good days, but things have since leveled off to a degree of improvement that I find disappointing. Minocycline is very obviously helping me, but I just don't know if it will get me more than 50% well; a level at which I anticipate being able to return to work. I will give this a few more days. If there are no signs of further recovery, I will add back prazosin. I was hoping to avoid taking prazosin because it reduces my libido.
Exercising patience is a real pain in the _ss.
- Scott
Posted by Tomatheus on September 9, 2012, at 14:36:42
In reply to Re: Starting minocycline., posted by SLS on September 9, 2012, at 3:00:56
Scott,
I'm sorry to hear that the degree of improvement that you've been experiencing as of late with minocycline has been disappointing. I think it's good that you're being patient, despite the fact that it can be a real pain, and I also think it's good that you're giving your current regimen a few more days. If you do reintroduce prazosin to your medication regimen, I really hope that it will combine well with minocycline.
Best of luck to you,
Tomatheus
Posted by SLS on September 10, 2012, at 18:29:02
In reply to Re: Starting minocycline. » SLS, posted by Tomatheus on September 9, 2012, at 14:36:42
> Scott,
>
> I'm sorry to hear that the degree of improvement that you've been experiencing as of late with minocycline has been disappointing. I think it's good that you're being patient, despite the fact that it can be a real pain, and I also think it's good that you're giving your current regimen a few more days. If you do reintroduce prazosin to your medication regimen, I really hope that it will combine well with minocycline.
>
> Best of luck to you,Thanks.
I was pleasantly surprised today. I felt better than I have since beginning minocycline treatment three weeks ago. I am very glad that I exercised some patience and didn't run back to prazosin so quickly. I think we're getting close to that magical feeling that happens when you emerge from depression as the light fills the darkness and your mind operates with energy and clarity.
How are you coming along?
- Scott
Posted by Tomatheus on September 10, 2012, at 22:11:29
In reply to Re: Starting minocycline. » Tomatheus, posted by SLS on September 10, 2012, at 18:29:02
Scott,
Thank you for sharing the good news about the way you're coming along on minocycline. I'm happy that as of today, you're feeling the best that you've felt since you started minocycline. I hope that you're right that a strong response is likely around the corner for you, and I certainly hope that you will at least continue to experience the benefits that you're experiencing up to this point in time.
Although I'm not feeling nearly as bad as I was feeling when my depressive symptoms were at their worst, I haven't been doing too well lately. I was noticing some improvements on the supplement Sytrinol (which somebody on another site recommended to me) for about a week before that response gave way a few days ago. To see if I could recapture some of the benefits that I was initially noticing from taking the Sytrinol, I increased the dose yesterday. I would say that I seem to be noticing a little something from the dose increase (a slight increase in energy, a slight boost in concentration, and a slight reduction in hypersomnia), but overall I would say that my response is rather weak -- and definitely weaker than my initial response from when I started Sytrinol. In addition to Sytrinol, the supplements that I'm taking are folic acid (which is to combat anxiety that emerged after I took aminoguanidine), coenzyme q10, Korean ginseng, liquid vitamin B12, and liquid SAM-e. Other than the folic acid, the supplements that I take are for the management of my depressive symptoms (diminished energy, psychomotor retardation, hypersomnia, difficulty concentrating, and anhedonia), but even together, the supplements that I'm taking don't seem to be doing much.
At this point, I'm considering adding phosphatidlycholine to my regimen of medications and supplements. The phosphatidylcholine would hopefully help with my cognitive impairment, which along with my anxiety and psychosis, emerged shortly after I took aminoguanidine. Unfortunately, I have good reason to think that the phosphatidylcholine might also have a detrimental effect on my depressive symptoms (particularly the diminished energy and psychomotor retardation). Still, I think that I will take this supplement and plan to possibly increase my SAM-e intake and also possibly my Starbucks hot cocoa intake, because SAM-e and Starbucks hot cocoa have historically been some of the most helpful tools that I've had in combating my depressive symptoms. SAM-e tablets no longer seem to do much of anything for me, and a liquid version of the supplement helps me significantly on a rather short-term basis, but I would like to test this idea that I have that phosphatidylcholine might help to give SAM-e some new life. My idea that phosphatidylcholine might sort of reactivate the SAM-e is based on the fact that when I last took phosphatidylcholine (and also when I last took DMAE, which is another cholinergic supplement), my cognition seemed to improve, but my depressive symptoms seemed to get worse. This was more consistent with the way that I felt when I responded well to SAM-e, which was prior to the time that I took aminoguanidine, which is what I think probably brought on my cognitive impairment (along with my psychosis and my anxiety) in the first place. Of course, time will tell whether or not my idea about phosphatidylcholine giving SAM-e new life will have any merit to it. I think that the odds actually favor me being wrong with this idea, but it's something that I want to test.
Another treatment that I may try soon is low-dose nalxtrexone, possibly along with an MAOI such as Rhodiola rosea or moclobemide. Slabicki from these boards said that she had good results for quite a while from taking low-dose naltrexone in addition to moclobemide, and her response to moclobemide monotherapy was similar to mine (a strong, but very short-lived response), so I'm hoping that I might see some results from trying low-dose naltrexone with an MAOI.
Well, I think that what I've written above basically sums up where my treatment is at right now and where I'm thinking about possibly taking it. If you have any suggestions for me, I'd be interested in hearing them.
Let's hope that the response that you noticed today will be the beginning of better days ahead for you. And of course, let's hope that better days will be ahead for all on Psycho-Babble, myself included.
Tomatheus
Posted by AlexCanada on September 11, 2012, at 5:23:17
In reply to Re: Starting minocycline. » Tomatheus, posted by SLS on September 10, 2012, at 18:29:02
Hey Scott. Good to hear you are improving.
Do you feel minocycline may be working for you due to it's effect on Norepinephrine or other factors?
> > Scott,
> >
> > I'm sorry to hear that the degree of improvement that you've been experiencing as of late with minocycline has been disappointing. I think it's good that you're being patient, despite the fact that it can be a real pain, and I also think it's good that you're giving your current regimen a few more days. If you do reintroduce prazosin to your medication regimen, I really hope that it will combine well with minocycline.
> >
> > Best of luck to you,
>
> Thanks.
>
> I was pleasantly surprised today. I felt better than I have since beginning minocycline treatment three weeks ago. I am very glad that I exercised some patience and didn't run back to prazosin so quickly. I think we're getting close to that magical feeling that happens when you emerge from depression as the light fills the darkness and your mind operates with energy and clarity.
>
> How are you coming along?
>
>
> - Scott
>
>
Posted by SLS on September 11, 2012, at 6:21:30
In reply to Re: Starting minocycline. » SLS, posted by AlexCanada on September 11, 2012, at 5:23:17
> Hey Scott. Good to hear you are improving.
Thanks.
:-)
> Do you feel minocycline may be working for you due to it's effect on Norepinephrine or other factors?Gosh. It's so hard to know for sure. I am guessing that there is more than one effect that is contributing to my therapeutic response. I know that minocycline amplifies the antidepressant effect of desipramine. It might work with other TCAs as well. Researchers have found that it also has anti-glutamatergic properties via receptor downregulation. These might amplify the antidepressant effects of Lamictal, a glutamate release inhibitor. Even its anti-inflammatory properties might contribute, as drugs with this effect have shown antidepressant activity in rats. In fact, there is a study currently underway that is designed to see if the addition of aspirin to minocycline works better for bipolar depression than minocycline alone. These treatments are to be compared to placebo. Although it might not produce new nerve cells (neurogenesis), minocycline does protect new cells from damage (neuroprotection) by suppressing microglia activity. Microglia have a nasty habit of producing neurotoxic pro-inflammatory modulators.
There comes a time when I say the heck with theory. To some degree, we act as blind guinea pigs for one another. So far, this guinea pig is happy with the results of my minocycline investigation. It is important to note that I am taking Lamictal. Theory here is helpful in that it might indicate to someone who is not responding to minocycline therapy that adding Lamictal would "unlock" its therapeutic potential or vice-versa.
Currently:
Parnate 80 mg/day
Nortriptyline 150 mg/day
Lamictal 200 mg/day
Lithium 300 mg/day
Abilify 10 mg/day
Minocycline 200 mg/dayI found that minocycline works better for me at 200 mg/day than it did at 100 mg/day. Most of the current studies of minocycline to treat depression use 200 mg/day or higher. It should be dosed twice a day.
I was able to discontinue prazosin, which produced a significant antidepressant effect for me. My next move will be to attempt to discontinue Abilify. I am less confident that I will able to do this without relapsing. I might need its dopamine system stabilizing (DSS) properties. However, it is logical to try this due to the metabolic side effects Abilify produces. I have gained 50 pounds over the course of several years and my triglycerides are way too high. Abilify is the likely culprit.
Do you feel that noradrenergic (NE) hypofunction is a component of your illness?
- Scott
Posted by AlexCanada on September 12, 2012, at 11:17:37
In reply to Re: Starting minocycline. » AlexCanada, posted by SLS on September 11, 2012, at 6:21:30
> > Do you feel minocycline may be working for you due to it's effect on Norepinephrine or other factors?
>
> Gosh. It's so hard to know for sure. I am guessing that there is more than one effect that is contributing to my therapeutic response. I know that minocycline amplifies the antidepressant effect of desipramine. It might work with other TCAs as well. Researchers have found that it also has anti-glutamatergic properties via receptor downregulation. These might amplify the antidepressant effects of Lamictal, a glutamate release inhibitor. Even its anti-inflammatory properties might contribute, as drugs with this effect have shown antidepressant activity in rats. In fact, there is a study currently underway that is designed to see if the addition of aspirin to minocycline works better for bipolar depression than minocycline alone. These treatments are to be compared to placebo. Although it might not produce new nerve cells (neurogenesis), minocycline does protect new cells from damage (neuroprotection) by suppressing microglia activity. Microglia have a nasty habit of producing neurotoxic pro-inflammatory modulators.I have tried Lamictal before and it seemed promising in terms of improving my mood initially, I was starting to enjoy things a little bit but it very quickly was negatively impacting my already poor cognition and I'd also feel empty headed and very dull. I never felt more dumb on any medication than I did on lamictal and even my short term memory was severely compromised. Constantly forgetting things moment by moment.
Do you know which other meds may have anti-glutamatergic action? Lamictal seemed promising but I just could not handle the infamous side effects. The ''Lamictal Stupid'' effect that is well documented online.
A very prominent doctor here in Canada stated glutamine could be one possible factor in my melancholic depression but he never specified anything on the issue and I am no longer able to reach him as he is not my main doctor.
Minocycline, might it be a viable option for augmenting an SSRI such as Zoloft which I am currently taking (and so far feeling very dull, blunted, flat, as I am on day 6 of 25mg) or an SNRI (such as Savella or others?). Or is it more suited to augment TCAs? Because I'm not sure if I'll be trying a TCA any time soon.
> There comes a time when I say the heck with theory. To some degree, we act as blind guinea pigs for one another. So far, this guinea pig is happy with the results of my minocycline investigation. It is important to note that I am taking Lamictal. Theory here is helpful in that it might indicate to someone who is not responding to minocycline therapy that adding Lamictal would "unlock" its therapeutic potential or vice-versa.
>
> Currently:
>
> Parnate 80 mg/day
> Nortriptyline 150 mg/day
> Lamictal 200 mg/day
> Lithium 300 mg/day
> Abilify 10 mg/day
> Minocycline 200 mg/day
>
> I found that minocycline works better for me at 200 mg/day than it did at 100 mg/day. Most of the current studies of minocycline to treat depression use 200 mg/day or higher. It should be dosed twice a day.
>
> I was able to discontinue prazosin, which produced a significant antidepressant effect for me. My next move will be to attempt to discontinue Abilify. I am less confident that I will able to do this without relapsing. I might need its dopamine system stabilizing (DSS) properties. However, it is logical to try this due to the metabolic side effects Abilify produces. I have gained 50 pounds over the course of several years and my triglycerides are way too high. Abilify is the likely culprit.
>
> Do you feel that noradrenergic (NE) hypofunction is a component of your illness?I think it very well could be a missing link. Considering NRIs etc can supposedly have benefits to cognition, memory, drive, motivation, energy, things which I very often lack especially on the cognitive side. When my mind is more active and does not feel so cognitively blocked off and I am able to have some flowing stream of thought often other things become easier as well. In the past I did not respond well to Effexor, Wellbutrin, among others though. Effexor rapidly caused my condition to worsen but those were early days when aside from strong melancholic dep I was also dealing with severe ''out of nowhere'' anxiety, anxiety without reason, and intense burning pains in my head. I was never able to give effexor and certain other similar meds a long enough trial due to the worsening of my symptoms. Anxiety would strongly manifest itself yet in theory Norepinephrine info seems like it may help greatly.
Perhaps I have too much norepinephine? And very low dopamine and seratonin. I don't know. Dopamine based meds have worked wonders (ritalin/dexedrine/parnate etc) in the past. These days I have much tolerance to ritalin.
My anxiety these days is usually very low and has always been very secondary compared to my melancholic depression but much of this low anxiety might be due to how dulled and cognitively impaired i am right now.
Posted by SLS on September 17, 2012, at 8:20:26
In reply to Re: Starting minocycline. » SLS, posted by AlexCanada on September 12, 2012, at 11:17:37
> My anxiety these days is usually very low and has always been very secondary compared to my melancholic depression but much of this low anxiety might be due to how dulled and cognitively impaired i am right now.
That's a very insightful connection you make between cognitive impairment and the anxiety that can emerge as a result of being hypofunctional in a busy world. It is difficult not to become anxious when one is asked to perform at a level beyond their capabilities.
I wonder if using low-dose lithium treatment would help in combination with antidepressants. Adding lithium to Parnate had been a favorite strategy 30 years ago. Of course, adding it to TCAs was a common treatment. Lithium might act as a buffer against excessive NE and GLU activity via receptor modulation produced by inhibiting second messenger cascades.
- Scott
Posted by SLS on September 17, 2012, at 8:21:54
In reply to Re: Starting minocycline. » AlexCanada, posted by SLS on September 17, 2012, at 8:20:26
Minocycline is still working...
...better and better.
- Scott
Posted by Tomatheus on September 17, 2012, at 15:00:19
In reply to Re: Starting minocycline., posted by SLS on September 17, 2012, at 8:21:54
Posted by brynb on September 17, 2012, at 15:05:49
In reply to Re: Starting minocycline., posted by SLS on September 17, 2012, at 8:21:54
> Minocycline is still working...
>
> ...better and better.
>
>
> - Scott
>Wow, that's awesome! I think I mentioned I have an Rx (from my derm). I'd love to bring this up to my pdoc.
Posted by rovers95 on September 18, 2012, at 15:57:32
In reply to Re: Starting minocycline., posted by SLS on September 17, 2012, at 8:21:54
> Minocycline is still working...
>
> ...better and better.
>
>
> - Scott
>
>Okay, whilst it is difficult for me to discern what represents a response from what is a 'high' from eating a few carbs, I seem to be doing a lot better. I am now at 100mg and whilst I was quite flat friday to sunday, in the last few couple of days I have good spells that suggest considerable improvement.
Obviously, I have issues in other areas (binge eating, diet)that need addressing. I was considering suggesting an SSRI (zoloft) or using 5htp to see if this would help this side of my treatment.
Scott, would be interesting to know what made you try minocycline...apart from running out of ideas! Is your pdoc using with others? Are they having similar success and do you know of anyone who has been on this long term?
Cheers, Rover
Posted by SLS on September 18, 2012, at 18:30:51
In reply to Re: (maybe) working for me too » SLS, posted by rovers95 on September 18, 2012, at 15:57:32
> > Minocycline is still working...
> >
> > ...better and better.> Okay, whilst it is difficult for me to discern what represents a response from what is a 'high' from eating a few carbs, I seem to be doing a lot better. I am now at 100mg and whilst I was quite flat friday to sunday, in the last few couple of days I have good spells that suggest considerable improvement.
That mirrors my experience with minocycline. I felt flat for the first few days, but felt better going into day 5. Your mood might be somewhat variable throughout the day at first. Mine was. It is less so now.
> Obviously, I have issues in other areas (binge eating, diet)that need addressing. I was considering suggesting an SSRI (zoloft) or using 5htp to see if this would help this side of my treatment.
Have you tried Prozac? What about desipramine or other TCAs? One study of rats showed that minocyclne helped desipramine work better. The same was also true of Prozac, but in a different manner. The other SRIs might work just as well, but they weren't tested.
> Scott, would be interesting to know what made you try minocycline...
It was a suggestion coming from the psychiatry department at Massachussets General Hospital.
> Is your pdoc using with others?
I'm his first.
Fortunately, my doctor has an open mind. I didn't have to work too hard to convince him to allow me to try minocycline. He's big on some of the newer ideas regarding brain inflammation. Although I am convinced that there is an association between inflammation and depressive illness, I tend to believe that the anti-glutamatergic properties of minocycline are most responsible for its more immediate antidepressant effect. I could be very wrong, of course.
> do you know of anyone who has been on this long term?
Not yet.
What other drugs are you taking?
- Scott
Posted by SLS on December 30, 2012, at 12:50:37
In reply to Re: Starting minocycline., posted by SLS on September 17, 2012, at 8:21:54
I'm doing pretty damned well right now. It's relative, of course. I am probably 35% of the way there. You don't realize how sick you were until you begin to recover. I am really working towards returning to work next year. I am beginning to believe that it will happen. A 50% improvement should do it.
Minocycline is making the difference between plateauing on prazosin and moving forwared towards remission. I temporarily discontinued the minocycline to see if raising the prazosin alone would do the job. I seemed to lose ground and reached a point of stagnation. Once I was satisfied that I had plateaued, I added back the minocycline. Within a week, I am beginning to feel the magic again.
Heeeeere we go...
My current regime:
Parnate 80 mg/day
nortriptyline 150 mg/day
Lamictal 200 mg/day
lithium 300 mg/day
Abilify 10 mg/day
prazosin 15 mg/day
minocycline 200 mg/day7 drugs? Well, until medical science solves the puzzle, I am stuck with polypharmacy. I am incredibly fortunate.
- Scott
Posted by SLS on December 30, 2012, at 12:55:24
In reply to Re: (maybe) working for me too » SLS, posted by rovers95 on September 18, 2012, at 15:57:32
How are you doing?
I learned recently that minocycline can take as long as a full year to produce a 100% remission from depression. If you began to feel even a slight improvement within the first three weeks, I think that this would be a very good sign.
- Scott
Posted by JonCatnip on February 18, 2013, at 17:07:15
In reply to Re: (maybe) working for me too » rovers95, posted by SLS on December 30, 2012, at 12:55:24
Hi,
I'd be curious to hear any more updates about minocycline. I have searched online for weeks and this has been about the most informative source for any feedback on the actual use of minocycline in treating bi-polar conditions.
I know there are several studies underway to study minocycline... but they won't be published for a year. After reading several very interesting reports about the benefits of minocycline, I'd think there would be more attention in the press paid to this new discovery. I would think that extraordinary case of the patient in Japan who had Schizophrenia cured with minocycline might have generated some buzz. If indeed many brain health issues are related to inflamation... and minocycline can be shown effective in treating it, I'd like to know more.
It was encouraging to see that President Obama wants to devote resources to studying the brain, along the same lines as mapping the genome.
Anyhow, if anyone has more feedback about minocycline, I'd be interested to know more. I can't get my doctor to sign off on it, so I'm looking for all the information I can get.
Posted by SLS on February 18, 2013, at 17:29:23
In reply to Re: (maybe) working for me too, posted by JonCatnip on February 18, 2013, at 17:07:15
> Anyhow, if anyone has more feedback about minocycline, I'd be interested to know more. I can't get my doctor to sign off on it,
Why not? Intracranial hypertension?
> so I'm looking for all the information I can get.
I tried stopping minocycline twice since August. Once was intentional. Once was inadvertent. On both occasions, my depression worsened within a week. Upon restarting minocycline, recovery occurred within 48 hours. I doubt your doctor will find my words compelling, though.
What kind of information are you looking for?
- Scott
Posted by SLS on February 18, 2013, at 17:34:35
In reply to Re: (maybe) working for me too, posted by JonCatnip on February 18, 2013, at 17:07:15
What literature have you brought in for your doctor to see?
- Scott
Posted by mogger on May 24, 2014, at 10:05:29
In reply to Re: Starting minocycline SLS » Slabicki, posted by SLS on August 21, 2012, at 6:37:01
Scott I know this is an old post but I am just starting minocycline today for depression. My pdoc prescribed be 100mgs of the ER version. Do you think I could if it works still see benefits with the ER version? Hope so,
Mogger
Posted by Jeroen on May 24, 2014, at 10:13:48
In reply to Re: Starting minocycline SLS » SLS, posted by mogger on May 24, 2014, at 10:05:29
1 mg is okay but 2,5 mg added can lead to psychosis and seizures
Posted by SLS on May 24, 2014, at 14:55:49
In reply to Re: Starting minocycline SLS » SLS, posted by mogger on May 24, 2014, at 10:05:29
> Scott I know this is an old post but I am just starting minocycline today for depression. My pdoc prescribed be 100mgs of the ER version. Do you think I could if it works still see benefits with the ER version? Hope so,
>
> MoggerMogger, I can't be sure, but I have not encountered anything that would lead me to believe that there would be a difference between the two versions of minocyline. I was taking 100 mg twice a day for over two years. I recently discontinued minocycline because hyperpigmentation emerged. I think I caught it in time. It can be irreversible. The dark blue color began on my feet and was working its way up my shins. This side effect can affect as many as 20% of people who take more than 100 mg/day for two or more years. There is some indication that taking large doses of vitamin C can prevent hyperpigmentation from occurring. The dosage of vitamin C that I see suggested is 1000 mg/day. Taking more won't hurt, of course. I didn't learn about the vitamin C until recently, or I would have started it at the beginning.
I hope you do well with minocycline. It can work very quickly. Have you noticed an increase in energy?
- Scott
Posted by mogger on May 24, 2014, at 23:21:49
In reply to Re: Starting minocycline SLS » mogger, posted by SLS on May 24, 2014, at 14:55:49
Thanks Scott. Insurance is still being sorted so will be a few days until I start. I am all over the vitamin c recommendation. Sorry that it happened to you. I shall give you an update. Started Saphris on a side note a few nights ago which so far has been positive but early days of course. Saw saphris works on glutamate which is interesting. Thanks again,
Mogger
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