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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by rod on March 4, 2004, at 5:34:25
Does anyone have experiences with Reminyl (Galantamine) for memory, cognitive purposes without having true Alzheimer? Is it the same Dosage? Less? I am planning to give it a try to improve memory and maybe its also working to help quit smoking.
any comment appreciated
Roland
Posted by SLS on March 4, 2004, at 7:25:36
In reply to Dosage of Galantamine for non Alzheimer Purpose?, posted by rod on March 4, 2004, at 5:34:25
> Does anyone have experiences with Reminyl (Galantamine) for memory, cognitive purposes without having true Alzheimer? Is it the same Dosage? Less? I am planning to give it a try to improve memory and maybe its also working to help quit smoking.
>
> any comment appreciated
>
> RolandAlthough it doesn't affect everyone this way, Ach cholinesterase inhibitors like galantamine are known to cause or make worse depression. I would still try it, though.
- Scott
Posted by rod on March 6, 2004, at 5:22:00
In reply to Re: Dosage of Galantamine for non Alzheimer Purpose?, posted by SLS on March 4, 2004, at 7:25:36
> Although it doesn't affect everyone this way, Ach cholinesterase inhibitors like galantamine are known to cause or make worse depression. I would still try it, though.
>
>
> - ScottYes, I know about this and have experienced this by myself. Exelon is quite depressiogenic for me, but Galantamine schould be somewhat different, because it directly or indirectly increases stimulation of nicotinic acetylcholine receptors. Thats a feature which isnt shared with any of the other achetylcholine-esterase inhibitors. I am asking because I feared the dangers of a cholinergic crisis. These drugs are lethal in overdose.
And hell yes, it seems to work for me! Its day 3 on 6 mg and I really feel an improvement in memory but whats most astonishing also in mood, mental energy, and improves my inability to make a decision. I think many of these improvements are also a result of incresaed perfusion (blood flow) of the brain (Thats what the AchE Inh. also do). And conincidentally I do have left brain sided hypoperfusion, which the doctors I have talked about are somewhat ignoring. The ability to make a decision is related to the left frontal lobe...
Hmmm, I think I will take it for long term use.
Other drugs I take are Lamictal, Neurontin, Solian (Amisulpride), Nortriptyline, Amantadine and Diphenhydramine.Roland
PS I hope this is not a transient effect.
Posted by SLS on March 6, 2004, at 7:49:25
In reply to Re: Dosage of Galantamine for non Alzheimer Purpos, posted by rod on March 6, 2004, at 5:22:00
> > Although it doesn't affect everyone this way, Ach cholinesterase inhibitors like galantamine are known to cause or make worse depression. I would still try it, though.
> Yes, I know about this and have experienced this by myself. Exelon is quite depressiogenic for me, but Galantamine schould be somewhat different, because it directly or indirectly increases stimulation of nicotinic acetylcholine receptors. Thats a feature which isnt shared with any of the other achetylcholine-esterase inhibitors.
That should boost dopamine release in PFC and NACC, right?
> I am asking because I feared the dangers of a cholinergic crisis. These drugs are lethal in overdose.
Gosh. I didn't know that.
> And hell yes, it seems to work for me! Its day 3 on 6 mg and I really feel an improvement in memory but whats most astonishing also in mood, mental energy, and improves my inability to make a decision.That's great! What a pleasant surprise!
> I think many of these improvements are also a result of incresaed perfusion (blood flow) of the brain (Thats what the AchE Inh. also do). And conincidentally I do have left brain sided hypoperfusion,
How were you tested for this?
> Hmmm, I think I will take it for long term use.
> Other drugs I take are Lamictal, Neurontin, Solian (Amisulpride), Nortriptyline, Amantadine and Diphenhydramine.How would you describe your illness? Maybe it has a few things in common with mine. What do you feel the amantadine is doing for you? My cocktail is similar to yours. I'm taking Lamictal, imipramine, Zoloft, memantine, and Abilify. If you continue to improve with galantamine, I'll definitely put it on my list of things to try. How do you respond to MAOIs?
> PS I hope this is not a transient effect.
I just put in a little prayer to make it so.
Good luck!
- Scott
Posted by rod on March 6, 2004, at 8:26:37
In reply to Re: Dosage of Galantamine for non Alzheimer Purpos » rod, posted by SLS on March 6, 2004, at 7:49:25
> > > Although it doesn't affect everyone this way, Ach cholinesterase inhibitors like galantamine are known to cause or make worse depression. I would still try it, though.
>
> > Yes, I know about this and have experienced this by myself. Exelon is quite depressiogenic for me, but Galantamine schould be somewhat different, because it directly or indirectly increases stimulation of nicotinic acetylcholine receptors. Thats a feature which isnt shared with any of the other achetylcholine-esterase inhibitors.
>
> That should boost dopamine release in PFC and NACC, right?
>In fact I dont know about the exact effect. But I have read somewhere that it indeed faciliates the release of some neurotransmitters. Thanks for the info.
> > I am asking because I feared the dangers of a cholinergic crisis. These drugs are lethal in overdose.
>
> Gosh. I didn't know that.
>
> > And hell yes, it seems to work for me! Its day 3 on 6 mg and I really feel an improvement in memory but whats most astonishing also in mood, mental energy, and improves my inability to make a decision.
>
> That's great! What a pleasant surprise!
>
> > I think many of these improvements are also a result of incresaed perfusion (blood flow) of the brain (Thats what the AchE Inh. also do). And conincidentally I do have left brain sided hypoperfusion,
>
> How were you tested for this?
>I did a SPECT scan. Not at Amen clinic. Did this in an public hospital. The hypoperfusion is not severe, so the doctors I talked to, somewhat ignore the results. They only find worth treating this, if your symptoms are severe as they are when you had a stroke. But If I look which things are attributed to the two sides of our brain, the right side is ok, while the left side isnt. But its somewhat similar to depression.
> > Hmmm, I think I will take it for long term use.
> > Other drugs I take are Lamictal, Neurontin, Solian (Amisulpride), Nortriptyline, Amantadine and Diphenhydramine.
>
> How would you describe your illness? Maybe it has a few things in common with mine. What do you feel the amantadine is doing for you? My cocktail is similar to yours. I'm taking Lamictal, imipramine, Zoloft, memantine, and Abilify. If you continue to improve with galantamine, I'll definitely put it on my list of things to try.Well, its a mixture of many diagnosis. I have comorbid ADD (I did a computer test and I performed very poor), Social Anxiety Disorder (But I would rather say I am just socially withdrawn. I like to be alone most of the time and avoid masses of people. I dont feel comfortable if there are many people around), my current doctor said i have some aspects of the deficit syndrome (but without ever having psychosis or beeing schizophrenic), maybe ultra rapid cycling with mainly mixed states, and dystymia with recurrent depressive episodes. And maybe some kind of subsyndromal epilepsy, because of hypoperfusion. Also the temporal lobe. This might explain my ADD symptoms and why I get worse on SSRIs (Temporal Lobe ADD). But I fact I dont know what is causing what and if things are comorbid or are seperate.
Its hard to find the right words about what Amantadine is doing for me. It somewhat feels like a mood stabiliser, making me a bit more normal.
Each component of my coctail is a small but valuable step towards normality.
>How do you respond to MAOIs?
The only one I have tried was Moclobomide, which didnt had great effect for me. Nor good or bad.
The other ones are no longer available in my place :-(>
> > PS I hope this is not a transient effect.
>
> I just put in a little prayer to make it so.
>Thanks!
> Good luck!
>
>
> - Scott
>Roland
Posted by SLS on March 6, 2004, at 9:26:44
In reply to Re: Dosage of Galantamine for non Alzheimer Purpos » SLS, posted by rod on March 6, 2004, at 8:26:37
Dear Roland,
> > How would you describe your illness? Maybe it has a few things in common with mine. What do you feel the amantadine is doing for you? My cocktail is similar to yours. I'm taking Lamictal, imipramine, Zoloft, memantine, and Abilify. If you continue to improve with galantamine, I'll definitely put it on my list of things to try.
> Well, its a mixture of many diagnosis. I have comorbid ADD (I did a computer test and I performed very poor),My cognition is greatly impaired by this illness. I don't doubt that I would perform poorly on any kind of exam, including ADD. Maybe I should take the same one to see how our scores compare.
> Social Anxiety Disorder (But I would rather say I am just socially withdrawn. I like to be alone most of the time and avoid masses of people. I dont feel comfortable if there are many people around)
I have experienced exactly what you describe here. I even hide when I see people walking outside that might be able to look through the window. I don't want to be seen. I experience anxiety in social situations that involve more than one person. However, I think this is more a manifestation of the depressive disorder than a comorbid condition.
> my current doctor said i have some aspects of the deficit syndrome (but without ever having psychosis or beeing schizophrenic),
My doctor used the exact same terminology to describe me. The deficit syndrome can exist independant of schizophrenia or major depression or can be associated with either.
http://www.biopsychiatry.com/anhedschiz.htm
> maybe ultra rapid cycling with mainly mixed states, and dystymia with recurrent depressive episodes.
Up until lithium was introduced at age 22 (now 44 - ouch), I had been an ultra-rapid cycler. I would be depressed for 8 days followed by 3 days of euthymia followed by 8 days of depression, etc. It was a dramatic and consistent phenomenon. Lithium abolished the cycling, but left me chronically depressed without relent.
> And maybe some kind of subsyndromal epilepsy, because of hypoperfusion. Also the temporal lobe. This might explain my ADD symptoms and why I get worse on SSRIs (Temporal Lobe ADD).
Hmmm. How are these things linked? How does the temporal lobe relate to SSRI-induced exacerbation of your depression? The following drugs made me feel moderately or severely worse:
moclobemide (Manerix, Aurorix)
protriptyline (Vivactil)
bupropion (Wellbutrin)
topiramate (Topamax)
tiagabine (Gabitril)
triiodothyronine (Cytomel)
amoxapine (Asendin)
mirtazepine (Remeron)
idazoxan (investigational)> But I fact I dont know what is causing what and if things are comorbid or are seperate.
Depression has many faces. It is possible that all of your symptoms represent a presentation of a single depressive illness. When a drug works for me, all of these symptoms vanish at once. My problem is that a robust response only lasts for days or weeks. They poop-out immediately.
- Scott
Posted by rod on March 6, 2004, at 10:11:27
In reply to Re: Dosage of Galantamine for non Alzheimer Purpos » rod, posted by SLS on March 6, 2004, at 9:26:44
> > And maybe some kind of subsyndromal epilepsy, because of hypoperfusion. Also the temporal lobe. This might explain my ADD symptoms and why I get worse on SSRIs (Temporal Lobe ADD).
>
> Hmmm. How are these things linked? How does the temporal lobe relate to SSRI-induced exacerbation of your depression?
>http://www.mindfixers.com/amensub5.html
-------------------------------------
Temporal Lobe ADD, according to Dr. AmenIn my clinical experience, temporal lobe symptoms are found in approximately
10-15% of patients with ADD. Temporal lobe symptoms can be among the most
painful.These include periods of panic or fear for no specific reason, periods of
spaciness or confusion, dark thoughts (such as suicidal or homicidal
thoughts), significant social withdrawal, frequent periods of deja vu,
irritability, rages, and visual changes (such as frequently seeing shadows
out of the corner of the eye).Temporal lobe dysfunction may be inherited or it may be caused by some sort of
brain trauma.Temporal lobe symptoms associated with ADD are often very responsive to
anti-seizure medication, such as Depakote, Neurontin or Tegretol. Temporal
lobe symptoms are often made worse by serotonergic medications such as
Prozac, Paxil, Zoloft, etc.
-----------------------------------------http://www.brainplace.com/bp/atlas/ch12.asp
4. Temporal lobe ADD, with symptoms of inattention and/or hyperactivity-impulsivity and mood instability, aggression, mild paranoia, anxiety with little provocation, atypical headaches or abdominal pain, visual or auditory illusions, and learning problems (especially reading and auditory processing). Brain SPECT imaging typically shows decreased or increased activity in the temporal lobes with decreased prefrontal cortex activity. Aggression tends to be more common with left temporal lobe abnormalities. This subtype typically responds best to anticonvulsant medications (such as gabapentin, divalproate, or carbamazepine and a psychostimulant.
--------------------------------
Epileptic discarges are somehow related to hypoperfusion. Hypoperfusion may cause the nerves to fire out of control. That might be the eason why people with temporal ADD respond to anticonvulsant medication. Neurontin increases attention and memory with me. And I get worse on SSRIs. I dont know why it is that way.The symptoms mentioned for this subgroup also fit the "indicators suggestive for subsyndromal epilepsy" http://www.dr-bob.org/tips/isse.html
But its no longer there...I think these two conditions are somewhat the same or at least overlap to a high degree.
> The following drugs made me feel moderately or severely worse:
> moclobemide (Manerix, Aurorix)
neutral
> protriptyline (Vivactil)
never tried
> bupropion (Wellbutrin)
worse
> topiramate (Topamax)
never tried
> tiagabine (Gabitril)
never tried
> triiodothyronine (Cytomel)
never tried
> amoxapine (Asendin)
never tried
> mirtazepine (Remeron)
worse
> idazoxan (investigational)
never tried
BTW, good luck with Memantine!Roland
Posted by rod on March 7, 2004, at 8:28:08
In reply to Re: Dosage of Galantamine for non Alzheimer Purpos » SLS, posted by rod on March 6, 2004, at 10:11:27
"Adjuvant galantamine administration improves negative symptoms in a patient with treatment-refractory schizophrenia."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12410061&dopt=Abstract--------
Adjuvant galantamine administration improves negative symptoms in a patient with treatment-refractory schizophrenia.Rosse RB, Deutsch SI.
Mental Health Service Line, Department of Veterans Affairs Medical Center, Washington, DC 20422, USA.
Because of the demonstration of a selective alpha nicotinic receptor abnormality in patients with schizophrenia, galantamine was added to the stable regimen of atypical and other antipsychotic medications in a 43-year-old man manifesting severe and persistent positive and negative symptoms, as well as mood disturbance and cognitive dysfunction. Galantamine is an inhibitor of acetylcholinesterase and a positive allosteric modulator of nicotinic cholinergic receptors (with a FDA-approved indication for the treatment of patients with mild to moderate Alzheimer disease (AD) under the trade name Reminyl). Galantamine HBr was initiated at a dose of 4 mg po BID, which was maintained for the first week of adjuvant therapy, and eventually was increased to 12 mg po BID during the final weeks of his 2-month trial. Remarkably, within 1 week of its initiation, there was a dramatic and clinically significant decrease of negative symptoms, as reflected in formal ratings on the Scale for the Assessment of Negative Symptoms. Moreover, within a few days of galantamine discontinuation, negative symptoms worsened, returning to the baseline level of severity. In addition to targeting memory dysfunction in AD, acetylcholinesterase inhibitors may have an expanded range of targets and clinical indications, including behavioral and psychotic symptoms. Galantamine is distinguished from other acetylcholinesterase inhibitors by its positive allosteric modulatory properties, improving the efficiency of transduction of the acetylcholine signal at nicotinic receptors. This latter property may have contributed to the observed improvement in negative symptoms observed in this patient. Importantly, positive symptoms were unchanged during this 2-month trial.(7)
------------interesting, eh?
Roland
Posted by SLS on March 7, 2004, at 12:03:02
In reply to Galantamine and negative symptoms - case report, posted by rod on March 7, 2004, at 8:28:08
Schizophrenics as a group are perhaps the heaviest users of tabacco. They are really self-medicating with nicotine. They actually receive benefit from it.
- Scott
Posted by rod on March 13, 2004, at 13:51:46
In reply to Dosage of Galantamine for non Alzheimer Purpose?, posted by rod on March 4, 2004, at 5:34:25
Well, after doing quite good for some days on 6mg, I went up to 9 mg (8mg is the starting dose for alzheimer; I have 12mg pills which I cut into 4 pieces) to get more effect. But just the opposite has happened. What a cruel world. Depression worsened while on 9mg dor 2 days. I reduced to 6mg again, but that didnt change much. So I doubled the dosage of my loved Diphenhydramine (what has an antidepressive effect on me, believe it or not) and I am getting better now and totally stopped Galantamine. I will try it again, but only at 3mg, some time. Good old dirty anticholinergic Diphenhydramine is a great drug fo me BTW.
greetings
Roland
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