![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by iforgotmypassword on August 23, 2005, at 19:00:33
(drugs like Aricept and Reminyl)
an outpatient doctor i saw a while ago said he didnt want to touch the idea of them as they were not to be taken lightly or some such. and my inpatient doctor (who is away this week) said that he thought they could be harmful as it could overdrive and burn out the cholinergic system... :( though i still have seen a small amount of these drugs being used with children... and they seem to improve executive fuctioning which i what i need so so badly... anyone have any wisdom?
Posted by linkadge on August 23, 2005, at 20:34:06
In reply to are anticholinisterase inhibitors harmful?, posted by iforgotmypassword on August 23, 2005, at 19:00:33
I don't think they would burn out the cholinergic system any more than say a SSRI would burn out the serotonergic system.
I think they are dangerous to those with mood disorders though, as overactive frontal cortex acetlycholine neurotransmission is one of the hallmarks of depressive states.
The doctors are right that they are not drugs to be taken lightly.
Most people I know who have taken them don't think much of them.
Linkadge
Posted by Tom Twilight on August 24, 2005, at 4:36:31
In reply to Re: are anticholinisterase inhibitors harmful?, posted by linkadge on August 23, 2005, at 20:34:06
As linkadge says they can worsen depression and I've never tried one
That said I have heard of some people finding them helpful for ADHD symptoms like excutive function, they can also be energising
You could always try one and discontinue if it made you feel worse
Posted by SLS on August 24, 2005, at 6:17:02
In reply to Re: are anticholinisterase inhibitors harmful?, posted by Tom Twilight on August 24, 2005, at 4:36:31
I tried Aricept (donepezil). It made my depression worse.
- Scott
Posted by iforgotmypassword on August 24, 2005, at 16:52:21
In reply to Re: are anticholinisterase inhibitors harmful?, posted by SLS on August 24, 2005, at 6:17:02
executive functioning is a *huge* problem of mine. :( and given my lack of feeling, neverending anhedonia, social ineptness and inability to speak properly, i'm wondering if i have a prefrontal cortex at all. :(
Posted by linkadge on August 24, 2005, at 19:06:17
In reply to executive functioning, posted by iforgotmypassword on August 24, 2005, at 16:52:21
Are you taking any prefrontal no-no drugs like SSRI's or anticonvulsants ?
You may want to look into deprenyl. I would certainly rank it far and above and acetylcholinsterase inhibitor in terms of ability to engage the frontal cortex.
Also supplement with omega 3. Omega 3 supplementation has been shown to significantly increase the serotonin and dopamine content in the frontal cortex (at least in pigs)
Linkadge
Posted by iforgotmypassword on August 24, 2005, at 19:50:15
In reply to Re: executive functioning, posted by linkadge on August 24, 2005, at 19:06:17
Posted by Iansf on August 25, 2005, at 0:45:18
In reply to executive functioning, posted by iforgotmypassword on August 24, 2005, at 16:52:21
> executive functioning is a *huge* problem of mine. :( and given my lack of feeling, neverending anhedonia, social ineptness and inability to speak properly, i'm wondering if i have a prefrontal cortex at all. :(
Could someone define executive functioning for me in this context? Does the term refer to a specific way of thinking or acting? Does it mean decision-making, organizing, or am I way off track? Thanks.
Posted by linkadge on August 25, 2005, at 6:41:01
In reply to Re: executive functioning » iforgotmypassword, posted by Iansf on August 25, 2005, at 0:45:18
You are definately on track. The frontal cortex is highly involved in executive function. Basically the part of the brain that takes command of the rest of the brain. Planning, communicating, focused attention, etc.
When the frontal cortex function wanes, you end up with less structured and more impusive thought.
The frontal cortex is though to be improperly functoning in a whole host of mental illnesses from ADD to schitsophrenia, although specific abnormalities may vary.
Anticonvulsants can impair certain aspects of frontal cortex function. Kind of like how alcohol can make you impulsive by shutting it down.
Some are more frontal cortex friendly than others. (I know that depakote induces the activity of growth factors in the frontal cortex, and can reverse the atrophy of the subgenual prefrontal cortex.)
I would suggest a few essentials to start. Exercise first. Vitamin D increases NGF in frontal cortex, and Omega 3 plumps up frontal cortex dopaminergic/serotonergic neurons.
Beyond that, I would look for agents that enhance frontal cortex catecholamine actiivty. Acetylcholinsterase inhibitors may increase certain aspects of frontal cortex function, but just don't think any benifits have been proven conclusively.
Go for it, if you want to try, but there may be some more tried and tested executive function modulators.
Linkadge
Posted by zeugma on August 25, 2005, at 21:34:26
In reply to Re: executive functioning » Iansf, posted by linkadge on August 25, 2005, at 6:41:01
Provigil is good for executive function. I can actually direct my actions towards a goal, to some small degree, on it.
-z
Posted by zeugma on August 28, 2005, at 7:22:51
In reply to Re: executive functioning, posted by zeugma on August 25, 2005, at 21:34:26
It seems the anterior cingulate cortex is involved in the assigning of values to outcomes of possible actions, thereby making it feasible to effectively guide one's behavior towards a goal:
Neuroscience. 1999;93(4):1271-87. Related Articles, Links
Emotional and behavioral correlates of the anterior cingulate cortex during associative learning in rats.Takenouchi K, Nishijo H, Uwano T, Tamura R, Takigawa M, Ono T.
Department of Neuropsychiatry, Faculty of Medicine, Kagoshima University, Japan.
Neuronal activity was recorded from the anterior cingulate cortex of behaving rats during discrimination and learning of conditioned stimuli associated with or without reinforcements. The rats were trained to lick a protruding spout just after a conditioned stimulus to obtain reward (intracranial self-stimulation or sucrose solution) or to avoid aversion. The conditioned stimuli included both elemental (auditory or visual stimuli) and configural (simultaneous presentation of auditory and visual stimuli predicting reward outcome opposite to that predicted by each stimulus presented alone) stimuli. Of the 62 anterior cingulate neurons responding during the task, 38 and four responded differentially and non-differentially to the conditioned stimuli (conditioned stimulus-related neurons), respectively. Of the 38 differential conditioned stimulus-related neurons, 33 displayed excitatory (n = 10) and inhibitory (n = 23) responses selectively to the conditioned stimuli predicting reward. These excitatory and inhibitory differential conditioned stimulus-related neurons were located mainly in the cingulate cortex areas 1 and 3 of the rostral and ventral parts of the anterior cingulate cortex, respectively. The remaining 20 neurons responded mainly during intracranial self-stimulation and/or ingestion of sucrose (ingestion/intracranial self-stimulation-related neurons). Increase in activity of the ingestion/intracranial self-stimulation-related neurons was correlated to the first lick to obtain rewards during the task, suggesting that the activity reflected some aspects of motor functions for learned instrumental behaviors. These ingestion/intracranial self-stimulation-related neurons were located sparsely in cingulate cortex area 1 of the rostral part of the anterior cingulate cortex and densely in frontal area 2 of the caudal and dorsal parts of the anterior cingulate cortex. Analysis by the multidimensional scaling of responses of 38 differential conditioned stimulus-related neurons indicated that the anterior cingulate cortex categorized the conditioned stimuli into three groups based on reward contingency, regardless of the physical characteristics of the stimuli, in a two-dimensional space; the three conditioned (two elemental and one configural) stimuli predicting sucrose solution, the three conditioned (two elemental and one configural) stimuli predicting no reward, and the lone conditioned stimulus predicting intracranial self-stimulation. The results suggest that the anterior cingulate cortex is organized topographically; stimulus attributes predicting reward or no reward are represented in the rostral and ventral parts of the anterior cingulate cortex, while the caudal and dorsal parts of the anterior cingulate cortex are related to execution of learned instrumental behaviors. These results are in line with recent neuropsychological studies suggesting that the rostral part of the anterior cingulate cortex plays a crucial role in socio-emotional behaviors by assigning a positive or negative value to future outcomes.
PMID: 10501451 [PubMed - indexed for MEDLINE]
--------------------------------------------------------------------------------
Brain. 1995 Feb;118 ( Pt 1):279-306. Related Articles, Links
Contributions of anterior cingulate cortex to behaviour.Devinsky O, Morrell MJ, Vogt BA.
Department of Neurology, New York University School of Medicine, New York.
Assessments of anterior cingulate cortex in experimental animals and humans have led to unifying theories of its structural organization and contributions to mammalian behaviour. The anterior cingulate cortex forms a large region around the rostrum of the corpus callosum that is termed the anterior executive region. This region has numerous projections into motor systems, however, since these projections originate from different parts of anterior cingulate cortex and because functional studies have shown that it does not have a uniform contribution to brain functions, the anterior executive region is further subdivided into 'affect' and 'cognition' components. The affect division includes areas 25, 33 and rostral area 24, and has extensive connections with the amygdala and periaqueductal grey, and parts of it project to autonomic brainstem motor nuclei. In addition to regulating autonomic and endocrine functions, it is involved in conditioned emotional learning, vocalizations associated with expressing internal states, assessments of motivational content and assigning emotional valence to internal and external stimuli, and maternal-infant interactions. The cognition division includes caudal areas 24' and 32', the cingulate motor areas in the cingulate sulcus and nociceptive cortex. The cingulate motor areas project to the spinal cord and red nucleus and have premotor functions, while the nociceptive area is engaged in both response selection and cognitively demanding information processing. The cingulate epilepsy syndrome provides important support of experimental animal and human functional imaging studies for the role of anterior cingulate cortex in movement, affect and social behaviours. Excessive cingulate activity in cases with seizures confirmed in anterior cingulate cortex with subdural electrode recordings, can impair consciousness, alter affective state and expression, and influence skeletomotor and autonomic activity. Interictally, patients with anterior cingulate cortex epilepsy often display psychopathic or sociopathic behaviours. In other clinical examples of elevated anterior cingulate cortex activity it may contribute to tics, obsessive-compulsive behaviours, and aberrent social behaviour. Conversely, reduced cingulate activity following infarcts or surgery can contribute to behavioural disorders including akinetic mutism, diminished self-awareness and depression, motor neglect and impaired motor initiation, reduced responses to pain, and aberrent social behaviour. The role of anterior cingulate cortex in pain responsiveness is suggested by cingulumotomy results and functional imaging studies during noxious somatic stimulation. The affect division of anterior cingulate cortex modulates autonomic activity and internal emotional responses, while the cognition division is engaged in response selection associated with skeletomotor activity and responses to noxious stimuli. Overall, anterior cingulate cortex appears to play a crucial role in initiation, motivation, and goal-directed behaviours.
This is the end of the 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.