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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by deniseuk190466 on October 4, 2007, at 15:00:29
After all this talk about shrivelled up dendrites and damaged cells I'm worried. Well I'm always worried. But what are the best drugs for protection.
I know linkadge has said lithium is neuroprotective but how protective would something like lamictal be?
I thought that SSRIs were supposed to be neuroprotective and then people are now saying that they cause damage?? so I'm confused.
Also, does Lamictal work directly on Glutamate receptors or does it work indirectly on them in the same way that SSRIs do?
Thanks.....Denise
Posted by Phillipa on October 4, 2007, at 15:08:47
In reply to Which drugs are the most neuroprotective?, posted by deniseuk190466 on October 4, 2007, at 15:00:29
Add trileptal to the list also please. Thanks Phillipa
Posted by bleauberry on October 4, 2007, at 15:49:49
In reply to Which drugs are the most neuroprotective?, posted by deniseuk190466 on October 4, 2007, at 15:00:29
Lithium is neuroprotective. But then, it isn't a drug but rather a natural salt.
Don't know about the others.
Probably not a bad idea to take healthy doses of C, E, and selenium.
Posted by medweirdo on October 4, 2007, at 15:59:14
In reply to Which drugs are the most neuroprotective?, posted by deniseuk190466 on October 4, 2007, at 15:00:29
I have red about Litium is neuroprotective but it can destroy your kedneys. natural Lithum in the form of lithium orotate is much more safer but I cannot agree that it actually protective since there aren't sufficient research about it.
Posted by zana on October 4, 2007, at 19:51:26
In reply to Which drugs are the most neuroprotective?, posted by deniseuk190466 on October 4, 2007, at 15:00:29
Check out a web site called HebWeb. The address is www.biopsychiatry.com they have tons of info and lots of info on drugs they consider neuroprotective. Can be a bit out there but a great resource.
Posted by linkadge on October 5, 2007, at 8:38:57
In reply to Re: Which drugs are the most neuroprotective?, posted by zana on October 4, 2007, at 19:51:26
Yes lithium can be bad for the kidneys, but it is a highly neuroprotective substnace.
Lithium goes beyond neuroprotection to actual neuroregeneration. Lithium enhances the activity of a substance called BCL-2 which actually promotes regeneration of axons. Lithium is neurotrophic thorought the brain, not just the hippocampus.
But lithium does not have the kind of pep that antidepressants do. Its one of those drugs that people take religiously for heuristic values.
Its one of those drugs that you take for 5 years and you look back and notice that you have a better brain. I found it very difficult to tollerate, but I am still toying with the idea of perhaps a low dose longer term.Some more recent work of Dr. Manjii on bipolar, suggests that even subtheraptutic doses can massivly increase the level of the BCL-2 protein, so it is his assumption that even very low doses my have some protective effect on disease progression.
All the anticonvulstants have *some* degree of neuroprotective capacity, but some of these studies results are disease dependant. The are generally neuroprotective via simply modulation of neurotransmitter release. They do not employ the activation of the cellular survival genes like lithium does ie BDNF/BCL-2
Antidepressants have mixed ability to be neuroprotective. They are highly neuroprotective in models of Huntingtons (which is a disease who's primary source of neurdegeneration is abnormal glutamate regulation) Ie all the SSRI's and SNRI's generally show a dramatic and medication specific ability to slow the progression of Huntintons. Actually, in this regard, antidepressants are a bit better than lithium which also has some application. This is suggestive of a glutamate modulating effect of the antidepressants. The SSRI's indirectly will lower glutamate release in certain brain regions.
If the SSRI's were neurotoxic, its not likely that the mechanism is glutamate neurotoxicity otherwise they would be as bad for Huntingtons as MSG is, which they are not.The notion that SSRI's cause brain dammage is somewhat more speculative, but is probably a result of mechanisms such as overstimulation of receptors, or neuroanatomical changes due to continually reduced dopaminergic neurotransmission.
I don't know if there is a difinitive model of antidepressant induced neurotoxicity. Most studies demonstrating such changes tend to use doses far in excess of the human dose range.
Linkadge
Posted by tecknohed on October 5, 2007, at 13:20:59
In reply to Which drugs are the most neuroprotective?, posted by deniseuk190466 on October 4, 2007, at 15:00:29
Selegiline appears to be neuroprotective via one of its metabolites, Desmethylselegiline.
From http://en.wikipedia.org/wiki/Selegiline :
Desmethylselegiline may have neuroprotective antiapoptotic properties. A large multicenter study suggests a decrease of in the disease progression of parkinsonism but may have reflected other symptomatic response.
Its often used as a nootropic (cognitive enhancing) drug.
Posted by Squiggles on October 5, 2007, at 21:15:41
In reply to Re: Which drugs are the most neuroprotective?, posted by linkadge on October 5, 2007, at 8:38:57
Yup, as clear an unmuddied lake, lithium is;
But once over the therapeutic level, or just
downright too high like any other drug, the
memory gets affected and you get spacey when
toxic. Otherwise, i think it does
enhance cognitive ability; whether that is due
to the equillibration of emotions or a direct
neurological effect, i don't know. BTW, i think
the kidney tale is a psycho-urban hyperbole-- it may depend on dose and conditions, just like other drugs.Squiggles
Lithium Poster Girl (27 yrs.)
Posted by linkadge on October 5, 2007, at 23:06:28
In reply to Re: Which drugs are the most neuroprotective? » linkadge, posted by Squiggles on October 5, 2007, at 21:15:41
>But once over the therapeutic level, or just
>downright too high like any other drug, the
>memory gets affected and you get spacey when
>toxic.Yes there is an excitotoxic nature to lithium. If you take too much too soon you can have glutamate neutoxocity as well. Acutely, lithium actually dramatically lowers glutamate reuptake resuliting in high levels of glutamate, but chronically it forces glutamate into a very narrow theraptutic index.
>Otherwise, i think it does
>enhance cognitive ability; whether that is due
>to the equillibration of emotions or a direct
>neurological effect,I found it definately slowed me down. It didn't make me dumb, it just slowed me down.
>i don't know. BTW, i think
>the kidney tale is a psycho-urban hyperbole-- it >may depend on dose and conditions, just like >other drugs.I dunno. That seems like wishfull thinking. I think the kidney issues are fiarly well established documented. Not everybody develops significant issues, but..
Linkadge
Posted by deniseuk190466 on October 7, 2007, at 12:57:46
In reply to Re: Which drugs are the most neuroprotective?, posted by linkadge on October 5, 2007, at 23:06:28
..
Posted by LostBoyinNCBecksDark on October 11, 2007, at 0:42:16
In reply to Which drugs are the most neuroprotective?, posted by deniseuk190466 on October 4, 2007, at 15:00:29
I would argue that good sleep is the single most "neuroprotective" thing you could do for your brain. Chronic sleep deprivation and screwed up sleep architecture as commonly seen in severe depression and obstructive sleep apnea can do a humdinger on the brain. Also, even mild hypoxia such as is found in sleep apnea can damage the brain.
Many refractory depressives suffer from obstructive sleep apnea, with resulting hypoxia and disrupted sleep architecture. Hypoxia destroys the hippocampus, a critical part of the brain associated with depression.
http://www.currentpsychiatry.com/article_pages.asp?AID=5386
"the hippocampus is the most vascularized brain region and the first to suffer from low oxygen)."
Eric
Posted by Squiggles on October 11, 2007, at 7:54:42
In reply to Re: Which drugs are the most neuroprotective?, posted by LostBoyinNCBecksDark on October 11, 2007, at 0:42:16
Let's say a patient presents with symptoms
such as sleep apnea and daytime oversleeping.
The doctor may suspect hypoxia and see certain drugs as the cause of hippocampus
damage; how would a doctor diagnose this? Are there
tests typically used to confirm hippocampus
damage?Squiggles
Posted by deniseuk190466 on October 14, 2007, at 4:05:23
In reply to Re: Which drugs are the most neuroprotective?, posted by LostBoyinNCBecksDark on October 11, 2007, at 0:42:16
Eric,
It's really good to see that you are still around. I've missed seeing your posts on the other board as they were always pretty controversial, stirred up a lot of reactions and used to make me smile even though I often didn't agree with what you said.
So did you ever have ECT and do you know what happened to lucida who used to post on the other depression medication site.
Denise
Posted by LostBoyinNCBecksDark on October 20, 2007, at 18:00:25
In reply to To Lostboyinnc, posted by deniseuk190466 on October 14, 2007, at 4:05:23
> Eric,
>
> It's really good to see that you are still around. I've missed seeing your posts on the other board as they were always pretty controversial, stirred up a lot of reactions and used to make me smile even though I often didn't agree with what you said.
>
> So did you ever have ECT and do you know what happened to lucida who used to post on the other depression medication site.
>
>
> DeniseNah, never had ECT as it turned out I didnt need it. However, I would have it if I needed it and I believe ECT is far, far superior to psychopharmacology, psychotherapy and rTMS.
As far as the person you are talking about, Lucida from ASD-Med, all I know about her is that she was institutionalized, had a bunch of ECTs, found out her shrink thinks she is psychotic. Last I read, which was several years ago, she had been placed on risperdal after the ECTs. I also heard a lot of people advised her to stay off of ASD-Med because its such a crazy place and hostile at times.
You have to be very severe to be institutionalized in the USA nowadays.
Lucida wasnt very much into biological psychiatry at the time and seemed all into her psychotherapy. I have no idea as to what happened to her, although I strongly suspect she isnt doing too great with her aversion to the hard fact that severe mental illness is more medical than anything else.
Eric
Posted by deniseuk190466 on October 23, 2007, at 14:26:18
In reply to Re: To Lostboyinnc, posted by LostBoyinNCBecksDark on October 20, 2007, at 18:00:25
Eric,
I sort of imagined that Lucida was doing really well after having ECT and hence hadn't felt compelled to go on any depression sites.
I did get a strong impression that she was more into the therapy side of things (which I'm not).
How did you get the idea that your problem might be sleep related?
I get to see my psychiatrist here on the NHS in the UK for 15 mins max, I barely get time to remind him of what I'm taking, nevermind to start asking him questions about sleep studies.
I don't think I have sleep apnea as Antidepressants worked really well for me in my 20s, they stopped in my 30s. My logic tells me that If I didn't have sleep apnea in my 20s I probably don't have it now.
I went to Vancouver over two years ago to try out rTMS and I didn't personally find it very effective. I don't regret going though, at least I tried it and saw a part of the world I haven't seen before.
It's good to see that you are still around anyway and well.
Denise
Posted by LostBoyinNCBecksDark on October 24, 2007, at 0:22:35
In reply to Re: To Lostboyinnc, posted by deniseuk190466 on October 23, 2007, at 14:26:18
> Eric,
>
> I sort of imagined that Lucida was doing really well after having ECT and hence hadn't felt compelled to go on any depression sites.Hi Denise,
Well, what I read about her was that she had some ECTs inpatient in the shortterm hospital and they helped her somewhat, but not enough. I remember she claimed they gave her the bilateral, at least at first and she claimed the bilateral ECTs cause the usual amnesia, disorientaton, etc. and she was rather mad about that.
I read afterwards, she still wasnt doing fantastic and somehow, she ended up being institutionalised for a while. I read she was stable on some risperdal...not an antidepressant.
To me, being institutionalized is not a sign you are doing well.
I never read anything afterwards about her...she disappeared. Maybe cause she is longterm institutionalized, I dont know. Its rather rare patients become institutionalized here in the USA these days...she must have been quite bad off for that.
>
> I did get a strong impression that she was more into the therapy side of things (which I'm not).Definitely she was and IMO, that was a big part of her problem.
>
> How did you get the idea that your problem might be sleep related?My psychiatrist referred me to a pulmonary specialist who has a sub specialty in sleep medicine. The pulmonary doctor did lung function tests on me, referred me for ANOTHER overnight sleep study and I was diagnosed with obstructive sleep apnea. The pulmonary doctor told me "the CPAP treatment was going to change my life."
>
> I get to see my psychiatrist here on the NHS in the UK for 15 mins max, I barely get time to remind him of what I'm taking, nevermind to start asking him questions about sleep studies.Yeah...I wouldnt bother asking a psychiatrist for a sleep study. I think I was lucky in that my psychiatrist actually pushed me to see that pulmonary specialist. If I was actually going to request a sleep study, Id go directly to the sleep medicine doctor themselves or if I had to get permission, Id start with my Internist. Bypass the shrink unless you have an EXTREMELY good relationship with them.
>
> I don't think I have sleep apnea as Antidepressants worked really well for me in my 20s, they stopped in my 30s. My logic tells me that If I didn't have sleep apnea in my 20s I probably don't have it now.Yeah, it affects men more than women they say. But you never know. There are other sleep disorders than sleep apnea though, like RLS. Women get that just as much as men.
>
> I went to Vancouver over two years ago to try out rTMS and I didn't personally find it very effective. I don't regret going though, at least I tried it and saw a part of the world I haven't seen before.Yeah, I had rTMS as well, years ago. Wasnt impressed by it in the least.
>
> It's good to see that you are still around anyway and well.you too...
Eric
>
>
This is the end of the thread.
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