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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by SLS on April 26, 2009, at 15:04:38
I began taking memantine 20mg earlier this week. I experienced an improvement within the first few days. Now I feel worse than I did before adding it.
So, what am I going to do about it?
There is a chance that there will be some oscillations in the biology of my depressive state early in treatment as this drug exerts its pharmacological effects. I do not know this for sure of course, however, I have experienced such things in the past. One of my NIMH doctors called these brief setbacks "resets". Let's hope that this is just the brain trying to compensate for the introduction of memantine and that after this reset occurs, I will once again experience an improvement.
When one has been on as many drugs as I have, there is no longer the luxury of choice. With so few options left, one must endure initial startup side effects to see whether or not they resolve and yield to a therapeutic response. I have developed an emotional tolerance for enduring drug-induced side effects. It's a necessary part of the game.
- Scott
Posted by Amelia_in_StPaul on April 26, 2009, at 15:09:14
In reply to Woohoo! - Feeling worse on memantine - Woohoo!, posted by SLS on April 26, 2009, at 15:04:38
Hello, that conclusion is very clear-eyed. I admire the strength you apply to your situation. It would take everything I have to be that strong; I really do admire you. I pray that the memantine comes back for you and works in the long run.
Many kind thoughts, Amelia
> I began taking memantine 20mg earlier this week. I experienced an improvement within the first few days. Now I feel worse than I did before adding it.
>
> So, what am I going to do about it?
>
> There is a chance that there will be some oscillations in the biology of my depressive state early in treatment as this drug exerts its pharmacological effects. I do not know this for sure of course, however, I have experienced such things in the past. One of my NIMH doctors called these brief setbacks "resets". Let's hope that this is just the brain trying to compensate for the introduction of memantine and that after this reset occurs, I will once again experience an improvement.
>
> When one has been on as many drugs as I have, there is no longer the luxury of choice. With so few options left, one must endure initial startup side effects to see whether or not they resolve and yield to a therapeutic response. I have developed an emotional tolerance for enduring drug-induced side effects. It's a necessary part of the game.
>
>
> - Scott
Posted by sowhysosad on April 26, 2009, at 15:32:15
In reply to Woohoo! - Feeling worse on memantine - Woohoo!, posted by SLS on April 26, 2009, at 15:04:38
> ...one must endure initial startup side effects to see whether or not they resolve and yield to a therapeutic response. I have developed an emotional tolerance for enduring drug-induced side effects. It's a necessary part of the game.
I think that's probably a truism for all of us Scott, regardless of how many treatment options remain for us. I guess it takes the brain some time to adapt to any psych med, and it seems that the adaptive mechanism is usually what initiates a longer-term improvement in symptoms.
I doubt we'll ever find the holy grail of a drug that reaches full effect in hours or days, despite the claims often made about novel meds.
Posted by SLS on April 26, 2009, at 15:33:20
In reply to Re: Woohoo! - Feeling worse on memantine - Woohoo!, posted by Amelia_in_StPaul on April 26, 2009, at 15:09:14
> Hello, that conclusion is very clear-eyed. I admire the strength you apply to your situation. It would take everything I have to be that strong; I really do admire you. I pray that the memantine comes back for you and works in the long run.
>
> Many kind thoughts, Amelia
Your kind thoughts and prayers have really helped to make this a good day for me.:-)
Thanks.
- Scott
Posted by SLS on April 26, 2009, at 15:50:22
In reply to Re: Woohoo! - Feeling worse on memantine - Woohoo!, posted by sowhysosad on April 26, 2009, at 15:32:15
> > ...one must endure initial startup side effects to see whether or not they resolve and yield to a therapeutic response. I have developed an emotional tolerance for enduring drug-induced side effects. It's a necessary part of the game.
> I think that's probably a truism for all of us Scott, regardless of how many treatment options remain for us.Absolutely. I wish more people would approach their drug trials that way. I would be so happy to see more people get well here.
Part of what drives me to tolerate so much crap is the recognition that the quality of my life depends on a successful treatment of my depressive disorder. Once I had a taste of what it was like to be without depression, I became that much more resolute in wanting to succeed in finding a treatment that would allow me to emerge from the darkness and pain.
> I doubt we'll ever find the holy grail of a drug that reaches full effect in hours or days, despite the claims often made about novel meds.
You might be right. It might be the nature of the illness that the only pharmacological tools that produce long lasting remissions involve changes in gene expression. For instance, it takes roughly 2 weeks for gene expressions to change such that compensatory changes occur in receptor numbers after the initial exposure to an antidepressant drug.
- Scott
Posted by sowhysosad on April 26, 2009, at 16:51:46
In reply to Re: Woohoo! - Feeling worse on memantine - Woohoo! » sowhysosad, posted by SLS on April 26, 2009, at 15:50:22
> Absolutely. I wish more people would approach their drug trials that way. I would be so happy to see more people get well here.
I completely agree - it upsets me to think some people will never get well because they won't live with comparatively mild side effects that may well pass after a couple of weeks. There's a thread here about Remeron where I express my frustration with a friend who fits into that category, although I do believe her pdoc didn't think his med strategy through properly before treating her.
> Part of what drives me to tolerate so much crap is the recognition that the quality of my life depends on a successful treatment of my depressive disorder. Once I had a taste of what it was like to be without depression, I became that much more resolute in wanting to succeed in finding a treatment that would allow me to emerge from the darkness and pain.
Yeah, I feel the same way after experiencing my first bout of MDD to last more than a few weeks, and being disappointed by several successive meds (previously the first SSRI tried has usually worked and I've gone into remission within weeks). I'm a lot more determined to get well again, and willing to compromise - transient side effects or an MAOI diet don't seem like such a big deal any more. As you say, I KNOW I can be free of depression and feel motivated to get back there.
> It might be the nature of the illness that the only pharmacological tools that produce long lasting remissions involve changes in gene expression. For instance, it takes roughly 2 weeks for gene expressions to change such that compensatory changes occur in receptor numbers after the initial exposure to an antidepressant drug.
You've eloquently explained the underlying science of my argument there.
Posted by Phillipa on April 26, 2009, at 20:09:50
In reply to Woohoo! - Feeling worse on memantine - Woohoo!, posted by SLS on April 26, 2009, at 15:04:38
Scott so sorry haven't read the rest of the posts. So it could still work for you? Sure hope so. Love Phillipa
This is the end of the thread.
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