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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 g_g_g_unit on April 18, 2009, at 11:29:02
hi, i am interested in trying memantine as mono-therapy for OCD and have found a pdoc willing to prescribe it (as of present, it has yet to be trialled for OCD where i live). a couple of questions though:
a) i've heard that stimulants can increase central focus, but at the expense of more peripheral creative sensations. i'm not sure of the relationship between memantine and more traditional stimulants, but can anyone describe what kind of cognitive effects (+, -, or neutral) it had on them?
b) is memantine viable as a long-term therapy, or does it poop out pretty quickly?
c) for those suffering from (post-SSRI) apathy, anhedonia, etc., did memantine go anyway towards reversing those sensations?
thanks for your time,
g
Posted by Phillipa on April 18, 2009, at 22:48:36
In reply to memantine - some questions, posted by g_g_g_unit on April 18, 2009, at 11:29:02
g g g unit could you babblemail me for a good reason???? Seriously.Love Phillipa ps would babblemail you but light not on.
Posted by g_g_g_unit on April 19, 2009, at 0:15:48
In reply to Re: memantine - some questions » g_g_g_unit, posted by Phillipa on April 18, 2009, at 22:48:36
> g g g unit could you babblemail me for a good reason???? Seriously.Love Phillipa ps would babblemail you but light not on.
I turned my babblemail on, so you can message me now.
Posted by Amelia_in_StPaul on April 21, 2009, at 18:14:34
In reply to memantine - some questions, posted by g_g_g_unit on April 18, 2009, at 11:29:02
Posted by softheprairie on April 22, 2009, at 3:45:04
In reply to good questions! waiting to see answers too... (nm), posted by Amelia_in_StPaul on April 21, 2009, at 18:14:34
Posted by g_g_g_unit on April 22, 2009, at 20:48:25
In reply to yep, I'm also hoping for answers on these Qs! (nm), posted by softheprairie on April 22, 2009, at 3:45:04
hey, myco e-mailed me these answers, based on his own research... hopefully he won't mind me reproducing them here!
"...is there a relationship between memantine and more traditional stimulants? i've heard that stimulants can increase central focus, but at the expense of more peripheral creative sensations (vocabulary, etc.) given my work as a writer, that might not be ideal ..."
Traditional stimulants of the amphetamine nature have almost no relationship to Memantine. Memantine does have dopamine affinities but they are minor - amphetamines hit dopamine and norepinephrine hardcore. Even pseudo-amphetamine based compounds like Ritalin have a relatively hard stimulant kick to them through dopamine and norepinephrine. These types of meds will have negative impact in the long run on your cognition, memory, learning etc...dopamine can be overloaded - to which the body downregulates in various ways...this results in "the stupids". But initial stimulant effect will be brilliant on your ability to perform...provided you find the right one (not all are created equal for everyone). So moral of the story is: use stimulants wisely and not everyday if you can. Memantine has, and not for everyone, at most a mild stimulatory effect. This is a partial result of its dopamine affinities but also some of it comes from the polyamine system it plays into (the NMDA receptors and the associated pathway for NO and it's metabolites - different than amphetamines)...point is...you may see some stimulation (but probably not much) or none...you may also get sleepy. Depends on how your body handles this...this is individual. To much dopamine makes me sleepy....just the right amount makes me concentrate and articulate my words well and get an interesting little creativity boost...all kinds of little ideas pop into my head...my second degree (incomplete thus far) is in engineering...so I end up thinking about ideas here and dopamine encourages that for some reason.
On a side note here....this is important....when you are playing with Memantine dosage, and you are playing, you need to adjust and adjust and adjust. Studies show (you will see in the big paper) that to little and to much are no good....it's individual and you need to experiment to find proper dosage for you....you wont find you ideal dose in a monograph...perhaps just a starting point for elderly alzheimers patients (what it was created for).
"...is memantine viable as a long-term therapy, or does it poop out pretty quickly?"
Again...studies for anxiety/depression patients etc (indications outside the rhealm of alzheimers or parkinsons) are still in the infancy stages to some degree. The concentration, thus far, is hardcore into the biochemistry. In the near future though we will see more general papers on treatments related to mood disorders. Therefor I can't answer the "poop out" question with any conviction. I know that as a long term therapy (8 months I think was the limit of one study) in elderly people, Memantine maintained its efficacy without raising of dose. Don't let this be a deciding issue...this med is one of the newest in a series of meds used for these purposes...it's "buzz", at the moment, is simply because it is the newest (or close to) agent. If it fails or doesnt work for you....dont worry...there are other nootropics and similar compounds.
"...for those suffering from (post-SSRI) apathy, anhedonia, etc., did memantine go anyway towards reversing those sensations?"
I will interpret this to mean "mood altering" or "mood boosting" effect. How's that? The polyamine system is the newest theory (results still inconslusive/contradicting across the board) on depression and anxiety and compounds in the pathway have been implicated in mood uplifting effects (i.e. ornithine - an amino acid produced in this pathway and also raised with the use of Nardil). But, again, conclusive evidence lacks. Memantine, to a smaller extent, also antagonizes seratonin production (lessens it)...so if you theorize that youve upregulated your seratonin system to a long term extent (after coming off them) then this med will lower that effect. Seratonin is implicated in apathy & a dull or non-emotional state....it's possible that Memantine may have an effect on this. You have nothing to lose by trying.
"...is it supposed to have any effect on anxiety?"Yes. It works on the polyamine system and NMDA receptors....products/metabolites of this pathway are known to be anxiolytic. For example: L-Arginine, Nitric Oxide, Ornithine, Galantamine....many have been proven in studies to be anxiolytic to various extents...but again this is individual. People will experience various results based on their own physiologies.
Posted by Kimbersaur on April 23, 2009, at 23:33:13
In reply to answers, posted by g_g_g_unit on April 22, 2009, at 20:48:25
I really want to try it but I'm a little scared.
Posted by desolationrower on April 24, 2009, at 15:28:43
In reply to Is memantine safe?, posted by Kimbersaur on April 23, 2009, at 23:33:13
has a low side effect profile. i can't think of any severe problems it could cause. the worst i can think of is fast withdrawl from high dose might be excitotoxic, but i've never seen anything saything that. its been used for a long time in europe.
-d/r
Posted by SLS on April 25, 2009, at 7:02:49
In reply to Re: Is memantine safe?, posted by desolationrower on April 24, 2009, at 15:28:43
I am currently taking memantine (Namenda) 20mg in addition to my other medications.
Currently:
Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
memantine 20mg
I am being treated for a stubborn case of bipolar depression. So far, so good. I don't seem to have any side-effects.
- Scott
Posted by Amelia_in_StPaul on April 26, 2009, at 13:42:04
In reply to Re: Is memantine safe?, posted by desolationrower on April 24, 2009, at 15:28:43
So in theory, memantine could be taken with an SSRI to balance out the serotonin a little bit? Perhaps esp. good for intermediate metabolizers (2D6) who experience a build-up of SSRI med?
Posted by sowhysosad on April 26, 2009, at 14:31:26
In reply to Memantine/SSRI balance?, posted by Amelia_in_StPaul on April 26, 2009, at 13:42:04
> So in theory, memantine could be taken with an SSRI to balance out the serotonin a little bit?
If that's the case it could be a terrific add-on for SSRI's.
Sadly they won't even prescribe it over here even for Alzheimer's, let alone depression!
Posted by metric on April 26, 2009, at 15:58:49
In reply to Re: Is memantine safe?, posted by SLS on April 25, 2009, at 7:02:49
> I am currently taking memantine (Namenda) 20mg in addition to my other medications.
>
> Currently:
>
> Parnate 80mg
> nortriptyline 150mg
> Lamictal 200mg
> Abilify 20mg
> memantine 20mg
>
>
> I am being treated for a stubborn case of bipolar depression. So far, so good. I don't seem to have any side-effects.What effects have you noticed from the memantine?
And why was it added (i.e., what are you hoping it will do)?
Posted by SLS on April 26, 2009, at 16:18:48
In reply to Re: Is memantine safe? » SLS, posted by metric on April 26, 2009, at 15:58:49
Hi Metric.
> > I am currently taking memantine (Namenda) 20mg in addition to my other medications.
> >
> > Currently:
> >
> > Parnate 80mg
> > nortriptyline 150mg
> > Lamictal 200mg
> > Abilify 20mg
> > memantine 20mg
> >
> >
> > I am being treated for a stubborn case of bipolar depression. So far, so good. I don't seem to have any side-effects.
>
> What effects have you noticed from the memantine?
> And why was it added (i.e., what are you hoping it will do)?To go back a year or two, I had felt very will on Nardil in combination with the other drugs I take, but I began to experience diminishing returns - poop out. I switched to Parnate and have regained some of what I had lost. However, I reached a plateau that has not allowed for me to reach a 50% improvement. I'll take 50% if I have to. I could probably return to work at 50%. It is my hope that memantine will help break through the wall.
I found the following clinical trial after deciding to go with memantine. I am excited that I just happen to be taking lamotrigine (Lamictal).
http://clinicaltrials.gov/ct2/show/NCT00305578?term=bipolar+AND+memantine&rank=2
What are you working with currently?
- Scott
Posted by desolationrower on April 26, 2009, at 23:19:31
In reply to Re: Is memantine safe? » metric, posted by SLS on April 26, 2009, at 16:18:48
i stopped taking memantine very roughly when i started getting this headache. its possbile they are related. i guess most alzheimer's patients stay on it till they kick off.
-d/r
Posted by yxibow on April 28, 2009, at 21:45:09
In reply to Re: Is memantine safe?, posted by desolationrower on April 26, 2009, at 23:19:31
> i stopped taking memantine very roughly when i started getting this headache. its possbile they are related. i guess most alzheimer's patients stay on it till they kick off.
>
> -d/rIt was unfortunately horrid for me at 20mg as I stated in a recent post.
That's not a very nice reference to those who suffer from Alzheimer's (or dementia). It is common enough unfortunately that there are undoubtedly members of this community who have relatives that are stuck in such an awful state.
-- Jay
Posted by zzzz7 on May 1, 2009, at 22:08:23
In reply to Re: Is memantine safe? » desolationrower, posted by yxibow on April 28, 2009, at 21:45:09
I felt some of the same cognitive side effects with Namenda that I feel with Lamictal. It wasn't as severe, but it did constrain my mind a bit.
This is the end of the thread.
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