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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 93. Go back in thread:
Posted by SLS on August 15, 2012, at 7:14:43
In reply to Re: Starting minocycline. » SLS, posted by Raisinb on August 15, 2012, at 0:30:57
> Good luck with it, Scott.
Thanks. I appreciate that.
> I'll be interested to hear the results.
I will keep you apprised of my progress. It might take a few weeks, although I have seen it work almost immediately.
Although I am using minocycline as an augmenter, some investigators will undoubtedly design clinical studies using it as monotherapy. Results of such studies might be disappointing, although it does display antidepressant properties in animial models of depression (forced-swim test). Minocycline might best be used in conjunction with noradrenergic antidepressants. It makes desipramine work better in some experiments. It acts similarly with anti-glutamate drugs. Because of this, I like the idea of combining minocycline with nortriptyline and Lamictal, a pro-noradrenergic and a anti-glutamergic drug repectively.
- Scott
Posted by b2chica on August 15, 2012, at 15:55:47
In reply to Starting minocycline., posted by SLS on August 14, 2012, at 9:23:51
Man, everything you listed makes it sound like a wonder drug.
maybe if...when the pristiq starts to die out again i could use Minocycline in my regimane? is it synergistic with SNRI's?
current regimen:100mg pristiq
20mg adderall TID
Gabapentin 300mg-1800mg
perphenazine 4mg night
xanax 1mg night (or during day if needed)
Melatonin 10mg night (just started it up again last week)
Posted by SLS on August 15, 2012, at 16:37:09
In reply to Re: Starting minocycline. » SLS, posted by b2chica on August 15, 2012, at 15:55:47
> Man, everything you listed makes it sound like a wonder drug.
As time goes on, scientists discover more and more properties of the drugs we use to treat depression. Minocycline sure does a lot of different things. I doubt that it will be a wonder drug, but I am sure that a certain percentage of people will respond to it.
> maybe if...when the pristiq starts to die out again i could use Minocycline in my regimane? is it synergistic with SNRI's?
I can't say for sure. I have an article that indicates minocycline would work well with noradrenergic drugs. One of the tests they used found it to be synergistic with desipramine, but not Prozac. Other tests do not make this distinction. Preclinical tests show that minocycline monotherapy produces antidepressant effects in mice. My guess is that minocycline would work well with higher doses of SNRIs.
Have you ever combined Pristiq with Wellbutrin? They often go well together. Wellbutrin can also be effective for ADD.
Have you tried Lamictal?
> current regimen:
>
> 100mg pristiq
> 20mg adderall TID
> Gabapentin 300mg-1800mg
> perphenazine 4mg night
> xanax 1mg night (or during day if needed)
> Melatonin 10mg night (just started it up again last week)Some people get depressed when they take melatonin. I imagine this is relatively infrequent, though.
By the way, how high have you gone with Effexor?
- Scott
Posted by Phillipa on August 15, 2012, at 20:26:37
In reply to Re: Starting minocycline. » b2chica, posted by SLS on August 15, 2012, at 16:37:09
Is the monocycline only useful in bipolar depression? And if not using as an antibiotic wouldn't this be considered to possibly make yourself antibiotic resistant and hence if got physically ill antibiotics wouldn't work? Phillipa
Posted by Jeroen on August 16, 2012, at 4:32:04
In reply to Starting minocycline., posted by SLS on August 14, 2012, at 9:23:51
is it safe for me to take this also? because i had a psychotic reaction to lamictal few years ago
Posted by SLS on August 16, 2012, at 6:45:24
In reply to TO SLS, posted by Jeroen on August 16, 2012, at 4:32:04
> is it safe for me to take this also? because i had a psychotic reaction to lamictal few years ago
I imagine people will have different reactions to minocycline, as is true with other psychotropics. I know it can have an energizing effect early in treatment. Is this an indicator that it can precipitate psychosis in vulnerable individuals? I can't be sure. However, it can reduce the behavioral effects of amphetamine and methamphetamine. This would suggest to me that minocycline can act to reduce psychosis, not trigger it.
http://www.ncbi.nlm.nih.gov/pubmed/20851278
You are down to so few alternatives, though, that it might be worth the risk to try minocycline. It has been researched more extensively for schizophrenia than it has for depressive disorders (MDD and BD). It is known to improve negative symptoms (apathy, emotional blunting, and social withdrawal) and cognitive function, and is usually administered as an adjunct to antipsychotic drugs. I could not find any reports of minocycline producing psychosis on Medline/Pubmed.
You might be interested in this abstract about Lamictal-induced psychosis:
http://www.ncbi.nlm.nih.gov/pubmed/17485241
Keep in mind that there were only 6 cases of emergent psychosis in the 1400 people treated for epilepsy. Unfortunately, you might be one of those 6.
Also, there is this:
http://www.ncbi.nlm.nih.gov/pubmed/17485241
This study contradicts several others. It reports that Lamictal is not effective for treating schizophrenia.
- Scott
Posted by Jeroen on August 16, 2012, at 9:47:17
In reply to Re: TO SLS » Jeroen, posted by SLS on August 16, 2012, at 6:45:24
I wish you good luck with the minocycline
i will find a doctor who wants to prescribe this to me too :)
Posted by b2chica on August 16, 2012, at 12:21:41
In reply to Re: Starting minocycline. » b2chica, posted by SLS on August 15, 2012, at 16:37:09
well i'm glad to hear its synergistic with desipramine, as if the pristiq at 100 hadn't worked i was going to switch to that. (or add on) anyway, as i'm on 100 of pristiq maybe it would work well?
i haven't combined pristiq with wellbutrin as i was on wellbutrin about 8 years ago and worked well for one year then pooped out. tried it again three years later (tried two generics and name brand) none of them worked. so i just assumed its completely null for me now?
I was only on Lamictal for about one week. they put me on it while i was in hospital and got off it when went to pdoc as he completely revamped my regimine at that time.
though i tend to not do well on 'mood stabilizers' it actually seems to make my mood cycle? trileptal, topamax, and i cant even think what else i've been on but i think lamictal is always a possibility i guess in the future.
i did notice a drop in mood the first go around on it. but i got some pretty good sleep for the first 2-3 weeks. i just need to get my sleep stabilized so i started it again.
i dont remember how high up i went on effexor, i know i didnt get too high before they had to take me off it. i had SEVERE rapid cycling like every 1-2 days mood change and they were Wild swings! i mean uncontrollable sobbing one day and next day or so i was tingly and on top of the world seeing colors and ideas never could imagine. also felt like i was in a bubble kind of saw myself as unrealistic.
So got off quickly and NEVER looked back. infact i was running out of ideas and it was by my insistance that i tried pristiq, as my then pdoc wanted me to go on lithium and for personal reasons i kept refusing. good thing too cuz pristiq has worked well for quite a few years for me.
Thanks for the input Scott.
i'm doing mostly pretty well on my regimen now, except for some sleep issues. cant get to sleep at night and cant wake up in the morning. so its a matter of shifting what i take and when...
Posted by SLS on August 17, 2012, at 9:56:46
In reply to Starting minocycline., posted by SLS on August 14, 2012, at 9:23:51
So far, so good.
I am not feeling worse. This is a good thing. In fact, the last two days have demonstrated improvement. This has not been characteristic of my more recent mood states. However, I did tweak the dosage of prazosin a few days ago. If I had to guess at this early juncture, I would suspect that I am responding to the addition of minocycline. But then again, I do have that strange personality disorder that presents as incorrigible optimism. I will endeavor to be objective, though.
- Scott
Posted by brynb on August 17, 2012, at 13:45:02
In reply to Starting minocycline., posted by SLS on August 14, 2012, at 9:23:51
Scott-
I find this so interesting. I have an Rx for minocycline from my dermatologist (for breakouts). It's 100mg capsules. I'm thinking of adding it to my current regimen. What's the proper dosage for treating depression/inflammation?
-b
Posted by SLS on August 17, 2012, at 15:21:14
In reply to Re: Starting minocycline. » SLS, posted by brynb on August 17, 2012, at 13:45:02
> Scott-
>
> I find this so interesting. I have an Rx for minocycline from my dermatologist (for breakouts). It's 100mg capsules. I'm thinking of adding it to my current regimen. What's the proper dosage for treating depression/inflammation?
>
> -bMost studies of minocycline to treat psychiatric illness have used 100 - 150 mg/day. I would start at 50 mg once per day for a few days, then 50 mg twice per day thereafter. I really don't have a "feel" for the behavior of this drug in other people yet. However, some people might be too sensitive to starting minocycline at 100 mg/day.
If it turns out that I am currently experiencing the beginnings of an antidepressant response to minocycline, then it is apparent to me that some people will experience an improvement within the first week. I have seen this before with this drug. However, it is important to note that I am taking other psychotropic drugs, including Lamictal and Abilify. Lamictal, in particular, might act in concert with minocycline to disinhibit mesolimbinc dopamine release by reducing glutamate activity in the VTA. The result is increased dopamine activity. I'm sure it's not that simple, though.
- Scott
Posted by Slabicki on August 17, 2012, at 18:13:04
In reply to Re: Starting minocycline. » brynb, posted by SLS on August 17, 2012, at 15:21:14
Hi,
I was just wondering how safe it is to try Minocycline if I have anxiety problem. I mean I'm just cycling from depression to anxiety.Could it increase my anxiety?
Any opinions on this?
Slabicki
Posted by Phillipa on August 17, 2012, at 20:44:47
In reply to Re: Minocycline, is it safe with anxiety?, posted by Slabicki on August 17, 2012, at 18:13:04
I was put on this a few weeks ago for skin at 75mg twice a day. I got headaches, and was dizzy. The dermatologist took me off said very common side effect. Also since I've taken long term antibiotics for lymes disease. I wonder won't I become antibiotic resistant? Phillipa
Posted by Slabicki on August 17, 2012, at 22:31:10
In reply to Re: Minocycline, is it safe with anxiety? » Slabicki, posted by Phillipa on August 17, 2012, at 20:44:47
Hi Scott,
I was wondering how are you doing on Minocycline,
do you have any response?
Also, what dosage are you taking?Slabicki
Posted by SLS on August 18, 2012, at 10:36:42
In reply to Re: Minocycline, SLS, posted by Slabicki on August 17, 2012, at 22:31:10
> Hi Scott,
>
> I was wondering how are you doing on Minocycline,
> do you have any response?
> Also, what dosage are you taking?
>
> SlabickiHi S.
The last three days have been pretty good - better than I am used to. However, it is difficult for me to separate out the addition of minocycline 6 days ago from the adjustment I made to my prazosin dosage 3 days ago. It is ideal to adjust one variable at a time, but I needed to continue the titration process with prazosin. Still, I didn't want to delay my minocycline trial, so I made two changes simultaneously. I should have a better idea next week as to what's going on. The emergence of an acute, robust response to treatment will lead me to believe that the minocycline is responsible for the clinical improvement. In the meantime, I am in a pretty good "zone" of response to prazosin at a dosage of 12 mg/day (4 mg t.i.d.).
I feel pretty good. :-)
It's easy when it's easy.
I am currently taking 100 mg/day of minocycline given in divided doses. So far, I cannot discern any side effects.
- Scott
Posted by brynb on August 19, 2012, at 8:11:46
In reply to Re: Starting minocycline. » brynb, posted by SLS on August 17, 2012, at 15:21:14
> > Scott-
> >
> > I find this so interesting. I have an Rx for minocycline from my dermatologist (for breakouts). It's 100mg capsules. I'm thinking of adding it to my current regimen. What's the proper dosage for treating depression/inflammation?
> >
> > -b
>
> Most studies of minocycline to treat psychiatric illness have used 100 - 150 mg/day. I would start at 50 mg once per day for a few days, then 50 mg twice per day thereafter. I really don't have a "feel" for the behavior of this drug in other people yet. However, some people might be too sensitive to starting minocycline at 100 mg/day.
>
> If it turns out that I am currently experiencing the beginnings of an antidepressant response to minocycline, then it is apparent to me that some people will experience an improvement within the first week. I have seen this before with this drug. However, it is important to note that I am taking other psychotropic drugs, including Lamictal and Abilify. Lamictal, in particular, might act in concert with minocycline to disinhibit mesolimbinc dopamine release by reducing glutamate activity in the VTA. The result is increased dopamine activity. I'm sure it's not that simple, though.
>
>
> - Scott
Thanks, and I'm curious to hear how it goes for you.Also, are you in NY? I thought I saw you mention NYU in one of your posts. I started w/ a new pdoc about 2 months or so ago, and I like him (at least at the moment!), but I'm always open to new docs/clinics/etc. with expertise in mood disorders.
-b
Posted by SLS on August 19, 2012, at 17:27:43
In reply to Re: Starting minocycline. » SLS, posted by brynb on August 19, 2012, at 8:11:46
> Also, are you in NY? I thought I saw you mention NYU in one of your posts.
It takes me about an hour to get to NYC. I have been seen by doctors at Columbia, NYU, and Beth Israel. You might be better off going to NYC for a consultation rather than switching doctors. Patrick McGrath at Columbia is pretty good. I saw him about 10 years ago.
http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=pjm5&DepAffil=Psychiatry
- Scott
Posted by brynb on August 19, 2012, at 19:21:25
In reply to Re: Starting minocycline. » brynb, posted by SLS on August 19, 2012, at 17:27:43
> > Also, are you in NY? I thought I saw you mention NYU in one of your posts.
>
> It takes me about an hour to get to NYC. I have been seen by doctors at Columbia, NYU, and Beth Israel. You might be better off going to NYC for a consultation rather than switching doctors. Patrick McGrath at Columbia is pretty good. I saw him about 10 years ago.
>
> http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=pjm5&DepAffil=Psychiatry
>
>
> - ScottThanks so much! I live in NYC and it's been so hard to find a good pdoc here (weird, right?). My current doc seems good, so I'm staying with him for now, but I always want backups just in case.
-b
Posted by SLS on August 20, 2012, at 17:38:17
In reply to Re: Starting minocycline. » SLS, posted by brynb on August 19, 2012, at 19:21:25
> > > Also, are you in NY? I thought I saw you mention NYU in one of your posts.
> >
> > It takes me about an hour to get to NYC. I have been seen by doctors at Columbia, NYU, and Beth Israel. You might be better off going to NYC for a consultation rather than switching doctors. Patrick McGrath at Columbia is pretty good. I saw him about 10 years ago.
> >
> > http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=pjm5&DepAffil=Psychiatry
> >
> >
> > - Scott
>
> Thanks so much! I live in NYC and it's been so hard to find a good pdoc here (weird, right?). My current doc seems good, so I'm staying with him for now, but I always want backups just in case.
>
> -b
If you do go for a consultation, ask the doctor for some referrals. You might not ever want to leave your current doctor, but it is nice to have alternatives ready should you need them.
- Scott
Posted by SLS on August 20, 2012, at 17:58:29
In reply to Re: Starting minocycline. » brynb, posted by SLS on August 20, 2012, at 17:38:17
Feeling better...
- Scott
Posted by Phillipa on August 20, 2012, at 21:23:10
In reply to Re: Starting minocycline., posted by SLS on August 20, 2012, at 17:58:29
Great and taking twice a day. Phillipa
Posted by Slabicki on August 20, 2012, at 23:25:16
In reply to Re: Starting minocycline., posted by SLS on August 20, 2012, at 17:58:29
> Feeling better...
>
>
> - ScottThat's a good news.
Scott, did you experience any side effects?
I've read that Minocycline can cause anxiety, or depression.
Did you experience any anxiety?Slabicki
Posted by SLS on August 21, 2012, at 6:37:01
In reply to Re: Starting minocycline SLS, posted by Slabicki on August 20, 2012, at 23:25:16
> > Feeling better...
> That's a good news.
> Scott, did you experience any side effects?
> I've read that Minocycline can cause anxiety, or depression.Let's review the the sources of this information. Can you provide any URL links?
I have not seen it written in the medical literature that minocycline produces depression as an adverse effect. I didn't see it appear on the manufacturer's label. I don't doubt that it has happened, though. If it does, it must do so very infrequently. I would guess that minocycline has less potential to produce depression as an adverse reaction than standard antidepressants.
So far, the only effect from minocylcine that I can ascertain is an improvement in depression. I have no side effects yet. Others have noted experiencing an uncomfortable activating effect after taking the first few doses. I don't know if this indicates that a dosage reduction is required or that it passes with continued treatment. Either way, it seems to disappear.
The dosage range of minocycline currently being used to treat depression (both MDD and BD) is 100 - 200 mg/day given in divided doses.
I have no reluctance in recommending to someone that they talk to their doctor about using minocycline to treat depression. For now, I am leaning in the direction that minocycline is more effective as an augmenting agent than it is as monotherapy. I suspect that, for me, minocycline is particularly effective when combined with Lamictal (lamotrigine), a glutamate release inhibitor (anti-glutamatergic). Minocycline is being studied as monotherapy, though. One study indicates that minocycline works better with desipramine than with Prozac (fluoxetine). It is perhaps more effective when using a noradrenergic (NE) antidepressant than a serotonergic (5-HT) antidepressant. There are reports of minocycline producing a therapeutic effect in the absence of antidepessants. There is some thought that minocycline would work in combination with other anti-glutamatergic drugs like glutamate receptor inhibitors.
http://www.sciencedirect.com/science/article/pii/S0165017309000691
I am currently tapering the prazosin I have been taking. For me, it has been a difficult drug to dose and it abolishes my sex-drive. If I feel significantly worse, I will simply restart it and perhaps replace it with the longer acting agent, doxazosin.
Abilify is another drug that I would like to jettison. However, I am not so convinced that I can do without it. My motivations to do this are that I have gained a large amount of weight and my triglycerides are very high.
I have yet to establish the optimal dosage of minocycline. I am not inclined to raise the dosage this week, though. However, since a Harvard study used 200 mg/day, I am happy to know that there is room to work with.
- Scott
Posted by Phillipa on August 21, 2012, at 21:54:48
In reply to Re: Starting minocycline SLS » Slabicki, posted by SLS on August 21, 2012, at 6:37:01
My only concern is this is an antibiotic. I want it to work as then will take mine again also. Philllipa
Posted by Slabicki on August 21, 2012, at 22:42:47
In reply to Re: Starting minocycline SLS » Slabicki, posted by SLS on August 21, 2012, at 6:37:01
Hi Scott,
Thank you for replaying, that was helpful.
I guess you didn't experience any anxiety as a side effect.
You have mentioned the activating effect.
I'm a little bit concerned to try it as my depression isn't the anergic one. I have mostly mental depression and I'm proned to anxiety.
On the other hand, it can be a life saver.
My main concern is anxiety as a side effect.
I have to research the anxiety meds options as my
back-up.
Emme in her thread has mentioned the anxiety as a side effect, and that she takes a Xanax with Minocycline.Slabicki
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