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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by g_g_g_unit on October 8, 2012, at 0:25:18
Can anyone here speculate why Memantine might be increasing my anxiety? I've titrated upwards quite slowly, in 2.5mg increments, and have recently reached 15mg. I've noticed that things are particularly bad for the first 3-4 days on a certain dose, but then level out a little after that; however, once I hit 10mg, the anxiety didn't really abate, and now, on my 3rd day taking 15mg, I feel incredibly tense, agitated, overstimulated, etc.
Is there a relationship between NMDA antagonism and catecholamine activity?
What's strange is that each time I dose, I get an acute, benzo-like effect (only cleaner) which is really promising, but only seems to last for an hour or two.
I've e-mailed two separate researchers who conducted studies on Memantine and OCD; one said anxiety was quite a rare side-effect, but when he encountered it, he titrated downwards until the patient adjusted to a given dose .. the other suggested titrating upwards, and that early anxiety might be a predictor of a positive response (as with SSRIs).
Posted by jono_in_adelaide on October 8, 2012, at 0:37:53
In reply to anxiety on memantine, posted by g_g_g_unit on October 8, 2012, at 0:25:18
"Memantine is, in general, well tolerated.[6] Common adverse drug reactions (≥1% of patients) include confusion, dizziness, drowsiness, headache, insomnia, agitation, and/or hallucinations. Less common adverse effects include vomiting, anxiety, hypertonia, cystitis, and increased libido"
Doesnt seem to be that uncommon - could you use it under the cover of an antianxiety drug (a benzodiazepine, mirtazepine, low dose risperidone?)
Posted by g_g_g_unit on October 8, 2012, at 7:08:07
In reply to Re: anxiety on memantine, posted by jono_in_adelaide on October 8, 2012, at 0:37:53
> "Memantine is, in general, well tolerated.[6] Common adverse drug reactions (≥1% of patients) include confusion, dizziness, drowsiness, headache, insomnia, agitation, and/or hallucinations. Less common adverse effects include vomiting, anxiety, hypertonia, cystitis, and increased libido"
>
> Doesnt seem to be that uncommon - could you use it under the cover of an antianxiety drug (a benzodiazepine, mirtazepine, low dose risperidone?)Well, I was confused since it's currently being investigated for anxiety disorders. The researchers I contacted who oversaw some of the trials in question said increased anxiety was uncommon or otherwise absent in participants.
There probably wouldn't be much point taking it in conjunction with an anxiolytic (unless it was a temporary measure), since I'm trying to use it to treat OCD/anxiety. I do take 0.5mg of Klonopin at night (tapered down from 2mg), but it doesn't do anything noticeable.
Posted by phillipa on October 8, 2012, at 10:21:23
In reply to Re: anxiety on memantine » jono_in_adelaide, posted by g_g_g_unit on October 8, 2012, at 7:08:07
Benzos now just make me tired. So not taking memanine? Phillipa
Posted by jono_in_adelaide on October 8, 2012, at 17:30:52
In reply to Re: anxiety on memantine » jono_in_adelaide, posted by g_g_g_unit on October 8, 2012, at 7:08:07
Could it be that you get the initial spike in anxiety, followed by an improvement over subsequent days/weeks, like with an SSRI?
Could you up the clonazepam to 0.5mg twice a day as a short term measure?
Posted by g_g_g_unit on October 9, 2012, at 2:05:59
In reply to Re: anxiety on memantine, posted by jono_in_adelaide on October 8, 2012, at 17:30:52
> Could it be that you get the initial spike in anxiety, followed by an improvement over subsequent days/weeks, like with an SSRI?
I have no idea; I'm really unfamiliar with the NMDA system, which is why I was curious if anyone could guess how an antagonist would increase anxiety (i.e. is there any relationship to catecholaminergic activity?). I'm aware that the 70+hour half-life -- and thus, the necessity to achieve a stable plasma level -- plays a part in side-effects, and explains why things are worst for the first 3-4 days on a given dose. But the anxiety didn't dissipate after 2 weeks on 10mg, which I found strange.
Anyway, it may just be a coincidence, since I took more Taurine than usual last night, and also overslept, but I've been feeling a bit calmer today (my 4th day on 15mg), so I'll see how things progress.
>
> Could you up the clonazepam to 0.5mg twice a day as a short term measure?I tried that when Parnate withdrawal was giving me grief but I just felt really sleepy and stuporous. If things continue in today's vein, I should be okay to ride it out; otherwise I might ask for a Xanax prescription.
This is the end of the thread.
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