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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by AlexCanada on October 19, 2012, at 0:34:27
I am day 2 on 5mg. I know that's a low dose but I am one of those types who is very sensitive to meds. I also take ritalin 2.5mg 4-5x a day. valium 2.5mg 3 times a day. gabapentin 200mg sometimes. And Rhodiola Rosea 300mg. For severe melancholic depression, poor cognition, memory, lack of interest, poor drive/motivation, tiredness and general anxiety, etc.
Yesterday evening I first took my 5mg dose and I wasn't sure if it was doing much but I had a better than usual night and watched a tv show. Though most of my positivity came from gabapentin. I had a more pleasnt and calm evening.
Today though 3-4 hours after taking a 5mg dose I started to just feel a bit weird. first there are floaters in my vision. eyes feel bit irritated and also felt irritated yesterday. my hands feel a bit cold. Music sounds less lively. Any anxiety I had (it's a bit on and off) feels completely gone but anxiety is usually not a huge issue for me. I feel more able to communicate with people which usually is difficult. I feel more able to write and express myself. Some cognitive improvement yet paradoxally I do feel impaired in some way.
I also definitely feel dissassociated. I feel definitely strange. I feel I am in a different state of mind. I generally usually do not feel connected to people and find it very difficult to relate to anyone or anything since it's often very difficult to have interest/drive/motivation and the ability to enjoy anything BUT... this feeling right now is different. I feel I can communicate more but I am very very not connected. This must be what dissassociation feels like?
The original intent for trying Memantine was due to it's D2, D3, and D4 receptor activity and glutamate. So it would be taken to improve my lousy cognition and help anhedonia and possibly my depression in general.
Do these feelings that I have now on Nameda/Memantine generally subside?
What can I expect in the days ahead? PLEASE inform me since reliable information on memantine is not easy to come by! With 10 years of trying various medications I cannot recall the last time, if Ever... that I have felt like this. It is just bizarre!
Posted by AlexCanada on October 19, 2012, at 3:02:41
In reply to Day 2 on Memantine/Nameda and feel Very Weird!!, posted by AlexCanada on October 19, 2012, at 0:34:27
I feel really strange. I cannot sleep. Feel very alert, imagination is there, and feels darker, definitely gloomy type of mood. my mindset feels very altered. i feel less part of this world. unable to feel joy and much emotion in general. feels like emotions are partially shut down. yet mind feels fairly active but not in a good way. feels very disconcerning. feels like life has less purpose.
but of course this will pass. there is something remarkable amount memantine regarding some of it's cognitive effect but i feel very much like I am not here.
the half-life is 60-70ish hours. soon enough i'll feel better. i hate this feeling right now.
Posted by SLS on October 19, 2012, at 4:11:28
In reply to This is a bit frightening. Alert but not awake., posted by AlexCanada on October 19, 2012, at 3:02:41
> I feel really strange. I cannot sleep. Feel very alert, imagination is there, and feels darker, definitely gloomy type of mood. my mindset feels very altered. i feel less part of this world. unable to feel joy and much emotion in general. feels like emotions are partially shut down. yet mind feels fairly active but not in a good way. feels very disconcerning. feels like life has less purpose.
>
> but of course this will pass. there is something remarkable amount memantine regarding some of it's cognitive effect but i feel very much like I am not here.
>
> the half-life is 60-70ish hours. soon enough i'll feel better. i hate this feeling right now.
What dosage of memantine did you start at?I felt weird, too, when I moved up from 20 mg/day to 40 mg/day. It was probably too big a jump. I felt sort of drunk. I got scared and stopped taking it. I wish that I were smart enough to have given it more time.
Sometimes weird is good. I always feel weird right before I begin to respond to MAOIs. Memantine is generally a benign drug. You might want to reduce the dosage temporarily. Did you follow the titration schedule suggested by the manufacturer? They used to give out starter packs to physicians for their patients to begin treatment. Perhaps memantine is not the right drug for you. I have a hard time thinking of a psychotropic drug that does not produce adverse effects for some people.
http://www.namenda.com/Taking-Namenda/How-Its-Taken.aspx
Good luck.
- Scott
Posted by AlexCanada on October 19, 2012, at 6:21:56
In reply to Re: This is a bit frightening. Alert but not awake. » AlexCanada, posted by SLS on October 19, 2012, at 4:11:28
just 5mg i've taken (2 days). the bare minimum it seems. Right now much of Memantine appears to have worn off. I feel less detached, more ''awake'', don't feel weird. I have some emotion back. And some piece of cognition improved. I think a subtype of memory. But... cognition overall in other ways was HIGHLY improved during the Memantine peak hours.
I was able to write highly detailed postings online regarding other subjects. In a manner where the words came very easily. I was able to properly express myself and feel the intellectual that was buried away a decade ago when my mental health problems began. I really want that brilliance again. It is remarkable how much easier it was to express myself hours ago. Right now back in what feels like my pre-Memantine state I have clearly noticed that my word finding difficulty is a huge issue. Plus it is difficult in general for my mind to process my thoughts anyway.
Memantine really opened up my eyes as to what I can be capable of.
So I wonder... what else might be there which is less likely to make me feel so damn weird and dissassociated and instead provide me with the positives of improved cognition, more active mind, and increased word finding capability? Because something about Memantine really made me feel dark and gloomy. It was genuinely frightening and in a manner which i rarely ever feel.
What action may the NDMA mechanisms of Memantine have?
And between d2 d3 d4 and whatever else memantine does... which factors may contribute to what?
I'm really eager to find something to help me think. I want my mind back. I cherished my intelligence so very much.
>
> What dosage of memantine did you start at?
>
> I felt weird, too, when I moved up from 20 mg/day to 40 mg/day. It was probably too big a jump. I felt sort of drunk. I got scared and stopped taking it. I wish that I were smart enough to have given it more time.
>
> Sometimes weird is good. I always feel weird right before I begin to respond to MAOIs. Memantine is generally a benign drug. You might want to reduce the dosage temporarily. Did you follow the titration schedule suggested by the manufacturer? They used to give out starter packs to physicians for their patients to begin treatment. Perhaps memantine is not the right drug for you. I have a hard time thinking of a psychotropic drug that does not produce adverse effects for some people.
>
> http://www.namenda.com/Taking-Namenda/How-Its-Taken.aspx
>
> Good luck.
>
>
> - Scott
Posted by AlexCanada on October 19, 2012, at 6:25:42
In reply to Re: This is a bit frightening. Alert but not awake. » AlexCanada, posted by SLS on October 19, 2012, at 4:11:28
The effect of Memantine is certainly powerful. Exceptionally powerful. I wish i could wrap my head around it.
How long was your trail of memantine? Ultimately what led you to stop taking it?
I am scared to try it again. If the negatives are compounded by how much it builds up in my system then I could end up having a really terrifying night. I may quit it entirely or attempt 2.5mg. Likely I will not take it anymore at all though.
I just wish the cognitive enhancing effect was more easily found in other medications. Every day it is so difficult for me to think.
Posted by SLS on October 19, 2012, at 9:04:48
In reply to Re: This is a bit frightening. Alert but not awake. » AlexCanada, posted by SLS on October 19, 2012, at 4:11:28
Hi Alex.
I don't have any immediate answers for you.
What is your diagnosis?
Have you been screened for ADHD?
How would you describe your depression?
Have you tried stimulants (amphetamine or methylphenidate)?
Have you ever tried a MAOI (Parnate or Nardil)?
What other drugs have you tried and what were the results?
A dopaminergic cocktail could include Lamictal, Abilify, Wellbutrin, and methylphenidate. I know that the use of Lamictal and Abilify seem counterintuitive at first, but they do support dopamine function, albeit via different mechanisms.
Some people gain a great deal of cognitive improvement using Aricept, a drug used for treating Dementia Alzheimer's Type (DAT). My only concern with that drug is that depression is a theoretical side effect. Still, some people do quite well with it. In fact, one person I now had a very robust antidepressant effect with Aricept.
Are you confident in your doctor?
- Scott
Posted by phillipa on October 19, 2012, at 9:26:46
In reply to Re: This is a bit frightening. Alert but not awake. » SLS, posted by SLS on October 19, 2012, at 9:04:48
Alex what did you decide to do? Phillipa
Posted by AlexCanada on October 19, 2012, at 22:17:11
In reply to Re: This is a bit frightening. Alert but not awake. » SLS, posted by SLS on October 19, 2012, at 9:04:48
today when i woke up around noon i felt quite terrible. and i had some intense fear regarding a certain person who was causing me stress. that issue is dealt with but the stress and rapid heartbeat would still continue. I still felt the weird dissassociated feeling from the day before but it is subsiding a little bit as the day goes on. also as the day goes on i feel less intelligent. i was able to have some remarkable thinking and deductive reasoning this morning. Memantine certainly has that one benefit but it really does make me feel more depressed. the small minor interest i'd have which would be enough to push myself to at least do a little something would be gone.
my diagnosis: treatment resistent melancholic depression, some general anxiety (usually not too severe), antero grade memory loss (difficulty retaining new information.
I don't have ADHD.
I often feel cognitively impaired, dull, cloudy, poor drive/motivation/interest and usually very poor ability to enjoy anything, feel bit dysphoric, unable to relate to normal people, very poor long term memory, fairly poor short term memory, low energy.
Parnate I tried and it worked remarkably well the first year (but especially the first month). Beyond that it continued to work but at less effectiveness. Eventually after 2 years it would lose much of its benefit. Despite the benefits of Parnate I would still often have trouble enjoying things, interest would be mild but better than nothing. Higher doses just made me too tired and cognitively impaired.
Ritalin and dexedrine have worked remarkably well for me in the past. Dexedrine when i tried it many years ago was the first time I actually felt that I was returning to my old self again, i had interest, drive, motivation, was full of life, passion, i felt normal, i felt alive rather than like some zombie. both rit and dex have built much tolerance but still ritalin usually helps to some degree yet I cannot be entirely sure if I perhaps possibly may be better without it in the long term due to it's dopamine down-regulation. It helps very very little now compared to years ago.
Nardil did not work well for me. But it was generic brand. Lamictal made me feel extremely stupid and impaired. Abilify would rapidly make me feel worse. Difficult to remember but I believe it gave me intense anxiety. Wellbutrin did not work for me. Lamictal did give me a tiny bit of interest but the extreme cognitive effects were too much to bare.
Aricept I have not tried yet but I will make a note of it. I've read about it before but don't recall the details.
I have only modest confidence in my doctor but most doctors give up on me anyway. He is one of those who feels I should more naturally go out and do things but I cannot get through to him that I cannot just snap my fingers and force myself into routines. Some days being productive comes more naturally and I have no control over it. I lack a spark. The desire to do things. My doctor is often open to me suggesting new things but sometimes is stubborn.
Gabapentin I may ramp up. It has tolerance issues and withdrawal causes some strong anxiety but I'm really tired of throwing so many months away. This year has been the worst in many.
I really need some relief.
I was going to try Savella/Ixel but like many promising medications I cannot get it in Canada and Canada's government has put new laws in place which keep medications stuck at the border. I have less options available to me thanks to those corrupt politicians.
> Hi Alex.
>
> I don't have any immediate answers for you.
>
> What is your diagnosis?
>
> Have you been screened for ADHD?
>
> How would you describe your depression?
>
> Have you tried stimulants (amphetamine or methylphenidate)?
>
> Have you ever tried a MAOI (Parnate or Nardil)?
>
> What other drugs have you tried and what were the results?
>
> A dopaminergic cocktail could include Lamictal, Abilify, Wellbutrin, and methylphenidate. I know that the use of Lamictal and Abilify seem counterintuitive at first, but they do support dopamine function, albeit via different mechanisms.
>
> Some people gain a great deal of cognitive improvement using Aricept, a drug used for treating Dementia Alzheimer's Type (DAT). My only concern with that drug is that depression is a theoretical side effect. Still, some people do quite well with it. In fact, one person I now had a very robust antidepressant effect with Aricept.
>
> Are you confident in your doctor?
>
>
> - Scott
Posted by AlexCanada on October 19, 2012, at 22:18:36
In reply to Re: This is a bit frightening. Alert but not awake., posted by phillipa on October 19, 2012, at 9:26:46
> Alex what did you decide to do? Phillipa
There is just no way I can keep taking it. It does make my depression worse. Darker. More gloomy. What a rotten day today would be. Slowly bit by bit getting better this evening but still feel quite odd.
Posted by phidippus on October 20, 2012, at 18:10:48
In reply to Day 2 on Memantine/Nameda and feel Very Weird!!, posted by AlexCanada on October 19, 2012, at 0:34:27
Wait until you get to 20 mg.
Eric
Posted by AlexCanada on October 24, 2012, at 19:00:42
In reply to Re: Day 2 on Memantine/Nameda and feel Very Weird!! » AlexCanada, posted by phidippus on October 20, 2012, at 18:10:48
> Wait until you get to 20 mg.
>
> EricWhat were to change if I went to 20mg? Is the mechanism of action altered? I was extremely detached and felt a lot of negativity and darkness on 5mg.
Posted by g_g_g_unit on October 25, 2012, at 5:48:56
In reply to Re: Day 2 on Memantine/Nameda and feel Very Weird!!, posted by AlexCanada on October 24, 2012, at 19:00:42
I'm trying Memantine for OCD/depression at the moment.
I started on 2.5mg and worked my way up to 15mg, but it skyrocketed my anxiety, made me dysphoric, caused insomnia and generally put me in quite a hellish place. There were some positive early effects at the lower doses -- moments where I felt more joyful, clear-headed, and this weird, almost psychedelic visual clarity where colors were insanely enhanced. It's effects on anxiety have been pretty inconsistent .. sometimes I'll feel really calm and stable, other times quite agitated.
That said, I, ever the stubborn one, have cut back to 2.5mg twice a day. I tend to be really sensitive to medication in general (my doctor suspects I'm a slow metabolizer), so I'm hoping the lower dose might help. I only lowered it 4 days ago and have been feeling *very* strange -- moody, dissociated etc. -- so I can totally relate to what you describe; it almost feels like a bad drug trip. But my mood has been a bit more stable than it was at the higher doses.
Anyway, I often feel dissociated from anxiety/depression anyway, so I'm just pushing through it. Maybe you should have given it longer, since my understanding is that it takes about 5-10 days to adjust to a dose, and the dissociation is supposed to pass. But then again, I'm so desperate for something to help w/out painful side-effects that I'm ploughing ahead .. I plan to give this dose about two weeks before calling it quits.
I'll keep you updated ..
Posted by phidippus on October 25, 2012, at 14:58:30
In reply to Re: Day 2 on Memantine/Nameda and feel Very Weird!!, posted by AlexCanada on October 24, 2012, at 19:00:42
>What were to change if I went to 20mg? Is the mechanism of action altered?
5ht3 antagonism increases, therefore increasing GABAergic action. This usually conforms to a stronger anxiolytic effect.
Keep in mind Memantine did hardly anything for me, even at 40 mg.
Eric
Posted by AlexCanada on November 2, 2012, at 8:31:54
In reply to Re: Day 2 on Memantine/Nameda and feel Very Weird!! » AlexCanada, posted by g_g_g_unit on October 25, 2012, at 5:48:56
> I'm trying Memantine for OCD/depression at the moment.
>
> I started on 2.5mg and worked my way up to 15mg, but it skyrocketed my anxiety, made me dysphoric, caused insomnia and generally put me in quite a hellish place. There were some positive early effects at the lower doses -- moments where I felt more joyful, clear-headed, and this weird, almost psychedelic visual clarity where colors were insanely enhanced. It's effects on anxiety have been pretty inconsistent .. sometimes I'll feel really calm and stable, other times quite agitated.
>
> That said, I, ever the stubborn one, have cut back to 2.5mg twice a day. I tend to be really sensitive to medication in general (my doctor suspects I'm a slow metabolizer), so I'm hoping the lower dose might help. I only lowered it 4 days ago and have been feeling *very* strange -- moody, dissociated etc. -- so I can totally relate to what you describe; it almost feels like a bad drug trip. But my mood has been a bit more stable than it was at the higher doses.
>
> Anyway, I often feel dissociated from anxiety/depression anyway, so I'm just pushing through it. Maybe you should have given it longer, since my understanding is that it takes about 5-10 days to adjust to a dose, and the dissociation is supposed to pass. But then again, I'm so desperate for something to help w/out painful side-effects that I'm ploughing ahead .. I plan to give this dose about two weeks before calling it quits.
>
> I'll keep you updated ..Thanks for the info. Hopefully it works out for you. How is it lately?
I have since given up on memantine because my intitial experience was horrific. The first dose seemed to be a net benefit but the 2nd one created such a nightmare where I could not stand to stay on it.
Possibly in the future I should try 2.5mg and see if I can adjust and stick with it for over a week rather than 2 days.
Posted by g_g_g_unit on November 6, 2012, at 6:35:02
In reply to Re: Day 2 on Memantine/Nameda and feel Very Weird!! » g_g_g_unit, posted by AlexCanada on November 2, 2012, at 8:31:54
>
> Thanks for the info. Hopefully it works out for you. How is it lately?
>
> I have since given up on memantine because my intitial experience was horrific. The first dose seemed to be a net benefit but the 2nd one created such a nightmare where I could not stand to stay on it.
>
> Possibly in the future I should try 2.5mg and see if I can adjust and stick with it for over a week rather than 2 days.Can't really tell, unfortunately. Some side-effects that were more prominent at higher doses (tachycardia, muscle tension, panic attacks) have eased up, but I still can't say it's doing much for anxiety and I'm having trouble sleeping.
I'm taking 2.5mg twice a day. I think I'll give it another week or so. After that, I give up.
This is the end of the thread.
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