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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 69 to 93 of 93. Go back in thread:
Posted by SLS on September 11, 2012, at 6:21:30
In reply to Re: Starting minocycline. » SLS, posted by AlexCanada on September 11, 2012, at 5:23:17
> Hey Scott. Good to hear you are improving.
Thanks.
:-)
> Do you feel minocycline may be working for you due to it's effect on Norepinephrine or other factors?Gosh. It's so hard to know for sure. I am guessing that there is more than one effect that is contributing to my therapeutic response. I know that minocycline amplifies the antidepressant effect of desipramine. It might work with other TCAs as well. Researchers have found that it also has anti-glutamatergic properties via receptor downregulation. These might amplify the antidepressant effects of Lamictal, a glutamate release inhibitor. Even its anti-inflammatory properties might contribute, as drugs with this effect have shown antidepressant activity in rats. In fact, there is a study currently underway that is designed to see if the addition of aspirin to minocycline works better for bipolar depression than minocycline alone. These treatments are to be compared to placebo. Although it might not produce new nerve cells (neurogenesis), minocycline does protect new cells from damage (neuroprotection) by suppressing microglia activity. Microglia have a nasty habit of producing neurotoxic pro-inflammatory modulators.
There comes a time when I say the heck with theory. To some degree, we act as blind guinea pigs for one another. So far, this guinea pig is happy with the results of my minocycline investigation. It is important to note that I am taking Lamictal. Theory here is helpful in that it might indicate to someone who is not responding to minocycline therapy that adding Lamictal would "unlock" its therapeutic potential or vice-versa.
Currently:
Parnate 80 mg/day
Nortriptyline 150 mg/day
Lamictal 200 mg/day
Lithium 300 mg/day
Abilify 10 mg/day
Minocycline 200 mg/dayI found that minocycline works better for me at 200 mg/day than it did at 100 mg/day. Most of the current studies of minocycline to treat depression use 200 mg/day or higher. It should be dosed twice a day.
I was able to discontinue prazosin, which produced a significant antidepressant effect for me. My next move will be to attempt to discontinue Abilify. I am less confident that I will able to do this without relapsing. I might need its dopamine system stabilizing (DSS) properties. However, it is logical to try this due to the metabolic side effects Abilify produces. I have gained 50 pounds over the course of several years and my triglycerides are way too high. Abilify is the likely culprit.
Do you feel that noradrenergic (NE) hypofunction is a component of your illness?
- Scott
Posted by AlexCanada on September 12, 2012, at 11:17:37
In reply to Re: Starting minocycline. » AlexCanada, posted by SLS on September 11, 2012, at 6:21:30
> > Do you feel minocycline may be working for you due to it's effect on Norepinephrine or other factors?
>
> Gosh. It's so hard to know for sure. I am guessing that there is more than one effect that is contributing to my therapeutic response. I know that minocycline amplifies the antidepressant effect of desipramine. It might work with other TCAs as well. Researchers have found that it also has anti-glutamatergic properties via receptor downregulation. These might amplify the antidepressant effects of Lamictal, a glutamate release inhibitor. Even its anti-inflammatory properties might contribute, as drugs with this effect have shown antidepressant activity in rats. In fact, there is a study currently underway that is designed to see if the addition of aspirin to minocycline works better for bipolar depression than minocycline alone. These treatments are to be compared to placebo. Although it might not produce new nerve cells (neurogenesis), minocycline does protect new cells from damage (neuroprotection) by suppressing microglia activity. Microglia have a nasty habit of producing neurotoxic pro-inflammatory modulators.I have tried Lamictal before and it seemed promising in terms of improving my mood initially, I was starting to enjoy things a little bit but it very quickly was negatively impacting my already poor cognition and I'd also feel empty headed and very dull. I never felt more dumb on any medication than I did on lamictal and even my short term memory was severely compromised. Constantly forgetting things moment by moment.
Do you know which other meds may have anti-glutamatergic action? Lamictal seemed promising but I just could not handle the infamous side effects. The ''Lamictal Stupid'' effect that is well documented online.
A very prominent doctor here in Canada stated glutamine could be one possible factor in my melancholic depression but he never specified anything on the issue and I am no longer able to reach him as he is not my main doctor.
Minocycline, might it be a viable option for augmenting an SSRI such as Zoloft which I am currently taking (and so far feeling very dull, blunted, flat, as I am on day 6 of 25mg) or an SNRI (such as Savella or others?). Or is it more suited to augment TCAs? Because I'm not sure if I'll be trying a TCA any time soon.
> There comes a time when I say the heck with theory. To some degree, we act as blind guinea pigs for one another. So far, this guinea pig is happy with the results of my minocycline investigation. It is important to note that I am taking Lamictal. Theory here is helpful in that it might indicate to someone who is not responding to minocycline therapy that adding Lamictal would "unlock" its therapeutic potential or vice-versa.
>
> Currently:
>
> Parnate 80 mg/day
> Nortriptyline 150 mg/day
> Lamictal 200 mg/day
> Lithium 300 mg/day
> Abilify 10 mg/day
> Minocycline 200 mg/day
>
> I found that minocycline works better for me at 200 mg/day than it did at 100 mg/day. Most of the current studies of minocycline to treat depression use 200 mg/day or higher. It should be dosed twice a day.
>
> I was able to discontinue prazosin, which produced a significant antidepressant effect for me. My next move will be to attempt to discontinue Abilify. I am less confident that I will able to do this without relapsing. I might need its dopamine system stabilizing (DSS) properties. However, it is logical to try this due to the metabolic side effects Abilify produces. I have gained 50 pounds over the course of several years and my triglycerides are way too high. Abilify is the likely culprit.
>
> Do you feel that noradrenergic (NE) hypofunction is a component of your illness?I think it very well could be a missing link. Considering NRIs etc can supposedly have benefits to cognition, memory, drive, motivation, energy, things which I very often lack especially on the cognitive side. When my mind is more active and does not feel so cognitively blocked off and I am able to have some flowing stream of thought often other things become easier as well. In the past I did not respond well to Effexor, Wellbutrin, among others though. Effexor rapidly caused my condition to worsen but those were early days when aside from strong melancholic dep I was also dealing with severe ''out of nowhere'' anxiety, anxiety without reason, and intense burning pains in my head. I was never able to give effexor and certain other similar meds a long enough trial due to the worsening of my symptoms. Anxiety would strongly manifest itself yet in theory Norepinephrine info seems like it may help greatly.
Perhaps I have too much norepinephine? And very low dopamine and seratonin. I don't know. Dopamine based meds have worked wonders (ritalin/dexedrine/parnate etc) in the past. These days I have much tolerance to ritalin.
My anxiety these days is usually very low and has always been very secondary compared to my melancholic depression but much of this low anxiety might be due to how dulled and cognitively impaired i am right now.
Posted by SLS on September 17, 2012, at 8:20:26
In reply to Re: Starting minocycline. » SLS, posted by AlexCanada on September 12, 2012, at 11:17:37
> My anxiety these days is usually very low and has always been very secondary compared to my melancholic depression but much of this low anxiety might be due to how dulled and cognitively impaired i am right now.
That's a very insightful connection you make between cognitive impairment and the anxiety that can emerge as a result of being hypofunctional in a busy world. It is difficult not to become anxious when one is asked to perform at a level beyond their capabilities.
I wonder if using low-dose lithium treatment would help in combination with antidepressants. Adding lithium to Parnate had been a favorite strategy 30 years ago. Of course, adding it to TCAs was a common treatment. Lithium might act as a buffer against excessive NE and GLU activity via receptor modulation produced by inhibiting second messenger cascades.
- Scott
Posted by SLS on September 17, 2012, at 8:21:54
In reply to Re: Starting minocycline. » AlexCanada, posted by SLS on September 17, 2012, at 8:20:26
Minocycline is still working...
...better and better.
- Scott
Posted by Tomatheus on September 17, 2012, at 15:00:19
In reply to Re: Starting minocycline., posted by SLS on September 17, 2012, at 8:21:54
Posted by brynb on September 17, 2012, at 15:05:49
In reply to Re: Starting minocycline., posted by SLS on September 17, 2012, at 8:21:54
> Minocycline is still working...
>
> ...better and better.
>
>
> - Scott
>Wow, that's awesome! I think I mentioned I have an Rx (from my derm). I'd love to bring this up to my pdoc.
Posted by rovers95 on September 18, 2012, at 15:57:32
In reply to Re: Starting minocycline., posted by SLS on September 17, 2012, at 8:21:54
> Minocycline is still working...
>
> ...better and better.
>
>
> - Scott
>
>Okay, whilst it is difficult for me to discern what represents a response from what is a 'high' from eating a few carbs, I seem to be doing a lot better. I am now at 100mg and whilst I was quite flat friday to sunday, in the last few couple of days I have good spells that suggest considerable improvement.
Obviously, I have issues in other areas (binge eating, diet)that need addressing. I was considering suggesting an SSRI (zoloft) or using 5htp to see if this would help this side of my treatment.
Scott, would be interesting to know what made you try minocycline...apart from running out of ideas! Is your pdoc using with others? Are they having similar success and do you know of anyone who has been on this long term?
Cheers, Rover
Posted by SLS on September 18, 2012, at 18:30:51
In reply to Re: (maybe) working for me too » SLS, posted by rovers95 on September 18, 2012, at 15:57:32
> > Minocycline is still working...
> >
> > ...better and better.> Okay, whilst it is difficult for me to discern what represents a response from what is a 'high' from eating a few carbs, I seem to be doing a lot better. I am now at 100mg and whilst I was quite flat friday to sunday, in the last few couple of days I have good spells that suggest considerable improvement.
That mirrors my experience with minocycline. I felt flat for the first few days, but felt better going into day 5. Your mood might be somewhat variable throughout the day at first. Mine was. It is less so now.
> Obviously, I have issues in other areas (binge eating, diet)that need addressing. I was considering suggesting an SSRI (zoloft) or using 5htp to see if this would help this side of my treatment.
Have you tried Prozac? What about desipramine or other TCAs? One study of rats showed that minocyclne helped desipramine work better. The same was also true of Prozac, but in a different manner. The other SRIs might work just as well, but they weren't tested.
> Scott, would be interesting to know what made you try minocycline...
It was a suggestion coming from the psychiatry department at Massachussets General Hospital.
> Is your pdoc using with others?
I'm his first.
Fortunately, my doctor has an open mind. I didn't have to work too hard to convince him to allow me to try minocycline. He's big on some of the newer ideas regarding brain inflammation. Although I am convinced that there is an association between inflammation and depressive illness, I tend to believe that the anti-glutamatergic properties of minocycline are most responsible for its more immediate antidepressant effect. I could be very wrong, of course.
> do you know of anyone who has been on this long term?
Not yet.
What other drugs are you taking?
- Scott
Posted by SLS on December 30, 2012, at 12:50:37
In reply to Re: Starting minocycline., posted by SLS on September 17, 2012, at 8:21:54
I'm doing pretty damned well right now. It's relative, of course. I am probably 35% of the way there. You don't realize how sick you were until you begin to recover. I am really working towards returning to work next year. I am beginning to believe that it will happen. A 50% improvement should do it.
Minocycline is making the difference between plateauing on prazosin and moving forwared towards remission. I temporarily discontinued the minocycline to see if raising the prazosin alone would do the job. I seemed to lose ground and reached a point of stagnation. Once I was satisfied that I had plateaued, I added back the minocycline. Within a week, I am beginning to feel the magic again.
Heeeeere we go...
My current regime:
Parnate 80 mg/day
nortriptyline 150 mg/day
Lamictal 200 mg/day
lithium 300 mg/day
Abilify 10 mg/day
prazosin 15 mg/day
minocycline 200 mg/day7 drugs? Well, until medical science solves the puzzle, I am stuck with polypharmacy. I am incredibly fortunate.
- Scott
Posted by SLS on December 30, 2012, at 12:55:24
In reply to Re: (maybe) working for me too » SLS, posted by rovers95 on September 18, 2012, at 15:57:32
How are you doing?
I learned recently that minocycline can take as long as a full year to produce a 100% remission from depression. If you began to feel even a slight improvement within the first three weeks, I think that this would be a very good sign.
- Scott
Posted by JonCatnip on February 18, 2013, at 17:07:15
In reply to Re: (maybe) working for me too » rovers95, posted by SLS on December 30, 2012, at 12:55:24
Hi,
I'd be curious to hear any more updates about minocycline. I have searched online for weeks and this has been about the most informative source for any feedback on the actual use of minocycline in treating bi-polar conditions.
I know there are several studies underway to study minocycline... but they won't be published for a year. After reading several very interesting reports about the benefits of minocycline, I'd think there would be more attention in the press paid to this new discovery. I would think that extraordinary case of the patient in Japan who had Schizophrenia cured with minocycline might have generated some buzz. If indeed many brain health issues are related to inflamation... and minocycline can be shown effective in treating it, I'd like to know more.
It was encouraging to see that President Obama wants to devote resources to studying the brain, along the same lines as mapping the genome.
Anyhow, if anyone has more feedback about minocycline, I'd be interested to know more. I can't get my doctor to sign off on it, so I'm looking for all the information I can get.
Posted by SLS on February 18, 2013, at 17:29:23
In reply to Re: (maybe) working for me too, posted by JonCatnip on February 18, 2013, at 17:07:15
> Anyhow, if anyone has more feedback about minocycline, I'd be interested to know more. I can't get my doctor to sign off on it,
Why not? Intracranial hypertension?
> so I'm looking for all the information I can get.
I tried stopping minocycline twice since August. Once was intentional. Once was inadvertent. On both occasions, my depression worsened within a week. Upon restarting minocycline, recovery occurred within 48 hours. I doubt your doctor will find my words compelling, though.
What kind of information are you looking for?
- Scott
Posted by SLS on February 18, 2013, at 17:34:35
In reply to Re: (maybe) working for me too, posted by JonCatnip on February 18, 2013, at 17:07:15
What literature have you brought in for your doctor to see?
- Scott
Posted by mogger on May 24, 2014, at 10:05:29
In reply to Re: Starting minocycline SLS » Slabicki, posted by SLS on August 21, 2012, at 6:37:01
Scott I know this is an old post but I am just starting minocycline today for depression. My pdoc prescribed be 100mgs of the ER version. Do you think I could if it works still see benefits with the ER version? Hope so,
Mogger
Posted by Jeroen on May 24, 2014, at 10:13:48
In reply to Re: Starting minocycline SLS » SLS, posted by mogger on May 24, 2014, at 10:05:29
1 mg is okay but 2,5 mg added can lead to psychosis and seizures
Posted by SLS on May 24, 2014, at 14:55:49
In reply to Re: Starting minocycline SLS » SLS, posted by mogger on May 24, 2014, at 10:05:29
> Scott I know this is an old post but I am just starting minocycline today for depression. My pdoc prescribed be 100mgs of the ER version. Do you think I could if it works still see benefits with the ER version? Hope so,
>
> MoggerMogger, I can't be sure, but I have not encountered anything that would lead me to believe that there would be a difference between the two versions of minocyline. I was taking 100 mg twice a day for over two years. I recently discontinued minocycline because hyperpigmentation emerged. I think I caught it in time. It can be irreversible. The dark blue color began on my feet and was working its way up my shins. This side effect can affect as many as 20% of people who take more than 100 mg/day for two or more years. There is some indication that taking large doses of vitamin C can prevent hyperpigmentation from occurring. The dosage of vitamin C that I see suggested is 1000 mg/day. Taking more won't hurt, of course. I didn't learn about the vitamin C until recently, or I would have started it at the beginning.
I hope you do well with minocycline. It can work very quickly. Have you noticed an increase in energy?
- Scott
Posted by mogger on May 24, 2014, at 23:21:49
In reply to Re: Starting minocycline SLS » mogger, posted by SLS on May 24, 2014, at 14:55:49
Thanks Scott. Insurance is still being sorted so will be a few days until I start. I am all over the vitamin c recommendation. Sorry that it happened to you. I shall give you an update. Started Saphris on a side note a few nights ago which so far has been positive but early days of course. Saw saphris works on glutamate which is interesting. Thanks again,
Mogger
Posted by Jeroen on May 25, 2014, at 3:03:25
In reply to Re: Starting minocycline SLS » SLS, posted by mogger on May 24, 2014, at 23:21:49
really on glutamate? : )
Posted by mogger on June 8, 2014, at 22:48:46
In reply to Re: Starting minocycline SLS » SLS, posted by mogger on May 24, 2014, at 23:21:49
Scott,
I was on 90mgs of minocycline ER version and had a quick anti depressant response only after a few days. My mood then flattened after a week and now I have increased the dose to 180mgs for 3 days so far. So all in all I have been on minocycline for 10 days. My question to you if you don't mind is how long did it take to work for you? Do you think if I haven't had a steady improvement since being on it for 10 days that perhaps it might not work? The initial response was excellent but I am disappointed that I have flattened. Thanks for your thoughts,
Joseph
Posted by former poster on June 9, 2014, at 4:50:30
In reply to Re: Starting minocycline SLS » mogger, posted by mogger on June 8, 2014, at 22:48:46
I'd like to try Minocycline. How do I get my Dr. to prescribe it?
Posted by SLS on June 9, 2014, at 8:21:52
In reply to Re: Starting minocycline SLS » mogger, posted by mogger on June 8, 2014, at 22:48:46
> Scott,
>
> I was on 90mgs of minocycline ER version and had a quick anti depressant response only after a few days. My mood then flattened after a week and now I have increased the dose to 180mgs for 3 days so far. So all in all I have been on minocycline for 10 days. My question to you if you don't mind is how long did it take to work for you? Do you think if I haven't had a steady improvement since being on it for 10 days that perhaps it might not work? The initial response was excellent but I am disappointed that I have flattened. Thanks for your thoughts,I felt significantly better by 5 days at a dosage of 200 mg/day (100 mg b.i.d.). You might as well give it 2 weeks. You might be a slow-responder. There isn't the type of data available to determine the range of response times for the antidepressant effects of minocycline to emerge.
Important: Take a minimum of 1000 mg/day of vitamin C with minocycline to prevent hyperpigmentation of the skin.
What else are you taking?
- Scott
Posted by mogger on June 9, 2014, at 10:47:47
In reply to Re: Starting minocycline SLS » mogger, posted by SLS on June 9, 2014, at 8:21:52
Thanks Scott,
What aren't I taking!
400mg Lamotrigine
5mg Saphris
150mgs Sertraline
1000mgs Metformin
90mgs Buspar
45mgs Remeron
1mg KlonopinI will give it another few weeks then thanks. My doctor is getting frustrated (nowhere near as much as I am of course) that I am staying put at a flattened level with moderate depression that won't abate. We have given most everything a shot so he thought about taking me off ADs and trying the selegiline patch. He suggested raising the Remeron to 60mgs from 45mgs as he has see some patients with improvement but who knows. I wouldn't imagine it would make that much of a difference. We haven't tried serzone or trazodone yet so that is something I might ask him about.
Joseph
Posted by SLS on June 9, 2014, at 11:54:43
In reply to Re: Starting minocycline SLS » SLS, posted by mogger on June 9, 2014, at 10:47:47
Hi Joseph.
> Thanks Scott,
>
> What aren't I taking!
>
> 400mg Lamotrigine
> 5mg Saphris
> 150mgs Sertraline
> 1000mgs Metformin
> 90mgs Buspar
> 45mgs Remeron
> 1mg Klonopin
>
> I will give it another few weeks then thanks. My doctor is getting frustrated (nowhere near as much as I am of course) that I am staying put at a flattened level with moderate depression that won't abate. We have given most everything a shot so he thought about taking me off ADs and trying the selegiline patch. He suggested raising the Remeron to 60mgs from 45mgs as he has see some patients with improvement but who knows. I wouldn't imagine it would make that much of a difference. We haven't tried serzone or trazodone yet so that is something I might ask him about.
>
> JosephI hope that you are pleasantly surprised by Remeron. Personally, I don't think people should give up on Remeron until they reach 60 mg/day, unless they feel worse or develop intolerable side effects. Some people need 90 mg/day.
What were your experiences with Effexor and Cymbalta?
What about Wellbutrin?
Your lamotrigine dosage is quite high. Does it affect your memory?
It is too bad that a doctor should allow his frustration to become visible to the patient. You should be afforded the same patience from your doctor as you require from yourself to tolerate the pain of your illness as you move through drug trials.
I hope you feel better soon.
- Scott
Posted by former poster on June 9, 2014, at 22:13:57
In reply to Re: Starting minocycline SLS » mogger, posted by mogger on June 8, 2014, at 22:48:46
I'd like to try Minocycline. How do I get my Dr. to prescribe it?
Posted by former poster on June 10, 2014, at 3:52:39
In reply to Re: Starting minocycline SLS » mogger, posted by former poster on June 9, 2014, at 22:13:57
Sorry I accidentally hit post 2 times...
I was curious if Minocycline could help with my chronic pain from arthritis as well as depression and OCD. I get conflicting data about the safety of taking it for these conditions.
Pharmacies in some countries provide antibiotics without a prescription. I could possibly be in one now. Advice anyone?
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