![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by SLS on August 23, 2021, at 8:42:46
.
This is a repost of something I wrote to Lambdage earlier today. I would like to thank him for his logic and sage insight:
______________________________________________________
Lambdage:> I wish you well. Always have. There aren't so many posters anymore.
Thanks.
You are right, Lambdage. I was probably premature in my disappointment. It's just that I have been here since 1999, living a life of torturous pain and numbness, like so many others have and are currently.I was riddled with guilt when I first started responding to treatment. I was very sad to have the feeling that I had found a new life with treatment while so few here have over this same period of time - over two decades. I genuinely wanted to bring everyone else with me.
Thank God that there are still incredibly intelligent and resourceful people to help lead the Psycho-Babble community. Throughout its existence, Psycho-Babble has been perhaps the single best Internet forum for the presentation of the latest research along with the sophistication of thought to render novel theories.
The lesson I hoped everyone would learn from me is that there is always hope - and that you never know when you will strike gold with a life-changing treatment. A rebirth into a new awareness is worth working for. Please - everyone - don't give up, especially when you already have. I had an advantage, though. Every now and then, I was given a brief demonstration of what life could be in the absence of depression when I experienced brief remissions. I was also an "ultra-rapid" cycler for two years until I was treated with lithium for the first time. Thereafter, my experience was one to constant depression. However, during those two years, I got to see the profound differences in the two states of consciousness every 11 days. I was in a unique position to be able to compare the differencest between depression and remission. I was actually fascinated by the psychobiology of these brain disorders. Being fascinated by the biological underpinnings of the disease that we find such perpetual pain and oppression in is, ironically, what so many of us experience here.
I began decades of pain, struggle, and frustration with the innumerable failed treatments during which I had several three-day total treatment-emergent remissions. I have made it to today by clutching tightly to memories of those times. The period of my cycle was an unwavering 11 days: 8 days of depression followed by 3 days (not 2 or 4 days) of near-remission. Once I recognized this cycle by having read the book, "Mood Swing" by R. R. Fieve (1975), I kept a social calendar around it. Fieve was the first research doctor to bring lithium to America and work to have it approved by the FDA in 1970. He had been working with lithium since the 1950s.
It was an amazing coincidence that I saw his name on one of the doors while sitting in the waiting room for my very first visit to a psychiatrist. I was accepted into the research program at Columbia Presbyterian / New York Psychiatric Institute in 1982. All they had to work with were MAOIs, tricyclics, and lithium. Later, I was one of the first people in the U.S. to be treated with experimental serotonin reuptake inhibitors and releasers in 1983. They came from France (Pharmaca Pharmaceuticals). SSRIs never really helped, with the exception of a brief improvement while taking Zoloft (sertraline) help. My doctor from Columbia had moved to Pfizer and helped conduct the clinical trials to get Zoloft approved by the FDA. Small world.
I was very, very angry to discover that my moods and thoughts were beyond my control to work through, and that feeling profoundly depressed and non-functional as a human being was biological rather than psychological. I would have gone to psychotherapy three times a day if it meant not being tethered to a chemical in order to live life normally.
*******************LAMBDAGE - I have been delighted to watch you grow through the years. Really. Sometimes, others see more change in someone than they see in themselves.
*******************
- Scott
Posted by Phillipa on August 23, 2021, at 8:58:17
In reply to My Disappointment here + My early years, posted by SLS on August 23, 2021, at 8:42:46
Scott you okay? I have quite a few old babblers on my facebook page. Right now we don't talk psych issues just fun dumb stuff at times. You are welcome to join anytime since you spent so much time here and you are such a knowledgeable loveable guy. And it's a nice change from babble. Phillipa
Posted by undopaminergic on August 24, 2021, at 8:04:32
In reply to My Disappointment here + My early years, posted by SLS on August 23, 2021, at 8:42:46
> .
>
> This is a repost of something I wrote to Lambdage earlier today. I would like to thank him for his logic and sage insight:
>Not to be critical, but it's "Lamdage".
>
> Lambdage:
>
> > I wish you well. Always have. There aren't so many posters anymore.
>
> Thanks.Thank you for another story of your adventures. For some reason, I find them inspiring.
>
> The lesson I hoped everyone would learn from me is that there is always hope - and that you never know when you will strike gold with a life-changing treatment. A rebirth into a new awareness is worth working for. Please - everyone - don't give up, especially when you already have. I had an advantage, though. Every now and then, I was given a brief demonstration of what life could be in the absence of depression when I experienced brief remissions.
>I have that advantage as well. My (hypo)manic episodes demonstrate that I can feel good. I've also had temporary remissions with some drugs, such as pramipexole which transiently resolved even my stubborn anhedonia.
>
> It was an amazing coincidence that I saw his name on one of the doors while sitting in the waiting room for my very first visit to a psychiatrist. I was accepted into the research program at Columbia Presbyterian / New York Psychiatric Institute in 1982. All they had to work with were MAOIs, tricyclics, and lithium.
>Really only those? What about antipsychotics like chlorpromazine, stimulants like methylphenidate and amphetamine, barbiturates and benzodiazepines?
> Later, I was one of the first people in the U.S. to be treated with experimental serotonin reuptake inhibitors and releasers in 1983.
>Releasers? Like amphetamines?
>
> I was very, very angry to discover that my moods and thoughts were beyond my control to work through, and that feeling profoundly depressed and non-functional as a human being was biological rather than psychological. I would have gone to psychotherapy three times a day if it meant not being tethered to a chemical in order to live life normally.
>It can seem purely biological, when your condition responds to drugs, but there is always a two-way relationship between the mind/psyche and the brain.
-undopaminergic
Posted by SLS on August 24, 2021, at 10:36:02
In reply to Re: My Disappointment here + My early years, posted by undopaminergic on August 24, 2021, at 8:04:32
Hi, UD.
> > This is a repost of something I wrote to Lambdage earlier today. I would like to thank him for his logic and sage insight:
> Not to be critical, but it's "Lamdage".
I don't see your correction of me to be at all critical. I corrected myself in a thread below.Thanks.
> Thank you for another story of your adventures. For some reason, I find them inspiring.
> > The lesson I hoped everyone would learn from me is that there is always hope - and that you never know when you will strike gold with a life-changing treatment. A rebirth into a new awareness is worth working for. Please - everyone - don't give up, especially when you already have. I had an advantage, though. Every now and then, I was given a brief demonstration of what life could be in the absence of depression when I experienced brief remissions.
> I have that advantage as well. My (hypo)manic episodes demonstrate that I can feel good. I've also had temporary remissions with some drugs, such as pramipexole which transiently resolved even my stubborn anhedonia.
Maybe you should try combining Nardil with pramipexole? Between Nardil and Parnate, I found Nardil to be a much better anti-anhedonic drug. It is also pro-social. However, mania can occur with Nardil, especially in bipolar disorder. I would be prepared and have on hand Zyprexa (olanzapine) as an antidote. It should work quickly, and you might be able to continue with Nardil and discontinue the Zyprexa once you get through the critical period early in treatment. Euphoria is a common experience for people in the very beginning of treatment, even people who are not bipolar. However, even without intervention, it usually resolves in unipolars. People often go chasing the eurphoria afterwards with dosage escalation.
> > It was an amazing coincidence that I saw his name on one of the doors while sitting in the waiting room for my very first visit to a psychiatrist. I was accepted into the research program at Columbia Presbyterian / New York Psychiatric Institute in 1982. All they had to work with were MAOIs, tricyclics, and lithium.
> Really only those? What about antipsychotics like chlorpromazine, stimulants like methylphenidate and amphetamine, barbiturates and benzodiazepines?
Good point. I was referring to depression, but I should have been more specific. Stimulants were definitely used as prior to the serendipitous discovery of MAO inhibitors in the late 1950s. They were then used primarily as augmenters. At the time I entered the program in 1982, Xanax (alprazolam) was being looked at for depression, with good reason. It is the most euphoric of the benzodiazepines. In addition, another benzodiazepine, adinazolam, was also being looked at for depression. I tried in 1984, I believe. My doctor, Baron Shopsin, was surprised to see it work so well for some of his patients. I experienced *no* sedative or anxiolytic effect. It was amazingly clean, but it didn't produse an improvement in my depression. I think adinazolam is approved in Japan. So is rolipram, a phosphodiesterase inhibitor. I imagine it works intracelullarly along the second-messenger cascade.
> > Later, I was one of the first people in the U.S. to be treated with experimental serotonin reuptake inhibitors and releasers in 1983.
> Releasers? Like amphetamines?
I'm not sure of the mechanism. I think Pharmuca designated it PK-1058 or something like that. Pharmuca also developed a serotonin reuptake inhibitor named indalpine that was sold in France for many years. I think it was discontinued, probably because of inferior therapeutic effect and sedation as a side effect. Pharmuca developed one more experimental serotonergic drug. It was both a reuptake inhibitor and releaser. I should look the numbers of the up.
> > I was very, very angry to discover that my moods and thoughts were beyond my control to work through, and that feeling profoundly depressed and non-functional as a human being was biological rather than psychological. I would have gone to psychotherapy three times a day if it meant not being tethered to a chemical in order to live life normally.
> It can seem purely biological, when your condition responds to drugs, but there is always a two-way relationship between the mind/psyche and the brain.
See my thread below entitled "Biology or Psychology". I wrote it 20 years ago and posted it on Psycho-Babble after distributing it to an unenlightened staff at a local clinic.One other thing. While I was a research patient at the NIH in 1992, I was one of the first people to have his brain imaged by a PET scan. Not fun. My head was completely immobilized in a cast of my face and head. The image on the left is almost exactly like mine.
- Scott
Posted by undopaminergic on August 24, 2021, at 12:36:42
In reply to Re: My Disappointment here + My early years » undopaminergic, posted by SLS on August 24, 2021, at 10:36:02
> Hi, UD.
Hi SLS.
> > I've also had temporary remissions with some drugs, such as pramipexole which transiently resolved even my stubborn anhedonia.
>
>
> Maybe you should try combining Nardil with pramipexole? Between Nardil and Parnate, I found Nardil to be a much better anti-anhedonic drug.
>Interesting. The difference between them is essentially the GABAergic metabolite of Nardil, and Parnate's "amphetaminergic" action.
Yes, I would definitely want to try a classic MAOI, but I don't have a "MAOI doctor".
I also want to re-try pramipexole at higher doses, but given that they think I have schizophrenia, I don't think I would be able to get it.
A combination? Yes, why not?
My initial move was to try a higher dose of Surmontil (I'm on 150 mg), but the doctor didn't like that, so we agreed to try Latuda, and next, I'm going to suggest a switch to asenapine (Sycrest, Saphris). That will be the last antipsychotic for this round. Next after that? Substitute another TCA for Surmontil? Try vortioxetine? But I've lost most of my interest in that one after the failure of Latuda to elicit any effect; I was hopeful about its serotonin 5-HT7 antagonism. I'm also thinking of combining a SSRI with an antipsychotic that blocks serotonin 5-HT2A and -2C, so maybe I'll suggest sertraline to be added to the asenapine. What do you think?
> It is also pro-social. However, mania can occur with Nardil, especially in bipolar disorder. I would be prepared and have on hand Zyprexa (olanzapine) as an antidote. It should work quickly, and you might be able to continue with Nardil and discontinue the Zyprexa once you get through the critical period early in treatment. Euphoria is a common experience for people in the very beginning of treatment, even people who are not bipolar. However, even without intervention, it usually resolves in unipolars. People often go chasing the eurphoria afterwards with dosage escalation.
>Well, at least I don't think I would have a problem getting Zyprexa. In fact, I was only able to get them to stop it in connection with starting clozapine.
> > > It was an amazing coincidence that I saw his name on one of the doors while sitting in the waiting room for my very first visit to a psychiatrist. I was accepted into the research program at Columbia Presbyterian / New York Psychiatric Institute in 1982.
>I would like to get involved in research, but I don't know how.
> > > All they had to work with were MAOIs, tricyclics, and lithium.
>
> > Really only those? What about antipsychotics like chlorpromazine, stimulants like methylphenidate and amphetamine, barbiturates and benzodiazepines?
>
>
> Good point. I was referring to depression, but I should have been more specific. Stimulants were definitely used as prior to the serendipitous discovery of MAO inhibitors in the late 1950s. They were then used primarily as augmenters. At the time I entered the program in 1982, Xanax (alprazolam) was being looked at for depression, with good reason. It is the most euphoric of the benzodiazepines.
>It's my understanding that it has been revisited more recently?
As for recreational benzodiazepine use, not all users prefer alprazolam. Why's that, if it's the most euphoric?
> In addition, another benzodiazepine, adinazolam, was also being looked at for depression. I tried in 1984, I believe. My doctor, Baron Shopsin, was surprised to see it work so well for some of his patients. I experienced *no* sedative or anxiolytic effect. It was amazingly clean, but it didn't produse an improvement in my depression. I think adinazolam is approved in Japan.
>There are interesting drugs available for prescription in some countries. In Japan and many other Asian countries, there is, for example, a drug called nimetazepam which is particularly sought after by recreational users.
> So is rolipram, a phosphodiesterase inhibitor. I imagine it works intracelullarly along the second-messenger cascade.
>I remember reading about that many years ago.
>
> One other thing. While I was a research patient at the NIH in 1992, I was one of the first people to have his brain imaged by a PET scan. Not fun. My head was completely immobilized in a cast of my face and head. The image on the left is almost exactly like mine.
>
> https://www.mayoclinic.org/-/media/kcms/gbs/patient-consumer/images/2017/05/15/20/19/c7_pet_depression-8col.jpg
>Interesting!
-undopaminergic
Posted by Jay2112 on August 26, 2021, at 12:56:45
In reply to My Disappointment here + My early years, posted by SLS on August 23, 2021, at 8:42:46
Hi Scott:
I remember our days from the beginning of this website. Your gentleman-like attitude was something I always looked up to, never mind your amazing scientific knowledge.
There were many times of *major* drama and personal politics on the site, yet you always persevered. My bipolar, I think, was what caused my manic-like postings back in the early and mid 2000's. (And some of it, I was just a jerk..lol.)
Being a psychiatric patient since 1994, (I know you dated back even a bit more..), I've come to see all of this as one big experiment. As we get older, our biology changes, and we keep having to switch, restart, drop meds. Our brains also seem to be in a state of flux, and adapt to meds, losing some or much of their positive effect for people. Like we talked about before, there is definitely an element of art in psychiatry.
Then, comes the time, when the planets and stars align (lol), and we find meds that stick with us, their positive effects lasting, and we start to feel better. As a social worker, I also believe (and I know you do too) that getting your life straightened out through talk therapy, plays a prominent role. As Andrew Solomon wrote in 'The Noonday Demon', that even with all the meds in the world, your personal/social problems are still going to be present. Andrew also has a really interesting TED talk..it's on Youtube.
We are all disappointed at some time Scott, but the point is to learn, and get back up and fight the 'black dog'. (As Churchill called it..and Vodka was his antidepressant, as none had even been invented..and look what he had to deal with!!) Sadly, we lose so, so many lives to these illness'. What I don't understand is the simple lack of treatments and progress, compared to Cancer treatment, with all due respect.
So, a toast to all of our charms...we are all TRYING, to crack that damn code. That TRYING is key, I think.
"You can fight..
Fight without ever winning
But never really win
Win without a fight..."
(The late) Neil Peart
Posted by SLS on August 27, 2021, at 13:36:55
In reply to Re: My Disappointment here + My early years » SLS, posted by Jay2112 on August 26, 2021, at 12:56:45
Jay - This is an amazing post you wrote. Thank you.
If you caught my "Biology versus Psychology" and "Depressive Pressure" posts, I think you will find plenty that agrees with your words here. I began work to improve my psyche - actually, rebuild it - at age 20 or so. I was very much involuted and unreachable by psychologists, who I began seeing at age 17. When I was 22, I read Fieve's "Mood Swing" and discovered that I had a biologically-driven depression that most likely evolved during my years of bullying, child abuse and neglect. Neglect is worse than abuse, actually. Once I understood that, I simply decided to work on my psyche while doctors worked on my brain. I wanted to be psychologically healthy so that I could leave the gate galloping and never look back. It wasn't easy, but the idea was to avoid investing so many years learning how to gallop once the gate opened. I saw psychologists periodically to help me through some rather common, but difficult issues.
If you have a chance, take a quick look at my two short essays down below. I think we are the same wavelength.
- Scott
.> Hi Scott:
>
> I remember our days from the beginning of this website. Your gentleman-like attitude was something I always looked up to, never mind your amazing scientific knowledge.
>
> There were many times of *major* drama and personal politics on the site, yet you always persevered. My bipolar, I think, was what caused my manic-like postings back in the early and mid 2000's. (And some of it, I was just a jerk..lol.)
>
> Being a psychiatric patient since 1994, (I know you dated back even a bit more..), I've come to see all of this as one big experiment. As we get older, our biology changes, and we keep having to switch, restart, drop meds. Our brains also seem to be in a state of flux, and adapt to meds, losing some or much of their positive effect for people. Like we talked about before, there is definitely an element of art in psychiatry.
>
> Then, comes the time, when the planets and stars align (lol), and we find meds that stick with us, their positive effects lasting, and we start to feel better. As a social worker, I also believe (and I know you do too) that getting your life straightened out through talk therapy, plays a prominent role. As Andrew Solomon wrote in 'The Noonday Demon', that even with all the meds in the world, your personal/social problems are still going to be present. Andrew also has a really interesting TED talk..it's on Youtube.
>
> We are all disappointed at some time Scott, but the point is to learn, and get back up and fight the 'black dog'. (As Churchill called it..and Vodka was his antidepressant, as none had even been invented..and look what he had to deal with!!) Sadly, we lose so, so many lives to these illness'. What I don't understand is the simple lack of treatments and progress, compared to Cancer treatment, with all due respect.
>
> So, a toast to all of our charms...we are all TRYING, to crack that damn code. That TRYING is key, I think.
>
> "You can fight..
> Fight without ever winning
> But never really win
> Win without a fight..."
> (The late) Neil Peart
>
>
Posted by SLS on August 30, 2021, at 9:00:04
In reply to Re: My Disappointment here + My early years » SLS, posted by Jay2112 on August 26, 2021, at 12:56:45
Hi, Jay.
I don't think I ever screamed, "God Damn It" louder than on the day I found out that my neighbor's severely depressed daughter, who I had met, committed suicide. When I was in my 20s, I wanted to become a research clinician to help understand biogenic mental illnesses and find effective treatments in order to help stop pain, suffering, and suicide. That became my life's goal, and I had planned to achieve it once I recovered my cognitive function upon my remission from bipolar depression.
When I was 33, the research clinician overseeing my case suggested that I give up on the idea of trying to become a doctor. He said that, even if he could bring me to remission, the stress and insane working schedule would probably cause me to relapse. I cried my eyes out. I knew that there were worse things, though. My prime mission, after all, was to successfully treat my illness and move forward without ever relapsing.
It's a good plan, anyway...
- Scott
Posted by Lamdage22 on September 1, 2021, at 6:29:16
In reply to Re: My Disappointment here + My early years » Jay2112, posted by SLS on August 30, 2021, at 9:00:04
You are opening up much more. The real SLS without depression showing himself! Thats good! Compared to a few years ago it is a night and day difference. I'm still puzzled by this because you arent doing anything majorly different with meds, are you? It sounds almost exactly like what you did in the past.
Posted by SLS on September 1, 2021, at 22:32:25
In reply to Re: My Disappointment here + My early years, posted by Lamdage22 on September 1, 2021, at 6:29:16
> You are opening up much more. The real SLS without depression showing himself! Thats good! Compared to a few years ago it is a night and day difference. I'm still puzzled by this because you arent doing anything majorly different with meds, are you? It sounds almost exactly like what you did in the past.
Previously -> Currently1. Nardil: 90 mg/day -> 75 mg/day
2. nortriptyline: 100 mg/day -> 75 mg/day
3. Lamictal: 300 mg/day Unchanged
4. lithium: 300 mg/day Unchanged
I have gravitated towards these medications in the past. Over the years, each drug demonstrated some degree of improvement, but my responses were generally short-lived. Some produce a very, very . early in treatment. The first time, the dosage of Lamictal was too and the dosage of nortriptyline was too high. It turns our that I was on the right drugs, but at the wrong dosages. If nothing else, my experience demonstrates that there is an optimal dosage of some drugs. Nortriptyline has a very hard dosage window. 50-150 mg/dL This is considered putativeThe funny(?) thing is that, with the FDA approval of Lamctal in 1996, all four of the drugs that I am responding to were available to cure me.
- Scott
Posted by Lamdage22 on September 2, 2021, at 1:02:22
In reply to Re: My Disappointment here + My early years » Lamdage22, posted by SLS on September 1, 2021, at 22:32:25
It sounds solid. I like that you have mood stabilization in there as well.
> 1. Nardil: 90 mg/day -> 75 mg/day
>
> 2. nortriptyline: 100 mg/day -> 75 mg/day
>
> 3. Lamictal: 300 mg/day Unchanged
>
> 4. lithium: 300 mg/day Unchanged
Posted by Lamdage22 on September 2, 2021, at 15:01:38
In reply to Re: My Disappointment here + My early years, posted by Lamdage22 on September 2, 2021, at 1:02:22
Whatever you do, keep doing it.
Posted by SLS on September 2, 2021, at 15:46:37
In reply to Re: My Disappointment here + My early years, posted by Lamdage22 on September 2, 2021, at 1:02:22
Hi, Lamdage.
> It sounds solid. I like that you have mood stabilization in there as well.
> > 1. Nardil: 90 mg/day -> 75 mg/day
> >
> > 2. nortriptyline: 100 mg/day -> 75 mg/day
> >
> > 3. Lamictal: 300 mg/day Unchanged
> >
> > 4. lithium: 300 mg/day UnchangedI would like to describe my experience with lithium. I have Bipolar Disorder, but it presents only as depression. I have had a handful of manic reactions to antidepressants, but I never had mania as a part of my untreated illness.
The facts about lithium include the observations that it displays a bimodal effect at different dosages. The bimodal distribution is observed in both clinical and neuronal activity. Low dosages of lithium (300 mg/day for me) can improve depression significantly. Monitoring blood levels in this scenario is not necessary. Just titrate it looking for clinical improvement. However, mania cannot be treated effectively at these low dosages. In this case, blood levels are the guideline to dosing, and usually follows a dosage range of 900-1500 mg/day. However, with me as an anecdotal example, if I go above 300 mg/day, my clinical improvement disappears, and I relapse into depression and also experience the common side effects, including amotivation, apathy, and flat affect. Therefore, I display a bimodal dose-response curve. There are studies reporting this exact bimodal effect on clinical symptoms of subjects with Major Depressive Disorder.
The second finding that I came across accidentally is that lithium has a bimodal effect on glutamate activity. At low dosages, it increases activity, whereas higher dosages reduce activity. There is some speculation that glutamate activity is associated with mood states. Glutamate is the most pervasive excitatory neurotransmitter. Too much glutamate is thought by some to be a contributing cause of mania. Conversely, too little activity might contribute to the depressive state.
If you have never experienced mania, and you feel that the worst thing that can happen is that you feel worse for a few days instead of better, give some thought to trying low-dosage lithium. Many years ago, Harvard (Fava and Nierenberg, I think) was working with Prozac (fluoxetine) + low-dosage lithium in treating treatment-resistant depression. They found that 300-600 mg/day of lithium combined with 60 mg/day of Prozac worked better than either drug alone. However, they attributed most of the synergistic effect to Prozac.
- Scott
Posted by Lamdage22 on September 3, 2021, at 2:33:55
In reply to Re: My Disappointment here + My early years » Lamdage22, posted by SLS on September 2, 2021, at 15:46:37
Hi Scott, already on 225 Lithium Carbonate ;) I feel it helps me not feel suicidal as often as before.
Posted by undopaminergic on September 3, 2021, at 8:35:44
In reply to Re: My Disappointment here + My early years » Lamdage22, posted by SLS on September 2, 2021, at 15:46:37
>
> The second finding that I came across accidentally is that lithium has a bimodal effect on glutamate activity. At low dosages, it increases activity, whereas higher dosages reduce activity. There is some speculation that glutamate activity is associated with mood states. Glutamate is the most pervasive excitatory neurotransmitter. Too much glutamate is thought by some to be a contributing cause of mania. Conversely, too little activity might contribute to the depressive state.
>If so, I have to ask why memantine, a NMDA-glutamate receptor antagonist, can induce mania for me?
Obviously, given that glutamate is the brain's major excitatory neurotransmitter, its neurology is likely complex. Ie. glutamate in one part of the brain does one thing, and glutamate in another part does another thing, possibly opposing each other.
-undopaminergic
Posted by Jay2112 on September 5, 2021, at 19:27:00
In reply to Re: My Disappointment here + My early years » SLS, posted by undopaminergic on September 3, 2021, at 8:35:44
> >
> > The second finding that I came across accidentally is that lithium has a bimodal effect on glutamate activity. At low dosages, it increases activity, whereas higher dosages reduce activity. There is some speculation that glutamate activity is associated with mood states. Glutamate is the most pervasive excitatory neurotransmitter. Too much glutamate is thought by some to be a contributing cause of mania. Conversely, too little activity might contribute to the depressive state.
> >
>
> If so, I have to ask why memantine, a NMDA-glutamate receptor antagonist, can induce mania for me?
>
> Obviously, given that glutamate is the brain's major excitatory neurotransmitter, its neurology is likely complex. Ie. glutamate in one part of the brain does one thing, and glutamate in another part does another thing, possibly opposing each other.
>
> -undopaminergic
>Hi U-D:
I believe memantine is closely related to amantadine? Amantadine is a dopamine agonist, so memantine may share some of amantadine's dopamine agonism, which of course will send you orbiting.
Just a thought..
Jay
Posted by undopaminergic on September 6, 2021, at 3:49:39
In reply to Re: My Disappointment here + My early years » undopaminergic, posted by Jay2112 on September 5, 2021, at 19:27:00
> >
> > If so, I have to ask why memantine, a NMDA-glutamate receptor antagonist, can induce mania for me?
> >
> > -undopaminergic
> >
>
> Hi U-D:
>
> I believe memantine is closely related to amantadine?Yes, memantine is dimethyl-amantadine.
> Amantadine is a dopamine agonist, so memantine may share some of amantadine's dopamine agonism, which of course will send you orbiting.
>I'm my view, amantadine is also a NMDA-glutamate antagonist, but weaker than memantine. I don't agree that amantadine is any kind of serious dopamine-reuptake inhibitor, which one study claims it is. It is only *functionally* a dopamine agonist, by means of the NMDA-inhbitory action.
-undopaminergic
Posted by alchemy on September 8, 2021, at 16:37:17
In reply to My Disappointment here + My early years, posted by SLS on August 23, 2021, at 8:42:46
Hey Scott! I use to come to this board all the time and always thought you were one of the few wise ones :)
Your story is encouraging ...I am almost 40 years of pure tx resistant depression and every day I don't know if I can do it. I no longer try and play around with my meds because my body is so sensitive and pretty much everything just makes me worse.
Congrats. I'm very happy for you!
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
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