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Re: Shellie, Scott

Posted by SLS on October 5, 2000, at 13:53:17

In reply to Shellie, Scott, posted by AndrewB on October 5, 2000, at 12:30:43

Hi guys.

I think I'm battling the flu on top of the usual energy and concentration stuff, so you'll have to pardon the brevity of my response.

Shellie - I want you on my team.
Andrew, I think you may be right regarding DA hypersensitivity.

One thought - not much.

Without knowing very much about it, I would say that there may be some problems with opioid/dopamine balance interactions.

Simplistically speaking (the best I can do), if opioid receptor stimulation is decreased, I believe that some dopaminergic pathways with which opioid receptors and neurons interact might become hyperactive. Too much dopamine. More accurately, perhaps, too little control over the throttle and bad brakes.


Hydrocodone (opioid agonist) - feels good and is activating.
Naltrexone (opioid antagonist) - feels crappy.

The hydrocodone (an opioid) may be functioning to stabilize and attenuate DA activity in various regions, including the nucleus accumbens. There may be some alterations in the ratios of specific opioid subtypes.

I bet Dr. Goldstein has something regarding this. He seems to have some keen insights into this sort of thing. I don't know what opioid (mu-type?) agonists are available to try.

As far as dopamine receptor ligands are concerned, if low-dose antagonsists hurt (amisulpride), maybe low-dose agonists (bromocriptine) would help. Simplistic.

I've never tried codeine. It might be an interesting experiment.

Andrew, I agree with your posture on a trial of ketamine. Good luck.

- Scott

> Dear Scott and Shellie,
> I noticed that both of you have responded to lamotrigine and temporarily to an MAOI and little else. (Doesn't Anita have a similar profile?). Do you think that possibly you are birds of a feather, sharing, at least in part, a similar underlying dysfunction?
> Concerning Ketamine, it can be a very dangerous drug. It causes schizophrenic, psychotic and disassociative states as well as amnesia. It also is a street drug, some people enjoy the disassociative state it seems. It also has an important use as an anesthesia.
> As you know, some drugs act very differently at low doses than high, so we shouldn’t immediately condemn ketamine because of its effects at higher doses.
> Is it an AD and arousal agent at lower doses? Dr. Goldstein claims that for many it is, and these effects are not just short term. He also hasn’t noted a tendency for his patients to increase their doses and abuse the drug. The one person I have corresponded with who takes the low dose ketamine nasal spray confirms that it is an arousal agent, AD and cognition enhancer for him. But he also says it is fickle. There is a fine line between an effective dose and too much. Besides a couple of very short term studies, there are only these anecdotal reports indicating it can help with depression. I will try it in a week or so and let you know what I think. Its effects are short enough in duration that I don’t think I am risking much in trying it.
> Scott, I have been corresponding with Shellie and I want to fill in a few details about her drug responses (I hope you don’t mind Shellie) and ask you whether she may have dopaminergic dysfunction (hypofunction?)
> On Adderall (and also ritalin and dexadrine) she felt her body pulsating and felt drugged. These stimulants of course also act on NE. Do the above symptoms indicate either excess dopamine or NE?
> Here are Shellie’s reactions to other drugs:
> Tricyclics completely fog her
> Hydrocodone energizes her
> Naltrexone after one day made her feel awful
> Risperadone, one dose made her body stiff and speech slurred.
> Seroquel, one dose of it kept her up all night
> Amisulpride, one dose of only 25mgs completely fogged her head and gave her a shaky feeling.
> Scott, I suggested to Shellie that, like another person I am corresponding with, she may be supersensitive to amisulpride. The symptoms to me resemble an overdose of amisulpride. I suggested she try taking 6.25mg taken twice daily. The other person I mentioned seems to be doing well (time will tell) at 12.5 taken twice a day. I am thinking she may be even more sensitive.
> So what do you make of all this Scott. Are there any clues here as to her dopaminergic function.
> Best wishes,
> AndrewB




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