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Re: got a zanaflex prescription; wish me luck JohnX2

Posted by Elizabeth on December 1, 2001, at 14:44:40

In reply to Re: got a zanaflex prescription; wish me luck, posted by JohnX2 on November 30, 2001, at 18:07:17

> I've seen many references to Clonodine (Catapres)
> being used for benzo withdrawl. I think this is
> fairly common.

Well, I hope it works. I'm familiar with the use of clonidine (the correct spelling, BTW :-) ) and other such drugs for opioid withdrawal, although the alpha-2 agonists have a reputation for not being very helpful in that situation (they alleviate a couple of the more minor symptoms, that's it). Perhaps they're more helpful in benzo withdrawal.

> Zanaflex has a crummy 1/2 life (time in your body)
> so if it works I may need to take many doses
> in one day.

Indeed. Can I ask why your doctor chose it over clonidine or guanfacine (Tenex, another alpha-2 agonist)?

> Another med that
> I have seen references to treat benzo withdrawl
> is Baclofen.

Baclofen is a GABA-2 agonist. I've tried it as a muscle relaxant, and it didn't work at all, while benzos worked sometimes but were not reliable. I also know a guy who tried using baclofen to substitute for benzos (to prevent withdrawal, if nothing else) and reported that it didn't work at all. I have seen some possible preclinical evidence that it would have antitolerance properties, but nothing in humans. I hope that if you try it, it is helpful for you, in one way or another.

> I have also had success with Neurontin.

Now that seems like a good idea, although I have heard a few stories of people trying it without success (the dose may have been inadequate).

> It also seems that nmda antagonists like memantine
> share similar properties.

FWIW, there's an over-the-counter NMDA antagonist, dextromethorphan, that is sold as a cough suppressant. It's found in such products as Robitussin Maximum Strength, although most things that have dextromethorphan also have other things in them that you don't necessarily want (such as pseudoephedrine, antihistamines, or guaifenisen).

> I believe some of these atypical
> meds I have been studying like Zanaflex and memantine
> could be novel adjuncts for people with treatment
> resistant depression associated especially with
> a response that "poops out".

That's possible, and it certainly ought to be investigated. Two things to watch out for: clonidine (and probably other alpha-2 agonists) can worsen depression; and there was once hope that NMDA antagonists would prevent or slow the development of tolerance to opioids, but this proved not to be the case. So I'm not so sure that they would be any more helpful for antidepressant tolerance.

Interestingly, a small study of ketamine (also an NMDA antagonist) for depression produced positive results. (See: Biol Psychiatry 2000 Feb 15;47(4):351-4. Antidepressant effects of ketamine in depressed patients. Berman RM et al.) I don't believe this result has been replicated, but I would like to see more work in this area.

> Anyways, it is believed that alpha-2 agonists
> may be helpful in depression/anxiety associated with
> post-traumatic stress disorder.

I've heard of them being used to attenuate the startle response (and other hyperarousal sx) and to prevent nightmares in PTSD -- haven't heard anything of interest regarding general anxiety or depression associated with PTSD.

BTW, that's interesting that you get something positive out of ChlorTrimeton (my own antihistamine of choice). Although I prefer to avoid characterizations like "dopamine buzz" that imply a particular mechanism, it does sound like you've found something that helps you and that is relatively safe and easy to use. How much are you taking? (I have to take quite a lot to overcome the histamine release provoked by buprenorphine.)





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