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Re: Keppra (levetiracetam) for bipolar disorder? SLS

Posted by zeugma on August 17, 2005, at 16:29:03

In reply to Re: Keppra (levetiracetam) for bipolar disorder? zeugma, posted by SLS on August 17, 2005, at 7:52:45

Hi Scott.


>
> > > Pemoline?
> >
> > Tried it, worked great, was taken off it because of drastic weight loss.
> > >
> > >
> > >
> > Do you consider modafinil an indirect DA agonist?
>
> I am still undecided. So far, this drug has demonstrated increases in glutamatergic neurotransmission in at least two structures: the thalamus and the hypothalamus. Excitation of the neurons in the thalamus might stimulate DA neurons elsewhere in the limbic system such as the nucleus accumbans to produce reward. In the hypothalamus, certain nuclei are encouraged to secrete a substance called hypocretin, which when it reaches the cortex produces wakefulness. These are not necesarily dopaminergic. Modafinil has not been shown to be effective in treating ADHD.>

It is effective for my disorder, whatever its etiology, although it treats different symptoms than Ritalin. For example:

Color perception:

Improves on Ritalin dose-dependently, no effect from modafinil.

Physical coordination: Improves on modafinil, no effect or worsened on Ritalin.

Reaction time: improved on Ritalin, slowed on modafinil.

Pattern perception: improved on both, but more so on modafinil.

Organization: improved on modafinil, no effect or only slightly improved on Ritalin, and any improvement on Rit HIGHLY dose-dependent.

Color perception is known to be dopaminergically mediated, and this argues against a strong role for modafinil as dopaminergic.

Hypothalamically mediated parameter:

Appetite: Modafinil is the only drug on which I have an appetite. Modafinil is the only drug on which I have demonstrated weight gain. Appetite is known to be orexinergically (aka hypocretin) mediated- the word 'orexin' means 'appetite' in Greek. I have narcoleptic as well as appetitive problems, and both are orexinergically mediated and localized in the hypothalamus.

> >
>
>
>
> > I've heard that Abilify in particular is bad for akathisia, which I have endogeneously.
>
> It could conceivably stabilize DA synapses by acting as a patial agonist rather than a full antagonist as does the other neuroleptics.

Perhaps.

>
> > Modafinil actually works for this problem,
>
> That's interesting. Do you have any theories as to why?

I think the hypothalamus is concerned with the processing of interoceptive, particularly autonomic, stimuli. I think the same dysfunction that causes me to have no appetite also causes spasticity, of which akathisia is a manifestation. Modafinil has been reported to reduce spasticity in cerebral palsy. I consider myself to have some kind of movement disorder, related to hypothalamic dysfunction.

>
> Have you tried anticholinergic drugs like Akineton (biperidin)? They might suppress REM sleep.
>
I was on high doses of Cogentin when treated with an AP. I experienced unusually vivid dreaming during this time, secondary to neuroleptic administration.

> Maybe you can take pemoline and Zyprexa together. That might help with the weight loss issue and confer anxiogenic effects and enhance "clarity of thought".
>

That's an interesting idea. Do you think Zyprexa has cognotropic properties?


-z
>
> - Scott
>


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poster:zeugma thread:538236
URL: http://www.dr-bob.org/babble/20050816/msgs/543101.html