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Re: any luck with NEURONTIN? legal KETAMINE? iforgotmypassword

Posted by neuroman on October 3, 2005, at 12:30:15

In reply to any luck with NEURONTIN? legal KETAMINE?, posted by iforgotmypassword on September 30, 2005, at 17:42:58

Hi,

Sorry I missed this thread. I love Dr. Goldstein's book. When I read his theory as to why people develop neurosomatic illnesses (CFS, chronic pain, etc.) I was like, "Yes! Someone finally understands!" Unfortunately, the only doctor that "gets it" is retired... :-(

> i'm kind of finding the structure of this book really random, is there a best way to read it.

I know what you mean. Dr. Goldstein was a great doctor, but he's a lousy writer. I had to read it several times before some stuff started sinking in. Also, I would suggest using a hi-lighter.

> he spoke very highly of NEURONTIN and KETAMINE.

IV ketamine was his most successful treatment. I'm still trying to find a doctor who'll let me try this. Neurontin was his favorite oral medication. I have a huge bottle of it. I like neurontin. It helps me sleep, helps with neuropathic pain and makes me horny?! But it's short duration of action is a major problem for me. If only they had an extended release version.

> he placed much importance on regulating glutamate and antagonizing NMDA receptors, but also even the opposite stimulating NMDA receptors to achieve "salience"... hmm does anyone know what he's getting at here.

It's way beyond my ability to explain all this. The NMDA receptor is responsible for long term potentiation and learning. Apparently, it is the main "coincidance detector". NMDA hyperactivity can lead to overlearning and hypersensitivty of the nervous system to stimuli which are benign to "normal" people but trigger a negative physiological response to someone with a neurosomatic disorder. This is probably why many people with CFS and other neurosomatic disorders are often over-sensitive to psychological and emotional stress and often are bothered by chemical smells and bright lights and loud noises and do poorly in high stimulus environments. Here are some relevant quotes:

"...'salient' is used to refer to stimuli with special biological significance."

"A postulate to which I shall continually refer in this book is that patients with neurosomatic disorders have overly learned and overly generalized associative responses and that the primary molecular basis of this memory dysfunction involves the NMDA receptor."

"One aspect of the pharmacology of ketamine relevant to the subsequent sections is that ketamine decreases one's ability to attend to stimuli, and neurosomatic disorders may be conceptualized as overattending to nonsalient stimuli."

By the way, dopamine is an NMDA antagonist. This is probably why DA and NE raise the signal-to-noise ratio (a good thing) and why he believes low DA (Via transmitter depletion, synaptic fatigue or receptor malfunction, etc.) is one of the main problems in people with neurosomatic disorders.

> he doesn't seem to have as much hope in lamictal, but it does inhibit glutamate right? i have a bunch of it all over my house. it was really helping with anger (i think). would it help to try going past the dose i was once on?

Actually, he thinks it's one of the more useful meds. I'm on a low dose now and it seems to be causing too much suppression of my already low dopamine levels. It may be blocking too many ion channels. I lowered the dose and noticed an increase in diffuse neuropathic pain. I don't know if I should stick with it and add something to it or if I should stop it. I'm always worried I'm going to do more damage to my already fried brain/nervous system. This stuff is hard to figure out when you trying to do it on your own.

Paul


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