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Re: any namenda/memantine experiences? novelagent

Posted by SLS on March 22, 2012, at 14:58:30

In reply to Re: any namenda/memantine experiences? SLS, posted by novelagent on March 22, 2012, at 12:01:15

> I think depression sounds more like it's a sign of toxicity than it is a general side effect.

I don't think so. Cholinesterase inhibitors tend to be depressogenic at therapeutic dosages. In addition, they are more likely to reduce mania than to trigger it. However, as we both know, reactions to psychoactive drugs can be quite variable.

> anyhow, back to your point: cholinergic drugs aren't depressing;

Cholinesterase inhibitors can be, although not universally so. They even make rats more depressed.

http://www.ncbi.nlm.nih.gov/pubmed?term=donepezil%20depressogenic

http://books.google.com/books?id=X7XLhltqsv8C&pg=RA3-PA24&lpg=RA3-PA24&dq=cholinesterase+inhibitors+depressogenic&source=bl&ots=d61SRUqsE3&sig=GvQm5aacima3iDmZ6yLmSzK8U7k&hl=en&sa=X&ei=xX1rT4q5DaTf0QHU8b3UBg&ved=0CDYQ6AEwATgK#v=onepage&q=cholinesterase%20inhibitors%20depressogenic&f=false

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076045/

"Furthermore, in contrast to ChEI trials in dementia, where improvements in neuropsychiatric symptoms have been noted 15, 16, we detected a clinically significant increase in recurrent episodes of major depression. This observation may be consistent with the cholinergic hypothesis of mood disorders 19, 20, which holds that persons with depression show cholinergic hypersensitivity to depressogenic effects of cholinoceptive agents. The observation is also consistent with a recent report of scopolamines antidepressant efficacy in major depressive disorder.21 Such episodes may further amplify cognitive impairment and associated disability, thus offsetting the temporary gains in cognition observed earlier on. The positive effects of donepezil--modest cognitive and functional enhancement and slowing of dementia conversion rate-- must be weighed against the risk of recurrence of major depression in those with mild cognitive impairment and possible appearance of manic symptoms and worsening of suicidal ideation or behavior."

From what I have seen, cholinesterase inhibitors are of little value in mental illness. They don't even help with depression in Alzheimers, and they don't help with cognition in depression.

I guess we currently have a difference of opinion.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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poster:SLS thread:1012702
URL: http://www.dr-bob.org/babble/20120316/msgs/1013640.html