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Re: OCD Dont know where to go

Posted by ed_uk2010 on February 1, 2015, at 13:56:27

In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 13:10:41


>I tested positive for a MTFHR gene mutation....

Was this done because you were found to have elevated homocysteine levels, or perhaps because you have a family history of cardiovascular disease? I believe mutations are common in people with psych problems too. It's not a particular common test to have though. I suppose you will have seen quite a few different specialists.

I know you don't respond well to Deplin. I assume you've had your folate and B12 levels measured and any deficiencies corrected?
Do you know how you respond to supplements of folic acid, vitamin B12 and vitamin B6 (pyridoxine)?

>Also just got a DNA test done too so maybe that will tell me something.

What have you been tested for? CYP 2D6 status?

>Zoloft was at 50mg for 3 days haha.

Clearly, you can't take Prozac again since you seem to be allergic. And Luvox produced some bad reactions.... so you won't be going there again.

So, Zoloft 50mg made you agitated?

>I get primarily anticholinergic se from them like memory loss

'Anticholinergic' means a drug which blocks muscarinic acetylcholine receptors. Although some of the side effects you've experienced sound superficially similar to certain anticholinergic symptoms, none of the drugs you've taken are strongly anticholinergic and most are not anticholinergic at all. Memantine is not thought to be anticholinergic - your side effects are presumably occurring via a different mechanism. There are many different neurotransmitters and processes involved in memory other than acetylcholine. In addition, norepinephine plays a major role in the urinary tract.

Potent anticholinergic drugs such as tolterodine and oxybutynin have the effect of relaxing the bladder muscle and reducing the urge to urinate. These drugs are used to treat urge incontinence. They do not generally cause dribbling. Dribbling is most common in older men, due to prostate disease, but can occur in younger men due to drugs which constrict the bladder outlet. SNRIs, NRIs and stimulants can do this, via indirect alpha adrenergic receptor stimulation.

It's not clear to me by what mechanism Prozac would cause urinary retention. It's anticholinergic effect is so weak as to be irrelevant, so there must be another cause. It is a very weak NRI, but that doesn't seem a likely cause either. It's confusing.

What were the urinary effects of the SNRI Cymbalta for you?




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