Posted by SLS on January 19, 2002, at 11:30:45
In reply to Re: Mood-reactivity in atypical depression., posted by petters on January 19, 2002, at 1:35:00
Hi Petters.
I was hoping you'd be here up!
> By the way. Have you tried amantadine?
Not yet.
> I think you can get more mileage from your present meds by adding amantadine
That's an interesting way of looking at it. I will be excited to give it a try.
> or ( bupropion, but I think, if I´m not remember wrong, that you already tried it without success)
Your memory is not wrong, and I appreciate the concern for me that you demonstrate.
Thanks for reminding me about amantadine. It definitely is worth a try because I experience a mild improvement with Lamictal (lamotrigine), a drug that functionally reduces glutamate NMDA receptor stimulation. Amantadine does share to some degree the NMDA receptor antagonist properties with its sister drug, memantine. Ideally, memantine will soon become available. It might be that NMDA receptor antagonism results in an increase or modulation of dopaminergic activity in localized brain circuits.
> Sorry, I don´t have more to come up with.
I'll forgive you just this one time. :-) leende
> By the way. I am quite ok. I try to replace Remeron, because of reccurent infections.
Why did you conlude that Remeron caused the infections? Is this a common side effect?
> My current mix: Effexor + Remeron + Lamictal + Litium. Result:Aproximately 80% recovery.
For me, 80% would justify dedicating my first orgasm in remission to the chemists who discovered the drugs that provide it. At 50%, I am sure that I could funtion well enough to remain employable and squeeze enough joy and experience out of life to still make it worthwhile. I think I could make my peace with God and accept a muted existence. However, I will never concede defeat and reconcile the imprisonment of my mind such as to allow me to discontinue my consuming quest to actualize my potential - a potential that has occasionally been revealed to me as the brief awakenings afforded me by somatic treatments. I know in my mind and in my heart and in my soul what it is that could have been, and more importantly, what can yet be. It is too much for me to passively ignore and quietly abandon.
Any suggestion in replacing Remeron with?
I guess it depends on what properties of Remeron you think are important. For 5-HT2 antagonism, there is nefazodone, ritanserin (if you can find it), and the atypical neuroleptics (olanzapine, ziprasidone, and risperdal). For NE alpha-2 antagonism, there is yohimbine and buspirone. I would consider buspirone first as it also acts as a partial agonist of 5-HT1a. The stimulation of these autoreceptors might possibly act to disinhibit dopaminergic circuits involved in mood and motivation. Buspirone would be my first choice as it has demonstrated itself to perform occasionally robustly as an augmentor of antidepressants. It is not the parent azapirone molecule, buspirone, that affords NE alpha-2 antagonism, but rather, its principle metabolite, 1-(2-pyrimidinyl-piperazine). I don't know at this point how to regard the modest DA2 antagonism produced by buspirone.
> I have nightmare from Efexor. Cyproheptadine, or..?
I don't know. I believe that the intensity of your nightmares are likely due to a synergy between Effexor and Lamictal. Please post the results of your investigations into this matter. I can see why you chose cyproheptadine. How does it work? Histamine?
I'm getting sick of looking at all of this biological psychiatry stuff. Just tell me how many little pink pills to take in the morning with my orange juice (and not grapefruit juice), and let me go back to selling Hondas. I'd like to have some fun and disassemble a VTEC engine head to understand the performance design principles and mechanical implementation of Honda's electronically controlled variable valve timing and valve lift. I'll let the technicians put it back together, of course.
Petters - If you are interesting in corresponding with me, my e-mail address is:
Has the sun risen yet? :-) (leende)
Sincerely,
Scott
poster:SLS
thread:90736
URL: http://www.dr-bob.org/babble/20020116/msgs/90763.html