Posted by Rick on June 10, 2000, at 16:20:28
In reply to Provigil poop out; klonopin counteracts provigil?, posted by S.D. on June 9, 2000, at 17:14:11
You're right, SD, this is certainly one for the neurology/psychopharmacology experts to chime in on. But at this stage, rat brain GABA-inhibition studies can provide nothing more than theoretical food for thought on the possible clinical effect of adding Provigil in Klonopin-treated human Social Phobia.
There are just so many factors to consider that I cannot even begin to enumerate them (and I'm sure there are even far more considerations that the experts could cite). But here are just a few of the thoughts that come to mind (with the disclaimer that a few of my layman satements *might* reflect incomplete or even plain-wrong understanding of pharmocological or psychiatric issues):
-- GABA reactions to Provigil could be different in socially anxious rats, and certainly could be different in humans.
-- Several of the studies of the anti-GABA effects of Provigil varied from significant in some regions of the brain to nil (or requiring a much higher dose of Provigil) in others.
-- While similar in many ways, different benzos vary in strength and theraputic value. For instance, Klonopin is a high-potency benzo that has been proven very effective in Social Phobia, while Valium usually has no value at all in treating this form of anxiety. Moreover, Klonopin's unique effects in a variety of non-anxiety disorders such as epilepsy, restless leg syndrome, dystonia, and tremor, suggestions a pharmacology which may involve more than simple GABA agonism.
--If I was reading the studies correctly, the observed GABA-reduction with Provigil (and again, occuring only in selected site/dosage situations) maxed at 20%. (It was hard for me to understand the data as presented. I *believe* the 80% figure cited represented the amount of GABA *maintained* at those sites, but maybe it instead referred to GABA *reduction* levels.) A 20% maximum reduction would proably not have much clinical import, especially if other significant sites were unaffected.
-- For me, concurrent use of three C
poster:Rick
thread:36517
URL: http://www.dr-bob.org/babble/20000610/msgs/36855.html