Posted by JohnX2 on November 11, 2001, at 8:53:05
In reply to Re: Refractary bipolar depression To Scott !!!, posted by jazzdog on November 9, 2001, at 11:23:35
Hi Jane,Sorry I didn't get back to you sooner.
I believe a lot of disorders like
depersonalization/derelializtion,post-traumatic
stress-disorder,borderline personality disorder
are not well studied scientifically but seem
to be getting a lot of momentum in the scientific
community as vanilla depression,psychosis,mania
have been beaten to death (no pun intended).
It seems a lot of treatment resistant depression is
co-morbid with other disorders that have no known "proven"
treatment path.Regarding lamictal. It acts primarily by
stabilizing electrolytes (positive,negative
charges) that would stimulate the nmda receptor.
So as such it likely "bands" the eltrical impulses
required to stimulate these neurons to stabilize
them. I think in some cases this would dampen
transmission, put could imagine in other cases
it would indirectly stimulate transmission (say
if another part of the brain that was dampened
somehow in an inverse way stimulated
another). There are areas of the brain where
nmda, which is generally stimulatory, is an input
to gaba neurons, which generally inhibit transmission,
and vice-versa. Lamictal also has some mode of action that is
not totally well understood that is believed to be related to
its anti-depressant qualities; possibly some sort of chemical re-uptake
inhibition.I believe it is possible to get a rapid
response on Lamictal, as it is for any med. I have
read anecdotal evidence of it working quickly for
impulsiveness. Not typical...
but possible. I got a very short lived, rapid response
from lamictal at a low dose (25 mg) when I started.
This happened to me both times I started the med.
I felt a lot less anxious (kind of like xanax) and
a little more in touch with the world. I have had
problems with impulsivness and I also have feelings
of detachment (I don't feel like I can connect emotionally
to people). A lot of disorders related to
blunted affect, depersonalization, schizophernia,
ptsd, blah blah seem to be boiling down to dysfunctional
nmda receptor workings. At least that is what I
have been reading. What exactly are the symptoms of
depersonalization?There are people on pbabble who have studied
lamictal more closely than myself and may have
more insight why it is being found usefull for
these more "fringe" disorders.regards,
john
> >
> > I heard about this topomax + lamictal combo
> > and am also very curious. Seems they work
> > orhoganally, one focusing on NMDA (lamictal) and
> > the other AMPA and GABAa.
>
> Hi John - I'm just learning a bit about brain chemistry, so forgive the naive questions. Is lamictal an NMDA receptor agonist? Is that why it works to enhance cognition and treat depersonalization / derealization? I've just started a tiny dose of lamictal - 6.5 mg to tritrate slowly up to 150 + - along with 50 mg sertraline to treat my derealization and poor cognition. I've also got lifelong depression, so any help there will be good too. The thing is, I could swear that my head cleared for about half an hour the first day I took it. Is this possible on such a tiny dose, or am I imagining things? I'm usually pretty good at self-assessment for drug reactions, so I'm hoping it's the former. Lamictal is the only treatment so far for chronic derealization, and I so badly want to escape this waking dream. Thanks - Jane
poster:JohnX2
thread:83508
URL: http://www.dr-bob.org/babble/20011104/msgs/83881.html