Posted by Mitch on November 13, 2001, at 23:35:31
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » Mitch, posted by JohnX2 on November 13, 2001, at 18:31:22
>
> Guess what Mitch,
>
> The paper discussing this phenomena was
> specifically siting cases of Zoloft! I can
> send you a print if you send me an email address.John, thanks for the feedback, but I really don't need *that* much detail :)-I am on the computer enough as it is (between the web and my work!-eek, that sounds a little macabre somehow).
>
> It recommended buspar as one anti-dote, another
> is a 5ht-2a antagonist. It suggested Serzone (which
> worked great for me) or possibly Remeron (not quite
> great). Didn't mention atypical anti-psychotics, but
> I believe that a dabble of zyprexa et. al may do the
> trick to.Well, can't do Remeron or Buspar due to the alpha-2 antagonist induced irritability (more "dirty" meds hitting receptors like a pin-ball game). If I went back on Serzone I would have to put up with some itching and difficulties seeing/reading, plus it is not very "liver-friendly", either.
>
> The future of the serotonin drugs are either stand alone
> SSRIs with *clean* 5ht-2 antagonism (not dirty like serzone)
> and/or an SSRI with a mixed in clean 5ht-2 antagonist.
> Get rid of those potential rls,eps,sexual dysfunction,
> tension headache,agitation, side effects...
> But what pharmaceutical company will win this horse
> race? Tell me and I'll buy the stock!
> There are from what I understand clean (selective)
> 5ht-2a antagonists in the pipeline and with celexa and
> prozac going off patent I could see those manufacturers
> bundling the clean 5ht-2a meds with the generics in one
> pill....
>
> -johnProbably what is going on there is just bottom-line economics (not that I disapprove-they are also rolling bucks into the *new* stuff). When we start to see the patents expiring for Zoloft, Paxil, and Celexa-THAT is when we will probably see the meds you are talking about start "coming to the surface". If you can make an SSRI tolerable-wow that's where the money would be.
Mitch
> > >Anyways, I did a bit
> > > of research on tension headaches, which are
> > > less vascular, and more related to muscle
> > > contraction spasms. I found that SSRIs can induce
> > > them in an area of the brain where dopamine
> > > counteracts acetylcholine in the stimulation of
> > > the masseter (jaw) muscles. These dopamine neurons
> > > are unique in that they do not contain self
> > > regulating auto-receptors. Their firing is gated
> > > by serotonin receptors (proportional to 5ht-1a
> > > post synaptictic and inversely proportional to
> > > 5ht-2a receptors) at the junction and also by
> > > dopaminergic projections from a pool of dopamine
> > > neurons at the VTA where there are other somotodendric
> > > dopamine neurons gated in a similar manner but by
> > > many afferents (it does have the same serotonin
> > > input). The serotonin input can be exacerbated
> > > by stress. Stress can cause greater serotonin
> > > impulses due to interesting cross talk with
> > > the noradrenergic stress center (the locus
> > > coerulus) and all this indirectly can lead to
> > > bruxism and tension headache because of the
> > > goofed up dopamine modulation. In the hypo-dopaminergic
> > > state a dopaminergic med like Adderall makes the
> > > headache go away, so do 5ht-2a antagonists. This
> > > is in the literature and also my experience.
> >
> >
> > Aha! So, that's why I grind my teeth and get headaches from Zoloft. That is interesting about the 5-HT2a antagonists. Maybe you ought to pitch some Serzone in there (if you are not already)? I noticed that when I took Serzone I had greatly reduced *agitation* and restlesslness and didn't experience any headache or stomach upset (at low doses). The trouble with Serzone was mild pruritis and amyblyopia (big time-had difficulty reading).
> > Maybe a little Serzone with a little Adderall in combination with a mood stabilizer?? Hmm.
> >
> > Mitch
poster:Mitch
thread:50878
URL: http://www.dr-bob.org/babble/20011113/msgs/84178.html