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Re: New med advice? (sorry, long post!) » kagome

Posted by SLS on March 11, 2012, at 6:15:57

In reply to Re: New med advice? (sorry, long post!), posted by kagome on March 11, 2012, at 0:59:00

> I'm somewhat interested in Lithium, but I've never been diagnosed as bipolar.

Low dose lithium (300 - 600 mg) has long been used as an adjunct to antidepressants in unipolar depression. An old trick is to add lithium to Parnate.


THE BIPOLAR SPECTRUM

BIPOLAR I: Both mania and major depression

BIPOLAR II: Major depression and hypomania

BIPOLAR III: Cyclothymia. Mild depression and hypomania

BIPOLAR IV: Depression and usually no mania. Mania may be triggered by some
antidepressants.

BIPOLAR V: Depression and no mania. Some blood relatives have had mania

BIPOLAR VI: Mania and no depression


The following description is a form of bipolar disorder that is due to be included in the new DSM V.

"Bipolar V involves patients who only experience depressive symptoms as a diagnosis of major depressive disorder, but have a family history of bipolar disorder. The knowledge of bipolar disorder existing in family history would suggest starting depression treatment with a mood-stabilizer or an antipsychotic that treats depression. Because of the family history, if a patient was started on an antidepressant it could easily act as the trigger for developing bipolar because it produced manic symptoms (type IV). In family studies, the link between genetics and mental disorder has been proven to be strong. Patients should remember that genetics doesn't doom them to developing a disorder, there must be a trigger."

> I'll definitely look more into Prazosin. Do you feel like it's helped mood-wise

Yes. :-)

> bad memory-wise

Yes. :-)

> sleep-wise

Yes. :-)

> etc?

Yes. :-)

My sleep is better, but still somewhat disturbed, presumably as a result of my taking Parnate.

> As I mentioned before I'm an abuse survivor so it's definitely something to think about, I just have doubts about a blood pressure med doing much for the suicidal depression that is most troubling right now.

Prazosin is not a blood pressure medication. It is a chemical compound with blood pressure lowering properties. It also has other properties, including reducing PTSD symptoms, especially sleep disturbances and nightmares. It also seems to help with daytime anxiety and depression.

I almost didn't try prazosin because I thought my doctor was reaching for sh_t. I didn't believe that it would help, but I didn't think it would hurt. So, I let my doctor take his shot.

Prazosin blocks all three types of norepinephrine receptors: NE alpha-1a/b/d receptors.

Prazosin readily enters the brain.

Prazosin might block the NE alpha-1b receptors found in areas of the brain known to be hyperactive in depression. This is just a theory of mine. One site that I am interested in is the subgenual anterior cingulate Brodmanns Area 25.

After being on prazosin for awhile, I do not experience dizziness, despite being on Parnate.

Prazosin can produce fatigue, weakness, and lethargy early in treatment. These things disappeared within two weeks.

------------------------------------

In an effort to gather more evidence for my theory to relate to you, I just found this:

http://www.ncbi.nlm.nih.gov/pubmed/18704022

"In positron emission tomography studies, the metabolic activity was elevated in this region in the depressed relative to the remitted phases of the same MDD subjects, and effective antidepressant treatment was associated with a reduction in sgACC activity"

I think prazosin might act to "quiet" this elevated metabolic activity in the sgACC (subgenual anterior cingulate cortex).

------------------------------------


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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