Posted by bleauberry on January 17, 2014, at 7:52:51
In the infection or neurotoxin or inflammation world that I often talk about, some meds appear more useful than others in clinical practice. This information is anecdotal on my part. Dozens of lyme blogs, MD blogs, forums, psych journals, etc...
Antipsychotics seem to be very helpful. Pbabble's own Jereon gave hint of this....Seroquel worked like a miracle the first time it was tried but that same effect did not happen with the others....and Jereon has had "the pattern" we look for with antibiotics, so there is a fair degree of confidence that an infection issue is present. And for the suspected infection patient, which antipsychotic was it that stood out?....Seroquel. My first guess is that since they are blocking a wide variety of receptors, they are also at the same time blocking neurotoxins or other foreign substances from hitting those receptors. The meds give competition to the toxins for binding at the sites. The toxins can longer have free reign, they are partially blocked. A possible hypothesis anyway, and probably only a piece of the puzzle.
Seroquel comes up a lot. I do not know why. I have seen vague mention on pubmed about how it has some inherent antimicrobial mechanism in it. Maybe it somehow triggers a certain gene that we need. I don't know. What I do know is that it often brings immediate and significant help to many people when other meds did not. I personally do not like Seroquel, so there is definitely no bias in this observation. It is what it is. For whatever reason, Seroquel has a unique way of helping.
So now, when I see someone here report a great initial response to seroquel, I cannot help but think....well, suspicions are raised at the very least.
Zyprexa is my favorite. It does not get as much mention as Seroquel does.
Ritalin has benefits for many people with a wide variety of symptoms and diseases. Energy, endurance, mood, motivation, pleasure, brain fog. I find this med a bit harsh with its ups and downs, but with that trade-off there is some definite life quality improvement potential for many sick people. It happens to make my physical symptoms worse on the following day and I haven't figured that out yet, but nevertheless, it is according to my clinicians one of their favorite meds.
SSRIs. Really? This one I have a problem with. I guess that's because they generally made me feel more depressed. But the fact is, they are used a lot in the types of illnesses I talk about. The most common ones seem to be Zoloft and Lexapro. My personal favorites are Zoloft and Prozac.
But here is an important point on the SSRIs. Often in the types of conditions or diseases I talk about, the doses needed are either really tiny, or really huge, but not normal doses. I fall into the really tiny dose group.
To highlight this point, one of the lyme MDs I worked with starts patients with liquid versions of Lex or Zoloft. That's because the starting dose is 1 drop, which is 1/10th of 1mg. Sometimes the final dose where the patient feels best is somewhere in the 1mg to 5mg range! So you can see, anyone who went to doses higher than that, and ran into trouble or noneffectiveness.....the dose was maybe too high! On the other hand, no effect at all, maybe the dose needs to be 40mg, 60mg, 80mg! Yeah, really! I guess the point here is, normal commonly accepted dose ranges could be wrong and could be hindering patient progress. Outside-the-box doses should be tried, in my opinion.
TCAs. These don't appear to be utilized that much. When they are, it is usually for pain not mood. I happen to believe TCAs are not only good for pain, but also good to combine with SSRIs for an effect that neither alone can do.
The TCA Nortriptyline happened to be the only substance that completely made my headaches and stiff neck go away, completely go away. Nothing else did that for me, until later on with antibiotics. Despite I was heavily infected with bad headaches, nortriptyline had the power to completely over ride the symptoms. In the headache department anyway.
Benzos. Usually for that crazy anxiety-like stuff. While these can bring some short term relief, I have rarely seen good outcomes. Poopout, tolerance, and relapse seem almost universally predictable. Xanax and Klonopin appear to be most commonly used. In my experience, depakote or one of several herbs can do a better job with much better outcomes. But for short term relief, it is hard to beat the benzos. Long term, opposite.
Neurontin is a big one. We don't see it much here at pbabble. It is usually for pain issues and sometimes mood.
Of course, there is no "best" med. Each patient will find on their own journey what is best for them. I am merely reporting some of the more commonly used psychiatric meds outside of pbabble, in the lyme/infection/toxin/inflammation world, as seen through my eyes.
imo. patients should do their own research for validation.
poster:bleauberry
thread:1058764
URL: http://www.dr-bob.org/babble/20140104/msgs/1058764.html