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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by JahL on November 26, 2001, at 12:17:52
Hello.
Just been listening to the (BBC) radio & heard a report on a new drug for social anxiety being developed in Glagow, Scotland. The head of the research project is one Dr. Carol Ferguson.
Apparently it's been tested on hundreds of volunteers since March & could be available on prescription in the UK by the end of the year. It seems to work in around 2-3 weeks and reports are encouraging (hence the radio rpt of course).
My suspicion is that it could be PREGABLIN, which KregPark mentioned a while back (or is it just another SSRI?). Anyone able to shed any more light on this?
Any thoughts on Pregablin, all you clever types?
On a separate note, I'm due to see one of the country's top pharmacologists and would appreciate any ideas on novel BPII treatments I can throw at the guy. Naturally I will ask about the aforementioned med.
Ta,
J
Posted by Mitch on November 26, 2001, at 13:22:51
In reply to New Drug 4 Social Phobia. BPII., posted by JahL on November 26, 2001, at 12:17:52
> Hello.
>
> Just been listening to the (BBC) radio & heard a report on a new drug for social anxiety being developed in Glagow, Scotland. The head of the research project is one Dr. Carol Ferguson.
>
> Apparently it's been tested on hundreds of volunteers since March & could be available on prescription in the UK by the end of the year. It seems to work in around 2-3 weeks and reports are encouraging (hence the radio rpt of course).
>
> My suspicion is that it could be PREGABLIN, which KregPark mentioned a while back (or is it just another SSRI?). Anyone able to shed any more light on this?
>
> Any thoughts on Pregablin, all you clever types?
>
> On a separate note, I'm due to see one of the country's top pharmacologists and would appreciate any ideas on novel BPII treatments I can throw at the guy. Naturally I will ask about the aforementioned med.
>
> Ta,
> JJahL,
I am on Neurontin now (gabapentin). Pregabalin is supposed to be a more potent form of gabapentin. I suspect that is the med you heard about. I will be first in line at the pharmacy the day it comes out!
Mitch
Posted by jazzdog on November 26, 2001, at 14:32:40
In reply to New Drug 4 Social Phobia. BPII., posted by JahL on November 26, 2001, at 12:17:52
Hi Jahl -
I assume you're going to ask the pharmacologist about the derealization disorder we both suffer from. I'd be very interested in what he has to say.
Thanks - Jane
Posted by geno on November 26, 2001, at 15:50:59
In reply to Re: New Drug 4 Social Phobia. BPII. » JahL, posted by jazzdog on November 26, 2001, at 14:32:40
> Hi Jahl -
>
> I assume you're going to ask the pharmacologist about the derealization disorder we both suffer from. I'd be very interested in what he has to say.
>
> Thanks - Jane
Ya just like GHB is going to by (xyrem) for narcoepsy in 2003. NOTHING tops this for social phobia. But you have to watch you dont fall asleep too fast. I guess i suffer from derealization when on and off ghb.hahah
geno
Posted by Alan on November 26, 2001, at 16:26:03
In reply to New Drug 4 Social Phobia. BPII., posted by JahL on November 26, 2001, at 12:17:52
> Hello.
>
> Just been listening to the (BBC) radio & heard a report on a new drug for social anxiety being developed in Glagow, Scotland. The head of the research project is one Dr. Carol Ferguson.
>
> Apparently it's been tested on hundreds of volunteers since March & could be available on prescription in the UK by the end of the year. It seems to work in around 2-3 weeks and reports are encouraging (hence the radio rpt of course).
>
> My suspicion is that it could be PREGABLIN, which KregPark mentioned a while back (or is it just another SSRI?). Anyone able to shed any more light on this?
>
> Any thoughts on Pregablin, all you clever types?
>
> On a separate note, I'm due to see one of the country's top pharmacologists and would appreciate any ideas on novel BPII treatments I can throw at the guy. Naturally I will ask about the aforementioned med.
>
> Ta,
> J
Neurontin.Alan
Posted by JahL on November 26, 2001, at 17:13:37
In reply to Re: New Drug 4 Social Phobia. BPII., posted by Alan on November 26, 2001, at 16:26:03
> Neurontin.
>
> AlanNah, just what I hoped it wouldn't be, another effing SSRI. I found this press release on the BBC site:
"The drug is manufactured by the pharmaceutical firm Lundbeck. A similar drug, Citalopram, manufactured by the same company, is licensed in the UK for the treatment of panic attacks and depression.
*Escitalopram* works by modifying levels of a brain chemical called serotonin, which is known to influence mood. "
Mystery over.
J.
Posted by Krazy Kat on November 26, 2001, at 17:23:42
In reply to Re: New Drug 4 Social Phobia. BPII. » JahL, posted by Mitch on November 26, 2001, at 13:22:51
Mitch:
Do you know any more about it? Does it have the same low side effect profile?
Thanks for your comments previously re: my problems with Depakote and Prozac. I have lowered the Prozac and the anxiety/mania have gone down, and I lowered the Depakote. I'm doing better but still tired. I think I may need to lower the Prozac more due to a recent manic episode though (I almost left my husband!). I still can't understand how one can go through that and not see it, especially when it happens frequently.
Neurontin is still my "favorite" med - it just wasn't strong enough for me.
This is exciting.
Hope you're well.
- K.
Posted by JahL on November 26, 2001, at 17:46:55
In reply to Re: New Drug 4 Social Phobia. BPII. » Mitch, posted by Krazy Kat on November 26, 2001, at 17:23:42
> Neurontin is still my "favorite" med - it just wasn't strong enough for me.
>
> This is exciting.Sorry to get yr hopes up (see prev. post)! I still think Pregabalin is exciting tho' & I know they're investigating it up in Glasgow. I'll ask...
J.
Posted by Alan on November 26, 2001, at 21:32:38
In reply to Re: New Drug 4 Social Phobia. BPII. » Krazy Kat , posted by JahL on November 26, 2001, at 17:46:55
>
> > Neurontin is still my "favorite" med - it just wasn't strong enough for me.
> >
> > This is exciting.
>
> Sorry to get yr hopes up (see prev. post)! I still think Pregabalin is exciting tho' & I know they're investigating it up in Glasgow. I'll ask...
>
> J.
************************************************Neurontin is an antiepileptic or antiseizure med, not an ssri.
Alan.
Posted by Mitch on November 26, 2001, at 23:16:40
In reply to Re: New Drug 4 Social Phobia. BPII. » Mitch, posted by Krazy Kat on November 26, 2001, at 17:23:42
> Mitch:
>
> Do you know any more about it? Does it have the same low side effect profile?I think it has the same paranoia surrounding it that Neurontin (gabapentin) did about pancreatic tumors (I think phase III trials were stopped briefly because of that). There evidently was supposed to be a slight risk of that-well we know where slight risks can lead to these days. Many "useful" meds that are quite old probably would have much trouble being approved with today's standards. There also are a lot of folks with intractable epilepsy that may find relief with Pregabalin as well. I know there are trials in my hometown with Neurontin as *monotherapy* for generalized ("grand-mal") epilepsy. It is much easier to get an anti-convulsant approved as an adjunct (an "add-on"), than it is to get it approved as monotherapy (it's cheaper and easier).
>
> Thanks for your comments previously re: my problems with Depakote and Prozac. I have lowered the Prozac and the anxiety/mania have gone down, and I lowered the Depakote. I'm doing better but still tired. I think I may need to lower the Prozac more due to a recent manic episode though (I almost left my husband!). I still can't understand how one can go through that and not see it, especially when it happens frequently.FWIW, When I was on Prozac, the MAX I could handle (period) was 5mg/day. Doses as low as 2.5mg/day could still trigger hypomania. It puzzles and frustrates me that SSRi's help my SP symptoms the best, but they also aggravate hypomania. Oddly enough, I *like* Depakote as far as positive effects go (at low doses), but the weight gain and cognitive dulling/fatigue really hinders things.
>
> Neurontin is still my "favorite" med - it just wasn't strong enough for me.I have found through a LOT of trial and error that antidepressants can't be avoided entirely. It seems that if you can find the absolute minimum dose of an AD that has the most positive effects for you-stick with that. THEN, add the mood stabilizer(s) in a little at a time, DON'T start upping AD's to compensate for sfx of the "mood stabilizers", back off the dosage of the MS or switch, etc. to get things straightened out.
Mitch
>
> This is exciting.
>
> Hope you're well.>
> - K.Yes, I am doing relatively OK. My major depressions seem to respond better to stim-like AD's in low doses for me (Wellbutrin/nortriptline), with a little Zoloft (2mg/day) to "dust" the 5-Ht transporters with to combat anxiety/panic/SP stuff.
Mitch
Posted by JahL on November 26, 2001, at 23:58:56
In reply to Re: New Drug 4 Social Phobia. BPII., posted by Alan on November 26, 2001, at 21:32:38
> ************************************************
>
> Neurontin is an antiepileptic or antiseizure med, not an ssri.
>
> Alan.Who said it was an SSRI? And what's Neurontin got to do with all this?
(a confused) J.
Posted by Krazy Kat on November 27, 2001, at 10:10:03
In reply to Re: New Drug 4 Social Phobia. BPII. » Krazy Kat , posted by Mitch on November 26, 2001, at 23:16:40
> The "tweeking" you have done with your med regimen is very encouraging to me. I don't want to be "flat" but I can't continue to have "episodes" that could turn my life upside down. So I'm going to continue to work with it. Thinking of adding a Benzo if my pdoc approves for some anxiety and trouble drinking b/c of it. I think I'm also going to lower the Prozac to 20 mg a day (did I already mention that?).
Glad you're O.K. I have to say that since starting Depakote I have not had any major or moderate depressive episodes, which is great, and quite contradictory to most folks, I understand.
- K.
Posted by SLS on November 27, 2001, at 13:33:57
In reply to Re: New Drug 4 Social Phobia. BPII. » Alan, posted by JahL on November 26, 2001, at 23:58:56
>
> > ************************************************
> >
> > Neurontin is an antiepileptic or antiseizure med, not an ssri.
> >
> > Alan.
>
> Who said it was an SSRI? And what's Neurontin got to do with all this?
>
> (a confused) J.
Mitch's characterization of pregabalin is accurate.Pregabalin was developed as an anticonvulsant. Like gabapentin (Neurontin), it is structurally similar to the inhibitory "calming" neurotransmitter, GABA (Gamma-Amino-Butyric-Acid). However, neither drug seems to act like GABA in the brain. Both drugs appear to block certain kinds of calcium channels along the neuron. I'm sure they do other things as well.
Among the therapeutic potentials that both Neurontin and pregabalin share are:
1. Anticonvulsant - seizures disorders
2. Anxiolytic - anxiety disorders
3. Antinociceptive - pain disordersI guess #2 is where social phobia fits in.
- Scott
Posted by Mitch on November 27, 2001, at 13:45:53
In reply to Re: New Drug 4 Social Phobia. BPII. » Mitch, posted by Krazy Kat on November 27, 2001, at 10:10:03
> > The "tweeking" you have done with your med regimen is very encouraging to me. I don't want to be "flat" but I can't continue to have "episodes" that could turn my life upside down. So I'm going to continue to work with it. Thinking of adding a Benzo if my pdoc approves for some anxiety and trouble drinking b/c of it. I think I'm also going to lower the Prozac to 20 mg a day (did I already mention that?).
>
> Glad you're O.K. I have to say that since starting Depakote I have not had any major or moderate depressive episodes, which is great, and quite contradictory to most folks, I understand.
>
> - K.Hi,
I think the Prozac reduction is a good idea. It will be easy to do because of the long half-life. It will probably take nearly a month to reach a steady-state level after you drop the dose! I am glad you don't have any major depressive episodes on the Depakote. I wished my experience with it was that lucky.
Mitch
Posted by Alan on November 27, 2001, at 15:26:30
In reply to Re: New Drug 4 Social Phobia. BPII. » JahL, posted by SLS on November 27, 2001, at 13:33:57
> >
> > > ************************************************
> > >
> > > Neurontin is an antiepileptic or antiseizure med, not an ssri.
> > >
> > > Alan.
> >
> > Who said it was an SSRI? And what's Neurontin got to do with all this?
> >
> > (a confused) J.
>
>
> Mitch's characterization of pregabalin is accurate.
>
> Pregabalin was developed as an anticonvulsant. Like gabapentin (Neurontin), it is structurally similar to the inhibitory "calming" neurotransmitter, GABA (Gamma-Amino-Butyric-Acid). However, neither drug seems to act like GABA in the brain. Both drugs appear to block certain kinds of calcium channels along the neuron. I'm sure they do other things as well.
>
> Among the therapeutic potentials that both Neurontin and pregabalin share are:
>
> 1. Anticonvulsant - seizures disorders
> 2. Anxiolytic - anxiety disorders
> 3. Antinociceptive - pain disorders
>
> I guess #2 is where social phobia fits in.
>
>
> - Scott**********************************************
Thanks Scott for clarifying. This is my understanding too.
Alan
Posted by JahL on November 27, 2001, at 16:00:47
In reply to Re: New Drug 4 Social Phobia. BPII., posted by Alan on November 27, 2001, at 15:26:30
> > Mitch's characterization of pregabalin is accurate.
> >
> > Pregabalin was developed as an anticonvulsant. Like gabapentin (Neurontin), it is structurally similar to the inhibitory "calming" neurotransmitter, GABA (Gamma-Amino-Butyric-Acid). However, neither drug seems to act like GABA in the brain. Both drugs appear to block certain kinds of calcium channels along the neuron. I'm sure they do other things as well.
> >
> > Among the therapeutic potentials that both Neurontin and pregabalin share are:
> >
> > 1. Anticonvulsant - seizures disorders
> > 2. Anxiolytic - anxiety disorders
> > 3. Antinociceptive - pain disorders
> >
> > I guess #2 is where social phobia fits in.
> >
> >
> > - Scott
>
> **********************************************
>
> Thanks Scott for clarifying. This is my understanding too.
>
> AlanMine also. I was asking if anyone knew anything more than the bog-standard (in so far as it has been posted numerous times on this brd) info. Successful trials, anecdotal evidence etc. I still don't understand how the word 'Neurontin' answers any of my original questions...
Anyway, thanx Mitch, Scott. Jazzdog; I'll be sure to ask, don't worry about that! :)I was also hoping someone would have some suggestions 4 novel BPII treatments; my appt. is in just over 24hrs..............................................
J.
Posted by Mitch on November 27, 2001, at 23:50:35
In reply to Re: New Drug 4 Social Phobia. BPII., posted by JahL on November 27, 2001, at 16:00:47
> I was also hoping someone would have some suggestions 4 novel BPII treatments; my appt. is in just over 24hrs..............................................
>
> J.Hi JahL,
I doubt if I could shed any light on *novel* treatments (as monotherapy), but there might be some combinations to consider (that may or not be novel ones for you).
I have had BPII for over 25 years and I understand how antidepressants can accentuate the polarization of cycling (I have my doubts about the "aggravating the course of the illness" kindling theory, however-specifically in regard to BPII as a subtype-my most intense hypomanias were in my 20's and the hypomanias seem to have "burned out" to some degree with age).
IF you don't have a history of either "free-floating" or "situational" panic attacks, I really think that a pstim like Adderall or Dexedrine in a low dose has the best efficacy for bipolar depression and even seems to have a *mood-stabilizing* effect. If you don't have probs with panic, then, maybe a low-dose pstim in combination with a mood-stabilizer could work for you. I found Neurontin+Adderall worked superbly, but I have comorbid panic history that the pstim seemed to cause a lot of trouble with over time. If you can find a way to get away from (or minimize) antidepressants to treat *anxiety* and stay stable on something else (like a pstim) that will effectively treat the bipolar depression-you have got it made.
Mitch
Posted by JahL on November 28, 2001, at 11:36:01
In reply to Re: New Drug 4 Social Phobia. BPII. » JahL, posted by Mitch on November 27, 2001, at 23:50:35
> I understand how antidepressants can accentuate the polarization of cycling (I have my doubts about the "aggravating the course of the illness" kindling theory,
Actually the theory proved to be true for me. Ever since I understood the concept of death I have been chronically suicidal. However when I began SSRIs the suicidal feelings became more acute. Effexor was the last straw & it wiped the floor with me. Ever since (& this goes back a few years) I've been acutely suicidal with no let-up. I have to take 3 medications a day just to feel twice as bad as I did before I sought treatment :-(
> IF you don't have a history of either "free-floating" or "situational" panic attacks,Just free-floating anxiety & social phobia.
> I really think that a pstim like Adderall or Dexedrine in a low dose has the best efficacy for bipolar depression and even seems to have a *mood-stabilizing* effect. If you don't have probs with panic, then, maybe a low-dose pstim in combination with a mood-stabilizer could work for you. I found Neurontin+Adderall worked superbly, but I have comorbid panic history that the pstim seemed to cause a lot of trouble with over time.
Unfortunately I've been to the States to try all the various pstims. Nothing, even @ high doses. This wasn't surprising; I used to take a lot of meth in base form & all it did was allow me to dance all night. Oh and some 'nice' insects-in-yr-hair hallucinations. The fact that I've tried over 40 meds shows you I've pretty much exhausted all conventional options.
>If you can find a way to get away from (or minimize) antidepressants to treat *anxiety* and stay stable on something else (like a pstim) that will effectively treat the bipolar depression-you have got it made.
Indeed. Trouble is, stability isn't what I'm after. My BPII is characterised by profound, unremitting depression, for which I need something with AD properties (I currently take Lamictal). I'm not sure what the answer is...I'm keen to add another MS or 2 but UK pdocs are v hesitant to engage in polypharmacy.
I guess I'm looking for this kind of stuff:
http://people.ne.mediaone.net/pmbrig/BP_pharm.htmlThanks,
J.
Posted by Mitch on November 28, 2001, at 12:20:17
In reply to Re: Social Phobia / BPII. » Mitch, posted by JahL on November 28, 2001, at 11:36:01
> >If you can find a way to get away from (or minimize) antidepressants to treat *anxiety* and stay stable on something else (like a pstim) that will effectively treat the bipolar depression-you have got it made.
>
> Indeed. Trouble is, stability isn't what I'm after. My BPII is characterised by profound, unremitting depression, for which I need something with AD properties (I currently take Lamictal). I'm not sure what the answer is...I'm keen to add another MS or 2 but UK pdocs are v hesitant to engage in polypharmacy.
>
> I guess I'm looking for this kind of stuff:
> http://people.ne.mediaone.net/pmbrig/BP_pharm.html
>
> Thanks,
> J.
Jah,FWIW, I found that Trileptal (oxcarbazepine) had a definite AD effect for me (it seemed to *increase* attentiveness). I just couldn't stand the nausea. Maybe oxcarbazepine isn't available in the UK just yet? Maybe you could tolerate it?
Mitch
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