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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Maximus on November 7, 2002, at 12:36:26
Hi,
Don't be afraid i will give you the url :-)
This is another outstanding result from Lamictal's use.
Its mechanism of action. So many things have been told about its properties as antidepressant and mood stabizer in the bipolar depression. But how does it work exactly?
We know that a dysregulation (due to stess, genetic, etc.) of the HPA (hypothalamic-pituitary-adrenal) axis can bring a flood of mood disorder such as: depression, anxiety, PTSD, mania, etc.
Thus we know now that Lamictal is a partial glutamate antagonist via the NMDA receptors. So too much glutamate is neurotoxic for the brain. The action of Lamictal on the NMDA receptors would restore the regulation of the HPA and bring back our good mental health.
A lot more here:
http://www.cnsspectrums.com/Articles/july2001/CNS701_Mathew.html
Posted by colin wallace on November 7, 2002, at 16:21:45
In reply to Lamictal resets HPA axis, posted by Maximus on November 7, 2002, at 12:36:26
Great link- the holy grail of the common pathway implicated in affective disorders moves a step closer! Reading this, I see that my frazzled brain has been pulverised by a marauding horde of delinquent glutamate for many years.Glutamate-the Saddam Hussein of all neurons....or maybe the Hun...or Mongols...or Carthagenians...
Posted by colin wallace on November 7, 2002, at 16:25:10
In reply to Lamictal resets HPA axis, posted by Maximus on November 7, 2002, at 12:36:26
Vandals,Vikings or Visigoths.I hate glutamate.
Gimme some GABA.
Posted by Larry Hoover on November 7, 2002, at 17:25:49
In reply to Lamictal resets HPA axis, posted by Maximus on November 7, 2002, at 12:36:26
Excellent review article. Thanks!
By the way, magnesium is excreted in urine during stress, and it acts an an antagonist at the NMDA receptors. Maybe that's one of the ways that stress leads to glutamate hyperstimulation.
Lar
Posted by pelorojo on November 7, 2002, at 19:33:34
In reply to Re: Lamictal resets HPA axis, posted by Larry Hoover on November 7, 2002, at 17:25:49
*newbie alert*
So....if you had PTSD....would it be worth it to discuss this article with your psychiatrist? Possibly request Lamictil?
Regards
KenPTSD/social anxiety/depression boy &newbie! in Austin Texas
Posted by Larry Hoover on November 8, 2002, at 7:59:49
In reply to Re: Lamictal resets HPA axis, posted by pelorojo on November 7, 2002, at 19:33:34
There's one article in Medline. It's a very small, preliminary study.
Biol Psychiatry 1999 May 1;45(9):1226-9
A preliminary study of lamotrigine for the treatment of posttraumatic stress disorder.Hertzberg MA, Butterfield MI, Feldman ME, Beckham JC, Sutherland SM, Connor KM, Davidson JR.
Duke University Medical Center, Department of Psychiatry, Durham, NC, USA.
BACKGROUND: The anticonvulsant, lamotrigine, may be useful for symptom management in PTSD. METHODS: Subjects enrolled in a 12-week double-blind evaluation of lamotrigine and placebo. Patients were randomized 2:1 to either lamotrigine or placebo. Lamotrigine was initiated at 25 mg/day and slowly titrated every 1 to 2 weeks over 8 weeks to a maximum dosage of 500 mg/day if tolerated. RESULTS: Fifteen subjects entered treatment, fourteen of whom returned for subsequent visits. Of 10 patients who received lamotrigine, 5 (50%) responded according to the DGRP, compared to 1 of 4 (25%) who received placebo. Lamotrigine patients showed improvement on reexperiencing and avoidance/numbing symptoms compared to placebo patients. Treatments were generally well tolerated. CONCLUSIONS: Lamotrigine may be effective as a primary psychopharmacologic treatment in both combat and civilian PTSD and could also be considered as an adjunct to antidepressant therapy used in the treatment of PTSD. These promising results warrant further large sample double-blind, placebo-controlled trials.
Posted by freedom2001 on November 8, 2002, at 9:04:14
In reply to Lamictal resets HPA axis, posted by Maximus on November 7, 2002, at 12:36:26
> Hi,
Does Lamictal help with OCD?
>
> Don't be afraid i will give you the url :-)
>
> This is another outstanding result from Lamictal's use.
>
> Its mechanism of action. So many things have been told about its properties as antidepressant and mood stabizer in the bipolar depression. But how does it work exactly?
>
> We know that a dysregulation (due to stess, genetic, etc.) of the HPA (hypothalamic-pituitary-adrenal) axis can bring a flood of mood disorder such as: depression, anxiety, PTSD, mania, etc.
>
> Thus we know now that Lamictal is a partial glutamate antagonist via the NMDA receptors. So too much glutamate is neurotoxic for the brain. The action of Lamictal on the NMDA receptors would restore the regulation of the HPA and bring back our good mental health.
>
> A lot more here:
>
> http://www.cnsspectrums.com/Articles/july2001/CNS701_Mathew.html
>
>
Posted by jaby on November 8, 2002, at 10:57:41
In reply to Lamictal resets HPA axis, posted by Maximus on November 7, 2002, at 12:36:26
Maximus,
How did you make the connection from Lamictal to the NMDA receptor? Someone wrote about this before, but I have yet to be able to find it in scientific literature. I read your link rather quickly, but I don't think it mentioned lamictal. Please let me know as I would be very very interested.
Thanks.
Posted by Maximus on November 8, 2002, at 11:15:12
In reply to Re: Lamictal resets HPA axisMaximus, posted by jaby on November 8, 2002, at 10:57:41
> Maximus,
> How did you make the connection from Lamictal to the NMDA receptor? Someone wrote about this before, but I have yet to be able to find it in scientific literature. I read your link rather quickly, but I don't think it mentioned lamictal. Please let me know as I would be very very interested.
> Thanks.Hi jaby,
Please read again the article carefully, it is mentionned.
You can also do a search with the engine *google*.
Put the following keywords: Lamictal, glutamate, NMDA.
You will have a lot of links.
Regards,
Max
Posted by Maximus on November 8, 2002, at 11:24:16
In reply to Re: Lamictal resets HPA axis » Maximus, posted by freedom2001 on November 8, 2002, at 9:04:14
> Does Lamictal help with OCD?
Hi freedom2001,
Yes Lamictal would definitively help, but more as add-on.
The bleeding cutting edge med for OCD is still Luvox. So a combo of Luvox + Lamictal should do a dramatic change.
Regards,
Max
Posted by cab on November 8, 2002, at 19:43:11
In reply to Re: Lamictal resets HPA axis » freedom2001, posted by Maximus on November 8, 2002, at 11:24:16
Hi,
I'm severely depressed and feeling desperate. I convinced my psychiatrist to start me on lamictal (I'm already on lithium, paxil, zyprexa), but he said he doesn't think it helps that much with severe depression (agitated, total despair, sobbing most of the time). Anyone here had it help for that?
Thanks,
CAB
Posted by McPac on November 9, 2002, at 1:28:15
In reply to Re: Lamictal resets HPA axis, posted by cab on November 8, 2002, at 19:43:11
Yes, it could help for those symptoms (it helped me)!
Posted by jaby on November 11, 2002, at 12:27:24
In reply to Re: Lamictal resets HPA axis » jaby, posted by Maximus on November 8, 2002, at 11:15:12
Max,
Do you know of any other meds with a similar mode of action? Lamictal was a dream come true only to poop out.
Thanks,
Jeff
Posted by Maximus on November 11, 2002, at 15:04:25
In reply to Re: Lamictal resets HPA axis, posted by jaby on November 11, 2002, at 12:27:24
> Max,
> Do you know of any other meds with a similar mode of action? Lamictal was a dream come true only to poop out.
> Thanks,
> JeffHi Jeff,
A med with a mode of action similar to Lamictal? No, not really. Well there is Memantine (used in dementia) which works on NMDA receptors, but Memantine targets also others receptors.
Max
Posted by Skeezix on November 11, 2002, at 20:25:37
In reply to Lamictal resets HPA axis, posted by Maximus on November 7, 2002, at 12:36:26
Has anyone here tried memantine? It is a partially competitive NMDA receptor antagonist which has been used in the treatment of Alzheimers and other neurodegenerative diseases. It has been available in Germany for some time and is now in Phase III trials in the U.S.
> A lot more here:
>
> http://www.cnsspectrums.com/Articles/july2001/CNS701_Mathew.html
>
>
Posted by freedom2001 on November 12, 2002, at 6:46:40
In reply to Re: Lamictal resets HPA axis » freedom2001, posted by Maximus on November 8, 2002, at 11:24:16
> > Does Lamictal help with OCD?
>
> Hi freedom2001,
>
> Yes Lamictal would definitively help, but more as add-on.
>
> The bleeding cutting edge med for OCD is still Luvox. So a combo of Luvox + Lamictal should do a dramatic change.what is the best augmentation for prozac?
would a multiple combo augment be more powerful or just a single lamictal. Seems that there are trazodone, clonazepam, neuroleptic, anticonvulsant, lots of things to augment prozac. The difficult thing to know is : WHICH ONE.
>
> Regards,
>
> Max
>
Posted by Maximus on November 12, 2002, at 9:20:57
In reply to Re: Lamictal resets HPA axis » Maximus, posted by freedom2001 on November 12, 2002, at 6:46:40
> > The bleeding cutting edge med for OCD is still Luvox. So a combo of Luvox + Lamictal should do a dramatic change.
>
> what is the best augmentation for prozac?
> would a multiple combo augment be more powerful or just a single lamictal. Seems that there are trazodone, clonazepam, neuroleptic, anticonvulsant, lots of things to augment prozac. The difficult thing to know is : WHICH ONE.I think that your psychiatrist is the best to guide you.
However, you can discuss with him/her for a combo of high dose of Prozac + high dose of Buspar. It is used very often with success for OCD.
Max
Posted by pelorojo on November 12, 2002, at 14:14:10
In reply to Re: Has anyone tried memantine?, posted by Skeezix on November 11, 2002, at 20:25:37
Interesting article on DXM, Memantine, Magnesium, and Amantadine and their use in chronic pain - article is about NMDA antagonists. Link:
http://www.nurse-anesthesia.com/painnmda.htm
Also this article on amantadine as an anti-depressant:
http://www.biopsychiatry.com/amantadine.htm
This is the end of the thread.
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