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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 2 of 2. This is the beginning of the thread.
Posted by blueberry on May 1, 2006, at 7:46:21
If you had a medication that inhibited the reuptake of serotonin, dopamine, glutamate, norepinephrine, and gaba all with equal affinity, and if glutamate levels were already very high to begin with while other levels were low...do you think the the glutamate would stay proportionately higher than the other neuros with this reuptake inhibitor, or would they balance out more equallly?...or would it cause some kind of down regulation or up regulation of the glutamate with the net effect of reducing it in comparison to the other neuros? Ideas?
My glutamate is already sky high compared to the other neuros. This particular reuptake inhibitor has worked well for me in the past, but that was before I had such significant fear-terror-paranoia stuff going on. Not sure, but I believe the sky high glutamate is at fault, and so getting started with such a well-rounded equal affinicty reuptake inhibitor is causing me hesitation.
Posted by SLS on May 1, 2006, at 8:27:25
In reply to SLS Pharmaco experts....question..., posted by blueberry on May 1, 2006, at 7:46:21
I don't know what drug you are alluding to, but you might consider adding Lamictal if you are worried about excessive glutamatergic activity. It reduces levels of extracellular glutamate, presumably by blocking its release. I would stay away from Provigil because its pro-glutamatergic action might antagonize Lamictal. Memantine might help stabilize glutamatergic neurotransmission at the NMDA receptor. It is a rather benign drug with respect to side effects, and has some mild antidepressant properties.
Have you thought to try sibutramine? Although it is generally thought of as a SNRI, I believe that it has some inhibitory action at the dopamine transporter. You could then add Gabitril as a selective GABA reuptake inhibitor.
Of course, you could go with a combination of Nardil and Lamictal if you don't need to limit yourself to reuptake inhibitors. You would get increased levels of dopamine, serotonin, norepinephrine, and GABA, while reducing levels of glutamate.
I know this is a simplistic way of thinking.
I understand your logic in proposing that a glutamate reuptake inhibitor might actually stabilize glutamatergic neurotransmission once membrane sensitivities have compensated for their increased exposure to synaptic glutamate. You might be able to use a benzodiazepine to act as a buffer during the first 2-3 weeks to prevent overstimulation.
Again, this is all very simplistic, but I don't know any better way to conceptualize it. As you know, things that look good on paper don't always translate to real life outcomes.
- Scott
This is the end of the thread.
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