3 replies to this topic

[chris87]

I was wondering if anyone could give me some insight.  I am looking at taking medication again.  My PDoc wants me to take Prozac, but I would like to try Strattera.  I know it's like comparing apples to oranges since one is an SSRI and the other is an NRI.  I have issues with OCD, ADHD, and Social Anxiety.  I had taken Lexapro and Zoloft in the past, but they did not help my OCD/SA at all.  I think that I had gotten the most benefit from stimulants, even though I didn't like taking them.  They seemed to eradicate my OCD symptoms (rituals, repetitive actions, inability to shift thought, etc).  This never made sense to me, as I would have expected stimulants to aggravate my OCD.  My social anxiety was also reduced, and my mind felt much calmer.

 

My PDoc thinks that my problems are mostly anxiety related and that an SSRI will help.  I'm afraid that my cognition will be affected, and it will make my ADHD issues worse.  As much as I dislike dealing with OCD, my ADHD problems and SA are more troublesome.  I can't focus at all, and it's extremely difficult to concentrate.  Just writing this post is torturous for me.  I have to keep stopping, and I can barely complete a thought.  I'm disorganized, and I procrastinate horribly.  I never follow through with a task, have difficulty making decisions, and feel like an inefficient, unreliable person.  My OCD gives me an overwhelming desire for perfection, but my ADHD makes this an impossibility.  It's very discouraging.

 

My PDoc said that he isn't crazy about Strattera, but I think he would prescribe it.  He feels that the side effects of Prozac are much less pronounced.  He indicated that with Strattera he sees more fatigue and nausea.  For whatever reason, I'm afraid of SSRIs.  I have read all kinds of articles online referencing GI bleeding, decreased bone density, premature aging/wrinkling, hair loss, and other side effects.  I'm sure that Strattera also has these possibilities (I've heard about the liver damage), but I'm not as scared to take it.

 

Can anyone give me advice?  I am totally confused about what to do.  I wish I could talk more openly with my PDoc, because he's very understanding.  When I have an appointment, I never adequately express my thoughts.  I appreciate any input.

[tfor]

Do you officially have ADHD? Have you been tested and what do you take for it?

What you describe sounds like ADHD.

 

If you're not on an ADHD drug then I'd get on one and then see what happens.

If you have ADHD and only take a SSRI it might make the ADHD issues worse cause from what I know

SSRI can lower dopamine.

 

I think if I were you I'd first try to get the ADHD under control and then you can try adding a SSRI or SNRI and so on.

 

Strattera shall also help against ADHD but from what I read stimulants are more effective. I'd give ritalin and adderall a try and then see what works better.

If none of them work then the next step would be strattera,wellbutrin or effexor. Effexor (snri) supposedly also helps against adhd. This way you could also

see wether something serotonergic works for you.

 

Edit: Sounds like you already tried stims.

If none of the stims worked for you then strattera or wellbutrin would be the next step.

 

You simply need to find out wether serotonin is your issue or not. But you can only do that by taking a ssri or snri.

If none of these work for you then you can at least tell that serotonin either isn't your issue or that the drugs simply dont help you.

 

I for example have ocd and ssri still don't seem to help me which is weird.

 

Edited by tfor, 08 September 2014 - 09:32 PM.

[Area-1255]

Do you officially have ADHD? Have you been tested and what do you take for it?

What you describe sounds like ADHD.

 

If you're not on an ADHD drug then I'd get on one and then see what happens.

If you have ADHD and only take a SSRI it might make the ADHD issues worse cause from what I know

SSRI can lower dopamine.

 

I think if I were you I'd first try to get the ADHD under control and then you can try adding a SSRI or SNRI and so on.

 

Strattera shall also help against ADHD but from what I read stimulants are more effective. I'd give ritalin and adderall a try and then see what works better.

If none of them work then the next step would be strattera,wellbutrin or effexor. Effexor (snri) supposedly also helps against adhd. This way you could also

see wether something serotonergic works for you.

 

Edit: Sounds like you already tried stims.

If none of the stims worked for you then strattera or wellbutrin would be the next step.

 

You simply need to find out wether serotonin is your issue or not. But you can only do that by taking a ssri or snri.

If none of these work for you then you can at least tell that serotonin either isn't your issue or that the drugs simply dont help you.

 

I for example have ocd and ssri still don't seem to help me which is weird.

OCD is based on general glutamate overactivity, and disruptions in genes related to serotonin - but not necessarily stemming from serotonin.

 

It seems it is NON NMDA-glutamate receptors that are involved in the etiology/pathophysiology of OCD.

As activation of NMDA-receptors seems to alleviate OCD - which makes sense because NMDA is the ONE subtype of glutamate that can actually have anti-anxiety effects and can help release anti-anxiety neurosteroids.

 

But then it comes back to testosterone:estrogen balance.

 

Things go haywire in the brain when estrogen gets too high, regardless of histamine/NMDA/Glutamate activity.

 

I would think that Histamine H((3)) receptors (which INHIBIT) histamine release AND Serotonin would be generally NEGATIVE and cause more OCD and depression etc

Blocking Histamine H3 and activating NMDA-glutamate can enhance GABA and serotonin, as well as dopamine which would help alleviate OCD.

 

I've taken D-Aspartic-Acid (an NMDA-glutamate activator) with H3 antagonists and histamine boosters...this helped my anxiety and OCD ALOT!!!!

 

http://www.longecity...-schizophrenia/

 

 

The role of NMDA receptors in the signal attenuation rat model of obsessive-compulsive disorder.

 

 

 

 

Abstract

RATIONALE:

In recent years, an increasing body of evidence points to the involvement of the glutamatergic system and specifically the glutamatergic ionotropic N-methyl-D-aspartate (NMDA) receptor in the pathophysiology of obsessive-compulsive disorder (OCD).

OBJECTIVES:

To test the role of NMDA receptors in compulsive behavior using the signal attenuation rat model of OCD. In this model, 'compulsive' behavior is induced by attenuating a signal indicating that a lever-press response was effective in producing food.

METHODS:

The NMDA antagonist, MK 801 (0.025-0.100 mg/kg) and the partial NMDA agonist, D-cycloserine (3-100 mg/kg) were administered to rats just before assessing their lever-press responding following signal attenuation (Experiments 1 and 2, respectively). Because the effects of signal attenuation are assessed under extinction conditions, drug doses that were effective in Experiments 1 and 2 were also tested in an extinction session of lever-press responding that was not preceded by signal attenuation (Experiment 3).

RESULTS:

Systemic administration of D: -cycloserine (15 mg/kg) selectively decreased compulsive lever pressing, whereas systemic administration of MK 801 did not affect compulsive lever-pressing but dramatically increased resistance to extinction.

CONCLUSIONS:

Activation of NMDA receptors may have an anti-compulsive effect in OCD patients.

 

The problem here is if you have a generally high level of glutamate it won't help to activate NMDA-you will just produce more excitotoxicity..but if you lower glutamate in generall... (through sulfur / garlic / supplementation) and add N-acetyl-Cysteine (which can help OCD and depression) then use a specific NMDA only glutamate activator as well as coordinate hormone balance / treat hormone imbalances...this is the key to treating/curing OCD and depression imHo.

 

Edited by Area-1255, 12 September 2014 - 05:00 AM.

[tfor]

@ area1255

 

Does this mean that SSRI are useless against ocd? Why does my pdoc not know about this? This angers me.

I mean I even brought up glutamate various times. No response from him.

I then changed pdocs. My never pdoc is more open. I suggested memantine and he agreed. I took it for a few weeks but at 20mg I felt like it made my memory

worse and then got off it. Unfortunately he didn't know any alternatives to memantine.

 

What kind of supplements would you recommend to safely lower glutamate? I know that there are also drugs out there but I don't know if they are safe and if I could

even get them prescribed.

 

Do you know if ritalin and wellbutrin increase glutamate in the brain? Do substances which are stimulating make these issues worse? Cause I take ritalin and wellbutrin.

 

And what about T:E2 balance?

How high or low should E2 be?

I suffer from low testosterone. I have always had low T.

My E2 is in the normal range but my T is always damn low.