Update on memantine use
Lots of things have happened in the interim. I have now been taking memantine daily for about 2 months now, slowly titrating up the dose. The results have been extraordinary.
I'll break down what I've done with my regimen since my last post on this thread:
I stopped using memantine for a long time after lasting posting here, until 3 months ago I decided to go again for real. I still dose under the tongue and hold it there for at least 15 mins or longer if I can stand it; so whether 3 drops or 6 drops, it is enough to affect me. I'm now up to about 9 mg every morning. It still has a negative impact on my writing but not as bad since I can usually spot the weirdness while typing it. My actual handwriting is now pretty interesting because now I do odd things like start writing a word, actually have the right word in my mind, and instead end up writing down another word that's related to it somehow, either phonetically or a word that has the same letters at the beginning but different letters at the end. For example, I've been studying organic chemistry for the past two weeks and sometimes write parent chane instead of parent chain, keytone instead of ketone, or write down a completely different word like extremely instead of extraneous. Since I don't do this when typing, my writing problems when typing consist primarily of crappy, idiotic grammar and sentence structure (but much better now), I believe the issue with my handwriting is more about muscle memory. This is the only serious adverse affect from the memantine now, I no longer get the blood pressure spikes.
Still, it's more than worth it. My grades have not been really hurt by any of it so far. But the major bonus is that my migraines have taken a very sharp nosedive. I still need to have sumatriptan at the ready wherever I go, but can go a few weeks without requiring one, so my quality of life has improved greatly by this one factor alone.
There have been other changes: I have increased methyphenidate dosage to roughly 20-25 mg daily. I've done this because I really wanted to give it a real chance to help me (I was taking it at very small doses before, and irregularly, primarily because I was afraid of it) and so far it's doing better than I'd hoped for. After about a month of doing thing, I realized I could try to get off bupropion again and have methyphenidate in its place. I've tried to taper off bupropion a few times before but failed because I would completely shut down and get migraines by the end of the first week of reducing the dose even by 1/5th (my normal bupropion dose was 150 mg SR twice daily). I've been on bupropion several years for depression so bad it's damaged my cognition and memory, and stayed on it because it actually reduced migraines to about 4-5 big ones per month where a plethora of prophylactics before it just made my migraines worse. It was the first antidepressant to actually do any good for me. Bupropion really did save my life in a certain way, so why do I want off of it? Because it triples my rage and makes me tense and irritable for hours about 2 hours after dosing, which I've had a problem with since childhood, and exacerbates the essential tremor in my hands. It also scatters my thoughts a little (mostly because of the tension I think). It helps depression and migraines but makes PSTD hypervigilance and autistic sensory sensitivity worse; almost unbearable now, and I still leave class or avoid it altogether just because of the other students and my frustration with their very presence (which I realize is not their fault). This side effect of bupropion is what drove me to finally accept a lorazepam prescription from my docs who've been pushing it on me for years--it helps but not enough without increasing dosage past .5 mg twice a day which I will not do with a true benzo. I've tried to get off of bupropion or reduce the dose several times before, with a few of my adventures posted on longecity, but failed every time before now.
My docs keep trying to put me on SSRIs, tricyclics, or other things that interact significantly with serotonin. I've been fighting it because of my first experience with such drugs that led to my first and only period of cutting, and first and only suicide attempt by taking 28 pills of 10mg ambien for no apparent reason (all I had left). The antidepressant that did this to me was Celexa and I was only on it for about 2.5 months when I was 23 (about 11 years ago); this experience still terrifies me because when I said I took all that ambien "for no apparent reason" I really mean it, while on celexa I gradually slipped into this dark hole of nihilism and apathy without even realizing what was happening to me. I wasn't upset when I took the ambien, I didn't plan it, I hadn't been ruminating about death and suicide for days beforehand, nothing like that -- I just did it robotically without even really thinking about what it meant. After this, docs switched me to bupropion which helped, and I was on that for about 6 months afterward until I lost all medical coverage for about 7 years and declined to a very sorry state before getting insurance again.
So anyway, back to serotonin. I almost gave in to the docs because the norepinephrine side effects of bupropion were really screwing things up, and other things tried before made migraines so much worse, but bought some tianeptine instead. At first my use was tentative and fearful because I had a few incidents where I think the tianeptine triggered migraine a few hours after dosing, and because with 10 mg doses I immediately noticed the distinct warm, calming sensation I get only from opioids like tramadol, morphine, oxycodone, codeine (past use from lower back injury, tooth extractions, multiple spinal tap testing for meningitis, pneumonia a few times, bronchitis a few times, the real flu a few times, and dumbass ER doctors prescribing it for migraine when they should have given a triptan... I have a really colorful medical history). So that mild opiate-high feeling from tianeptine and headaches had me very wary of taking this drug regularly. I stopped it for a while and it wasn't until I started taking memantine daily that I decided to try it again but for real this time, because memantine has me feeling almost invincible to migraine. I've been taking tianeptine 10-12 mg doses 3 times daily for almost a month now ... it's just amazing. The migraine threat from it is very low now, and it does help with bupropion's nastiness.
2 weeks ago I cut my bupropion dose in half; down to 75 mg twice daily. I did not fall down all over myself! Migraine did not get out of control! My body doesn't even seem to notice that I suddenly chopped the dose back by a full half! What is this sorcery? The memantine, methylphenidate, and tianeptine together, with the usual daily theanine and lion's mane, occasional lorazepam, starting to balance me out in every department that matters; migraine, anger, anxiety, concentration, motivation, depression, hypervigilance, unsociability, going out in daylight, staying in class, not freaking out in chem lab because of all the busyness, being organized, tremor and general chest tension. I still have to take my music everywhere with me, and wear headphones during class and tests often, but I don't think that's ever going to change. I can walk back bupropion now, I'm sure of it this time. In another 2 weeks I'll cut the dose in half again, and then the month after that I'l halve the dose again, and be off of it after 4 months if all goes according to plan. And when the bupropion is gone, I plan to get rid of the lorazepam after that.
The other pros of cutting back the bupropion is that I will be able to have caffeine without my potassium crashing and me going into A-fib, and I will no longer have to keep potassium pills on my person everywhere I go. It was also a relief to finally figure out what caused the multiple cardiac scares about 1.5 years back (I think?) that had me in and out of the ER and wearing a heart monitor for a few weeks--that it was bupropion indirectly giving me cardiac concerns because of the way the body metabolizes caffeine and bupropion (taking Excedrin or having some soda or coffee), and because of the effects on the heart from chronic stress, and post-stress (the aftermath being tense, irritable and frustrated for hours regularly; pure exhaustion).
All because of memantine's potent NMDA antagonism; it's given me more freedom of choice than anything else since the migraines began when I was 21 and pretty much destroyed my life. I'm going to ask my doc for scripts of memantine and tianeptine so I don't have to get it on the internet anymore. He knows I have the memantine but not the tianeptine.