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Moclobemide + NSI combo for severe anxiety

anxiety nsi-189 moclobemide aurorix depression tianeptine nsi

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#1 Diego55

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Posted 20 June 2017 - 07:29 AM


I am currently taking 300 mg of moclobemide for social anxiety, GAD, panic attacks and depression. I wanted to try NSI as monotherapy about a year ago but later I read that NSI is not for those with a predisposition to anxiety and so I could end up in even worse condition. I wonder how it would be in combination with moclobemide ? I have read that NSI works better with MAOI drugs. I primarily suffer from anxiety, depression is a secondary disorder.

 

I am also interested in Tianeptine + moclobemide combination, has anyone tried this combo? I have tried Tianeptine alone but it did almost nothing for my anxiety, it slightly improved my mood, depression for a few hours after dosing but didnt help with anxiety at all (I took 3 x 12,5 mg/day for two months).

 

Thanks.



#2 Mind_Paralysis

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Posted 20 June 2017 - 10:28 AM

If your primary problem is anxiety, then forget about Tianeptine and NSI-189 - none of them have any greater effect on Anxiety, and have both been known to CAUSE it! Especially when combined with other stimulating substances.

 

How are your depressive symptoms at the moment? If they are not of a significant magnitude still, even with Moclobemide, then I wouldn't add any more of the potent type of antidepressants.

 

Heck, maybe you shouldn't look into stuff like Tianeptine or NSI-189, but into some other non-monoaminergic compound with anxiolytic action?

 

Perhaps Memantine, yes? Some people can get very good results on anxiety with it.

 

Or, if you want to try something milder, then get a combo of Magnesium-L-Threonate and L-Theanine - that might be enough to get rid of the last trace-anxiety you have.

 

 

And finally - have you considered simply INCREASING your Moclobemide dosage? It says here, that in the treatment of another anxiety disorder, Social Phobia, the effective dosage is actually DOUBLE your dosage...! 600 mg! : O

 

Now, that's a bit much, but you might want to consider increasing to 450 mg instead of 300 mg, and see what the effects are for a week or so, at the very least. It might be enough, yeah?

 

https://www.medicine.../medicine/22291



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#3 Diego55

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Posted 21 June 2017 - 05:47 AM

thanks for your advice I appreciate it! 
 
The thing is, I tried moclobemide about 5 years ago and I can't remember that it did something for my issues. Maybe it helped with depression I don't know...i remember that I suffer from insomnia that time which is probably related to moclobemide ( i took around 600mg/day). So I don't expect much from Aurorix alone and therefore I am looking for other drugs as an augmentation. 
 
I have tried so many drugs and supplements and got to the point where there is nothing left to try (I mean from pharmaceuticals that are available in my country). I tried all SSRI, SNRI, TCAs, some antipsychotics, mood stabilizers, gabapentin/pregabalin...even old MAOI like Nardil which helped for some time but later the side effects were unbearable (I tried it on and off, later with other meds for almost 2 years). 
 
I asked my Dr for memantine but he didn't want to prescribe it for my condition. It would be off-label treatment and he said he didn't have anything to defend this type of therapy in my case and he is also very skeptic that something like memantine would do something positive for me. I can order it from the net but I am currently suffering from brain fog, very poor memory, and problematic concentration...so I am a quite scared to take something which could even make those problems worse. 
 
 ...took 1-3 tabs but it did nothing for me, maybe I felt a bit weird. I also tried the Swanson brand but it also didn't work for me.
 
What do you think about moclobemide with tianeptine? I don't wanna take anything that has too many side effects, have already tried over 60 drugs and I am literally sick of pharmaceutical pills.
The reason why I am on moclobemide for the second time is mostly that it should be "decent" in terms of side effects and I remember only on problems with sleep on higher doses. Tianeptine as well is a better drug-choice for me due to its minimal profile of side effects.
 
This week I just started with moclobemide so will see how things go and later I will probably increase the dosage.
 


#4 Diego55

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Posted 21 June 2017 - 08:40 AM

As for depression, I am living a life pretty much isolated from society I have literally zero friends. My whole day consists of stay at an office (where I work) for all day. I feel like I am totally caught up in my head, in patterns of thought and behavior which limit me in my freedom. Even simple daily tasks like going to the grocery, or going to the doctor is a HUGE deal to me now. It's bad because I avoiding everything that might put stress on me...so I am alone, between 4 walls and all that resulting in my depression.



#5 Diego55

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Posted 21 June 2017 - 08:48 AM

I wonder if there is anything like NSI-189 but mostly for anxiety, and it's available now, so I can order it.Thanks!


 


Edited by Diego55, 21 June 2017 - 08:48 AM.


#6 jaiho

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Posted 21 June 2017 - 10:12 AM

As for depression, I am living a life pretty much isolated from society I have literally zero friends. My whole day consists of stay at an office (where I work) for all day. I feel like I am totally caught up in my head, in patterns of thought and behavior which limit me in my freedom. Even simple daily tasks like going to the grocery, or going to the doctor is a HUGE deal to me now. It's bad because I avoiding everything that might put stress on me...so I am alone, between 4 walls and all that resulting in my depression.

 

I can tell you that a drug won't get you out of this situation. I know exactly what you're going through.

 

My suggestion is start taking up meditation, and take baby steps to exercise, getting out and about. Drugs will only assist you in making these steps.

 

Confronting anxiety is the best way to defeat it.



#7 Meggo

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Posted 21 June 2017 - 10:19 AM

As for depression, I am living a life pretty much isolated from society I have literally zero friends. My whole day consists of stay at an office (where I work) for all day. I feel like I am totally caught up in my head, in patterns of thought and behavior which limit me in my freedom. Even simple daily tasks like going to the grocery, or going to the doctor is a HUGE deal to me now. It's bad because I avoiding everything that might put stress on me...so I am alone, between 4 walls and all that resulting in my depression.

 

Try meditation. Search for the book Mastering the core teachings of the Buddha by Daniel Ingram. You can get it for free and you don't need friends to do it.


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#8 nsi189

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Posted 04 July 2017 - 12:35 AM

Waiiiiiiiiit a second, I suffer from severe treatment resistant depression, but also have bad social anxiety/gad......does this mean nsi is not for me?@!!!?. I am about to buy NSI189 ASAP..... 



#9 Mind_Paralysis

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Posted 04 July 2017 - 07:27 AM

Waiiiiiiiiit a second, I suffer from severe treatment resistant depression, but also have bad social anxiety/gad......does this mean nsi is not for me?@!!!?. I am about to buy NSI189 ASAP..... 

 

If you have severe anxiety, I'm afraid that NSI-189 alone could be somewhat dangerous.

 

But it's been trialled for the combination with an SSRI and the effects were quite good - neuronauts whom have trialled the combo in the wild also reported good effects. = )

 

 

If you know of any substance which helps with your severe anxiety, then simply combine those with NSI-189, and you should be good.

 

NOTE: If you're currently using Gabapentin or Pregabalin for the treatment of your GAD, during daytime, then combining those with NSI-189 would be counterproductive - there's evidence that some of the gabapentinoids mechanism of action is dependent on DECREASING neurogenesis - the exact opposite of NSI-189. This is quite possibly the source of the PRO-depressant side-effect which some people are stricken with, when using Pregabalin or other gabapentinoids.

 

Something to take in mind...
 



#10 focus83

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Posted 04 July 2017 - 08:24 PM

I've personally tried the combination Moclobemide + NSI and it was a great experience. It was neither anxiogenic nor anxiolytic.And I suffer from GAD, SAD, OCD and panic disorder.

As much as I appreciate Stinkorninjor's contributions to this board, I think it's wrong to give this advise:
 

If your primary problem is anxiety, then forget about Tianeptine and NSI-189 - none of them have any greater effect on Anxiety, and have both been known to CAUSE it! Especially when combined with other stimulating substances.

 

First and foremost, their is no quality data out there yet which would warrant making such an authorative statement. Second, people have reported all sorts of effects from NSI. For some it was hugely beneficial for various kinds of anxiety (even sedating --> somnolence being a common side effect), for others it was neutral and some unforunate souls have reported heightend states of anxiety.
Whether or not you will respond with anxiety can't be answered on the whiteboard. You need to be aware of that. You will have to get some NSI and take it. If you find that it doesn't mix well with your anxiety you simply stop. I have always wondered why people were to overly cautious when it comes to such non-life threating side effects. You simply stop if you can't tolerate it.

To make a long story short, NSI is NOT a proven anxiety provoking molecule. I don't see any reason why you shouldn't at least try it, assuming you are fine with the fact that this is still a research chemical with potentially still undiscovered serious side effects.



#11 nsi189

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Posted 04 July 2017 - 10:35 PM

Damn, I thought nsi would help with both depression and anxiety, as they go hand in hand?

I am an on ssri, well now switching from paxil to pristiq, although all the SSRI's ive tried have just made things worse. 

I do use benzos someimtes, and have  script for 1mg klonopin, should that be enough to control the anxiety?

I also do take 600mg-1200mg gabapentin at night, been taking it over a year and I feel NOTHING from it, at this point I take it just because im scared of getting WD's if I stop. So Im willing to stop this for nsi189, you know anything that might help with wd from gabapentin?

thanks

 

 

Waiiiiiiiiit a second, I suffer from severe treatment resistant depression, but also have bad social anxiety/gad......does this mean nsi is not for me?@!!!?. I am about to buy NSI189 ASAP..... 

 

If you have severe anxiety, I'm afraid that NSI-189 alone could be somewhat dangerous.

 

But it's been trialled for the combination with an SSRI and the effects were quite good - neuronauts whom have trialled the combo in the wild also reported good effects. = )

 

 

If you know of any substance which helps with your severe anxiety, then simply combine those with NSI-189, and you should be good.

 

NOTE: If you're currently using Gabapentin or Pregabalin for the treatment of your GAD, during daytime, then combining those with NSI-189 would be counterproductive - there's evidence that some of the gabapentinoids mechanism of action is dependent on DECREASING neurogenesis - the exact opposite of NSI-189. This is quite possibly the source of the PRO-depressant side-effect which some people are stricken with, when using Pregabalin or other gabapentinoids.

 

Something to take in mind...
 

 

 



#12 Mind_Paralysis

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Posted 05 July 2017 - 07:36 AM

I've personally tried the combination Moclobemide + NSI and it was a great experience. It was neither anxiogenic nor anxiolytic.And I suffer from GAD, SAD, OCD and panic disorder.

As much as I appreciate Stinkorninjor's contributions to this board, I think it's wrong to give this advise:
 

If your primary problem is anxiety, then forget about Tianeptine and NSI-189 - none of them have any greater effect on Anxiety, and have both been known to CAUSE it! Especially when combined with other stimulating substances.

 

First and foremost, their is no quality data out there yet which would warrant making such an authorative statement. Second, people have reported all sorts of effects from NSI. For some it was hugely beneficial for various kinds of anxiety (even sedating --> somnolence being a common side effect), for others it was neutral and some unfortunate souls have reported heightened states of anxiety.
Whether or not you will respond with anxiety can't be answered on the whiteboard. You need to be aware of that. You will have to get some NSI and take it. If you find that it doesn't mix well with your anxiety you simply stop. I have always wondered why people were to overly cautious when it comes to such non-life threatening side effects. You simply stop if you can't tolerate it.

To make a long story short, NSI is NOT a proven anxiety provoking molecule. I don't see any reason why you shouldn't at least try it, assuming you are fine with the fact that this is still a research chemical with potentially still undiscovered serious side effects.

 

It's also not a proven anxiolytic - in fact, NONE of the medical trials have been designed for the treatment of anxiety - this, coupled with the fact that there are several rapports of increased anxiety, as well as a mild stimulatory effect, tells me that the drug is not ideal in this sense.

 

But sure enough, you ARE right in that there's no evidence that it's truly anxiogenic - it's still early days, and we don't know what will ultimately be labelled on the packaging insert.

 

However, I still think one should use caution here - the very fact that we don't know, is a reason to be prepared for trouble. Yes, I am a bit cautious, but is this not the dominant paradigm within medicine? First and foremost, do no harm.

 

 

I'm a bit surprised that you don't see the potential for a anxiety-attack as more dangerous as well - I have a friend who gets terrible blackouts when she's had attacks, to the point that she becomes disoriented and can't drive her car, don't know where she is, et c. Surely you see that such an episode can be dangerous? I myself had a panic-attack while on NSI-189, and during his attack I also lashed out at my surroundings, as I suddenly could not control my emotions - such an episode can also end fairly badly.

 

It's fair enough to say that such reactions are not common, but since they DO exist, people with anxiety-disorders should be cautious when taking this drug - better safe than sorry.

 

 

And although it's logical to stop taking the drug if one notices increased anxiety, it's not always that simple - if one notices such an intense positive effect on ones depression, then one could easily push somewhat further, with the hopes of the side-effect going away - like I did.

 

(hmm, I suppose my first post had quite a bit of projecting in it, and less science - still, I'd hate to see someone make the same mistake I did)

 

 

 

Damn, I thought nsi would help with both depression and anxiety, as they go hand in hand?

I am an on ssri, well now switching from paxil to pristiq, although all the SSRI's ive tried have just made things worse. 

I do use benzos someimtes, and have  script for 1mg klonopin, should that be enough to control the anxiety?

I also do take 600mg-1200mg gabapentin at night, been taking it over a year and I feel NOTHING from it, at this point I take it just because im scared of getting WD's if I stop. So Im willing to stop this for nsi189, you know anything that might help with wd from gabapentin?

thanks

 

 

I was a bit unclear in my last post - my apologies for this - I assumed that you took a high dose of Gabapentinoid during the day-time, since you have GAD.

 

I'm actually taking NSI-189 20 mg and Gabapentin 150 mg together, myself. (nsi in the morning, and gabap at night)


If you don't feel anything from Gabapentin, then there's no reason to keep taking it - however, if you take it during night, it might actually be a potentially balanced combo with NSI-189 - mainly because there's been reports of how NSI-189 causes insomnia - possibly because its neurogenic effects continue while you sleep - however, this could then potentially increase activity in the brain somewhat too much, causing insomnia. There's obviously a balance that needs to be struck.

 

Talk to your Dr. about lowering your Gabapentin, since you don't feel all that much - I suggest making a schedule for the lowering of dosages - thereby you could avoid WD. However, if you already vary your dosage by the DOUBLE 0_o, then you don't seem very susceptible to withdrawal, so you should be ok.

 

There's actually other reports online about how the combo of taking an anti-neurogenic like GabaP with NSI-189 works fairly well.

 

 

Regarding the relationship between depression and anxiety: no - they're not the same thing, in fact newer research have finally put the kibosh on that theory. And no, they don't always go hand in hand - there is a distinction in the litterature between anhedonic depression and anxious depression - anhedonic has more of a loss of emotion, and can actually sometimes not feel any anxiety - anxious depression is of course the combination of the two.

 

 

References:

----------------------

 

Anxiety and Depression Association of America - Types of depression

https://www.adaa.org...s of Depression

 

NEUROBIOLOGY OF ANXIOUS DEPRESSION: A REVIEW

http://onlinelibrary...2/da.22095/full

 

Anxious and non-anxious forms of major depression: familial, personality and symptom characteristics

https://www.cambridg...A69B52BBC19CB1A

 

I find these excerpts interesting:

 

"...whereas those with anxious depression were associated with higher harm avoidance and had parents with a wider range of disorders, including mania. The association between major depression and bipolar disorder is seen only in anxious forms of depression."

 


 

Especially when taken into contrast with this:

 

A single infusion of ketamine improves depression scores in patients with anxious bipolar depression

http://onlinelibrary.../bdi.12277/full

 

Effect of baseline anxious depression on initial and sustained antidepressant response to ketamine.

http://europepmc.org...ct/med/25295436

 

Unexpectedly, patients with anxious depression responded better to ketamine than those with nonanxious depression, with longer time to relapse and no side effect differences.

 

 

NMDA-antagonists have proven effective in the treatment of rapid cycling in Bipolar Disorder, as well as in anxiety disorders - Memantine is the go-to drug here.

 

I wonder... could Anxious depression be a mild form of what some call BIPOLAR ANXIETY? I've seen the term bandied about, but found no actual scientific, factual description of what it is. The treatment-resistance actually fits into the pattern too - since MANY patients with treatment-resistant depression have some form of hard-to-diagnose atypical Bipolar Disorder.

 


Edited by Stinkorninjor, 05 July 2017 - 08:05 AM.


#13 nsi189

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Posted 05 July 2017 - 10:08 AM

I was a bit unclear in my last post - my apologies for this - I assumed that you took a high dose of Gabapentinoid during the day-time, since you have GAD.

 

I'm actually taking NSI-189 20 mg and Gabapentin 150 mg together, myself. (nsi in the morning, and gabap at night)


If you don't feel anything from Gabapentin, then there's no reason to keep taking it - however, if you take it during night, it might actually be a potentially balanced combo with NSI-189 - mainly because there's been reports of how NSI-189 causes insomnia - possibly because its neurogenic effects continue while you sleep - however, this could then potentially increase activity in the brain somewhat too much, causing insomnia. There's obviously a balance that needs to be struck.

 

Talk to your Dr. about lowering your Gabapentin, since you don't feel all that much - I suggest making a schedule for the lowering of dosages - thereby you could avoid WD. However, if you already vary your dosage by the DOUBLE 0_o, then you don't seem very susceptible to withdrawal, so you should be ok.

 

There's actually other reports online about how the combo of taking an anti-neurogenic like GabaP with NSI-189 works fairly well.

 

 

Regarding the relationship between depression and anxiety: no - they're not the same thing, in fact newer research have finally put the kibosh on that theory. And no, they don't always go hand in hand - there is a distinction in the litterature between anhedonic depression and anxious depression - anhedonic has more of a loss of emotion, and can actually sometimes not feel any anxiety - anxious depression is of course the combination of the two.

 

 

References:

----------------------

 

Anxiety and Depression Association of America - Types of depression

https://www.adaa.org...s of Depression

 

NEUROBIOLOGY OF ANXIOUS DEPRESSION: A REVIEW

http://onlinelibrary...2/da.22095/full

 

Anxious and non-anxious forms of major depression: familial, personality and symptom characteristics

https://www.cambridg...A69B52BBC19CB1A

 

I find these excerpts interesting:

 

"...whereas those with anxious depression were associated with higher harm avoidance and had parents with a wider range of disorders, including mania. The association between major depression and bipolar disorder is seen only in anxious forms of depression."

 

 

 

Especially when taken into contrast with this:

 

A single infusion of ketamine improves depression scores in patients with anxious bipolar depression

http://onlinelibrary.../bdi.12277/full

 

Effect of baseline anxious depression on initial and sustained antidepressant response to ketamine.

http://europepmc.org...ct/med/25295436

 

Unexpectedly, patients with anxious depression responded better to ketamine than those with nonanxious depression, with longer time to relapse and no side effect differences.

 

 

NMDA-antagonists have proven effective in the treatment of rapid cycling in Bipolar Disorder, as well as in anxiety disorders - Memantine is the go-to drug here.

 

I wonder... could Anxious depression be a mild form of what some call BIPOLAR ANXIETY? I've seen the term bandied about, but found no actual scientific, factual description of what it is. The treatment-resistance actually fits into the pattern too - since MANY patients with treatment-resistant depression have some form of hard-to-diagnose atypical Bipolar Disorder.

 

 

 

I guess I worded that wrong, but by hand in hand, I moreso meant that most antidepressants(ssri's, maois, tcas) treat both depression and anxiety, haven't heard of too many AD's that are anxiogenic, But then again I need to do a lot more reading and know nothing about this drug from a pharmacological standpoint, I just discovered it the other day and desperately want to try it now. 

Not sure how my depression would be labelled, but diagnosed MDD and treatment resistant, but I think there's more to it than that. The anhedonia is extreme and it may be the worst part, constantly dwelling on the past and obsessing over tiny things. always racing thoughts. constant nightmares that wake me up multiple times a night. I sleep like shit, I just go to sleep whenever my body gets tired, sometimes 4am, sometimes 4pm, sometimes 10pm, sometimes 12pm... etc no schedule at all. I can't enjoy anything whatsoever, also sex drive is dead. All I do is lay in bed in a dark room, and thats another thing, my room always has to be dark, even in the day, the light is never on, I just prefer it that way. I avoid social interactions, even making phone calls is hard. I prefer to be isolated. Brain fog is insane.... I cannot focus for shit, I constantly forget things, If I start reading something, I usually stop a few sentences in. When Im watching a movie or something my minds drifts off somewhere else, or I just forget as I go along, so I constantly need to pause and rewind the scene.

Im never content, every little thing is dysphoric, I hate going outside and I hate the sunlight and heat. Only comfortable in my own room on the computer, and still can't enjoy anything, but thats the only thing I feel like doing. Mostly watching movies and reading stuff. My comprehension has gotten so bad, I forget things as Im reading them and have to go back. Oh and the physical symptoms are debilitating, I feel like I weigh 1000lbs, I have no mobility, I can't bend and reach, my back and joints hurt, and its just very uncomfortable to do any type of exercise, I can't stand it, If I walk one block, my heart is pounding, and I am covered in sweat, and feel dizzy and like im about to collapse. I get really dizzy when I stand up. I always feel hot, even under the AC, im constantly sweating. No motivation at all whatsoever, if someone was about to drop a bomb on my house I wouldn't move.

Adderall/Stims used to help a lot with motivation, mobility, and confidence, but now they don't work anymore for some reason, even in high doses. Did 140mg vyvanse on no tolerance a few times, and barely felt a thing, Years ago, an even lower dose would have me ready to take on the world and bouncing off the walls. Same goes for opiates for the first few years, they were amazing and relieved almost all mental and physical symptoms. I take kratom now, and have grown a massive tolerance, and it lost its magic, but I still think I'd be worse off without it. 

 

The drug use only came after trying dozens of AD's with no help, they sometimes made me more fatigued, less motivated, and just zombie-like, especially SSRIS, But I just started pristiq now, because the dr wants me to.

But...yea when I first discovered opiates they were magic, obviously built a tolerance and whatnot, but every time I detoxed, the WD's would be absolute hell, to where I had to be hospitalized so I dont kill myself, I believe they were way worse, as they masked my depression to some degree, so stopping abruptly brings on a huge wave of extreme depression/suicidality and also have to deal with the WD's. Even after being clean for over 6 months, I felt like shit, and could not function whatsoever. Kratom was my last ditch effort, although Im using way too much, and it lost its effect, its still keeping me off other opiates.

And I never aimed to get high or to 'nod' like other people, I would use just enough to make me 'normal', that is all they did. Sorry if im being redundant, the point is the only drugs that made me feel better are opioids, and I can barely function without them. Im sure there is some neurological reason for this, I wish there was some type of test I could do to figure out why this is. What do you think about ALKS-5461 and CERC-501? I have major hope in these, and I think they will be revolutionary. They are KOR antagonists, which apparently play a huge role in symptoms of depression, even anhedonia. 

 

 

Im sorry for the wall of text. I figured you were knowledgeable so I thought I'd share, what do you make of this? And do you think NSI will help? I didn't list most of my symptoms, just some of the ones I could think of, If I listed all it would be a few pages. And is the anxiety from NSI only in the beginning or is it constant? And will a benzo be enough to stop it?

Btw does 150mg of gabapentin actually work for you? thats suck a low dose, what kind of effects do you get off that?

 

Thanks for the help/advice! You dont have to read all this if you dont want to. I would appreciate any suggestions you may have.

 

 

 

 

 

 

 

I was a bit unclear in my last post - my apologies for this - I assumed that you took a high dose of Gabapentinoid during the day-time, since you have GAD.

 

I'm actually taking NSI-189 20 mg and Gabapentin 150 mg together, myself. (nsi in the morning, and gabap at night)


If you don't feel anything from Gabapentin, then there's no reason to keep taking it - however, if you take it during night, it might actually be a potentially balanced combo with NSI-189 - mainly because there's been reports of how NSI-189 causes insomnia - possibly because its neurogenic effects continue while you sleep - however, this could then potentially increase activity in the brain somewhat too much, causing insomnia. There's obviously a balance that needs to be struck.

 

Talk to your Dr. about lowering your Gabapentin, since you don't feel all that much - I suggest making a schedule for the lowering of dosages - thereby you could avoid WD. However, if you already vary your dosage by the DOUBLE 0_o, then you don't seem very susceptible to withdrawal, so you should be ok.

 

There's actually other reports online about how the combo of taking an anti-neurogenic like GabaP with NSI-189 works fairly well.

 

 

Regarding the relationship between depression and anxiety: no - they're not the same thing, in fact newer research have finally put the kibosh on that theory. And no, they don't always go hand in hand - there is a distinction in the litterature between anhedonic depression and anxious depression - anhedonic has more of a loss of emotion, and can actually sometimes not feel any anxiety - anxious depression is of course the combination of the two.

 

 

References:

----------------------

 

Anxiety and Depression Association of America - Types of depression

https://www.adaa.org...s of Depression

 

NEUROBIOLOGY OF ANXIOUS DEPRESSION: A REVIEW

http://onlinelibrary...2/da.22095/full

 

Anxious and non-anxious forms of major depression: familial, personality and symptom characteristics

https://www.cambridg...A69B52BBC19CB1A

 

I find these excerpts interesting:

 

"...whereas those with anxious depression were associated with higher harm avoidance and had parents with a wider range of disorders, including mania. The association between major depression and bipolar disorder is seen only in anxious forms of depression."

 


 

Especially when taken into contrast with this:

 

A single infusion of ketamine improves depression scores in patients with anxious bipolar depression

http://onlinelibrary.../bdi.12277/full

 

Effect of baseline anxious depression on initial and sustained antidepressant response to ketamine.

http://europepmc.org...ct/med/25295436

 

Unexpectedly, patients with anxious depression responded better to ketamine than those with nonanxious depression, with longer time to relapse and no side effect differences.

 

 

NMDA-antagonists have proven effective in the treatment of rapid cycling in Bipolar Disorder, as well as in anxiety disorders - Memantine is the go-to drug here.

 

I wonder... could Anxious depression be a mild form of what some call BIPOLAR ANXIETY? I've seen the term bandied about, but found no actual scientific, factual description of what it is. The treatment-resistance actually fits into the pattern too - since MANY patients with treatment-resistant depression have some form of hard-to-diagnose atypical Bipolar Disorder.


Edited by nsi189, 05 July 2017 - 10:11 AM.


#14 focus83

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Posted 05 July 2017 - 09:27 PM

Stinkorninjor, I know you only had good intentions.

 

But anxiety is a side effect that is on the patient information leaflet of the vast majority of all psychotropical medications. For instance it's extremely common with SSRI and SNRI in the beginning of the treatment (first 4-6 weeks and can persist beyond that), so some docs even give benzos or other sedating drugs for the first weeks to make that side effect more bearable.

 

Apart from extreme anxiety reactions, anxiety is not acutely life-threatening per se. It is something you need to be prepared of mentally when initiating most psychiatric medications. Of course, you can always come up with anecdotes of patient XY who experienced such intense anxiety that he ended up in a life threatening situation. But that is certainly far from usual and should never be a reason to refuse treatment.



#15 nsi189

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Posted 07 July 2017 - 10:40 PM

So, the klonopin I take daily should be enough to tackle the anxiety, no?



#16 focus83

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Posted 07 July 2017 - 11:35 PM

If a benzo doesn't cut it, I don't know what else should.



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#17 Mind_Paralysis

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Posted 08 July 2017 - 09:19 AM

So, the klonopin I take daily should be enough to tackle the anxiety, no?

 

Sure, I believe there have been reports of people using benzo's with NSI without issue.

 

There's of course also stuff like high-dose Magnesium-L-Threonate as well, which some, myself included, have reported some relief from anxiety from.

 

 

References:

------------------

Chronic dietary magnesium-L-threonate speeds extinction and reduces spontaneous recovery of a conditioned taste aversion

https://www.ncbi.nlm...les/PMC3668337/

 

Hippocampal NMDA receptors and anxiety: At the interface between cognition and emotion

https://www.ncbi.nlm...les/PMC2824088/

 

Regulation of structural and functional synapse density by L-threonate through modulation of intraneuronal magnesium concentration.

https://www.ncbi.nlm...pubmed/27178134

 

(for those wondering - yes, MagLT appears to be a mild neurogenic in itself)







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