6 replies to this topic

[BlindingShape]

Hi, everyone. I joined today for the purpose of asking a rather complicated question. Nice to meet you.

I'm not really sure where to start. I guess I'll begin by saying I've never tried any nootropics before, but have been researching them for a while now. I'm hoping they will be able to help me get a fraction of my life back. Because really, my life seems to be disintegrating due to cognitive impairment.

I have a condition called dysautonomia, which is dysregulation of the autonomic nervous system. It's all very vague and complicated and can manifest itself through a number of different syndromes. One of the many symptoms, for me, is brain fog. Debilitating brain fog. Some days I can't remember my birthdate. Often, while reading, I can't get to the end of a paragraph and still remember how that paragraph started. Sometimes syllables seems foreign to me, and I can't string them together to create words and meaning. I get deja vus and jamais vus frequently along with other sensory disturbances probably because of auras. My memory and concentration is a nightmare. While the condition isn't dangerous, my life seems to be falling apart. I used to be a straight-A student and now I have to consider withdrawing from my courses. I can derive no pleasure from what my favorite thing used to be: reading and writing. I'm depressed and anxious, and I get migraines every single day. There could be a number of different things causing this, but one of them is likely insufficient cerebral bloodflow; my veins do not constrict properly, and so blood often doesn't get where it needs to go. Researching how to remedy this led me to nootropics. It seems like this could be a breakthrough in treating the severe cognitive impairment. Perhaps nootropic could help, even minimally, rebuild my pathetic brain and get some more blood flow going. I'm already on vinpocetine, and have been for a month or so, but haven't noticed anything remarkable with it.

Now, here's where it gets a little complicated. I'm desperate to try a racetam, but I need to know about any interactions it may have with other medications. Here are the ones I take:

Mestinon: inhibits acetylcholinesterase in the synaptic cleft, thus slowing down the hydrolysis of acetylcholine. Basically, this prevents the breakdown of acetylcholine. I need to take this in order to keep my blood vessels constricting properly and in order to keep my intestines from slowing down. I'm especially concerned about this medication regarding possible interactions with choline supplements. Can I take choline supplements with this without going into acetylcholine overdrive (or cholinergic crisis)? That would be a possibly fatal problem.

Gabapentin: a GABA analogue; it mimics GABA neurotransmitter to inhibit . I take this for migraines, chronic nerve pain, tics.

Seroquel: a dopamine, serotonin, and adrenergic antagonist, and a potent antihistamine with clinically negligible anticholinergic properties. It's usually used as an antipsychotic for those with mood disorders or schizophrenia, but mine was prescribed to me for anxiety and insomia as it's a massive tranquilizer when used at a low dose (as opposed to the higher doses which do not cause the same sedation, oddly enough)

I have also had some episodes of hypomania, though my psychiatrist doesn't know what to make of that. Could have been aggravated by an SSRI I was on (which I quit a long time ago, now), or it could be something else.

Will a racetam cause problems in this context? Are nootropics (racetams in particular) known to be safe when used in conjunction with other psychiatric drugs such as antidepressants?
I've purchased 10 grams of aniracetam for a trial, but I'm frankly too frightened to start it. I don't want to throw myself into cholinergic crisis, mania, or anything else.

I realize it's a huge amount of information to ponder, but I'll be thrilled if there's even one person out there with competent insight. Thanks for your time.

[hooter]

This forum is notoriously badly informed and I suggest you ignore literally everyone. Piracetam stimulates ACH. I'd wager this could cause a potentially fatal reaction. Stay away.

If you're really serious about this sort of stuff, I'd rather talk to a European specialist doctor who has experience with piracetam and such conditions. Don't ask the tools here, seriously the quality here is extraordinarily lacking and people lie about being doctors etc all the time. The mods aren't doing their job, and by now barely anyone is posting.

[BlindingShape]

Thanks for the honest reply. I knew asking such a complex question on an internet forum was a bit of a stretch.

That's really unfortunate regarding the state of the forum. Some of my initial research on nootropics was done through some older threads here, and I was hoping the knowledge-level had remained relatively intact. Or perhaps it's always been this bad and I just didn't know?

I don't suppose anyone on the forum has ever mentioned the name of a competent specialist? I live in North America, so I guess I'll just have to continue to look around. Thanks again.

[khemix]

You aren't going to get an informed opinion from any medical professional because their consensus is that most of these nootropics do not produce clinically significant results. This opinion has merit, because nootropics are not intended to treat any conditions or ailments. They are subtle cognitive enhancers. And by subtle I mean most people cannot tell their effects apart from placebo. If you are holding out for piracetam to be some kind of panacea that will reboot your brain back to pre-dysregulated levels then you seriously need to abandon this belief - I know it easy to latch on to such things in moments of desperation.

Now, onto your question. Piracetams primary mechanism of action is enhancing NDMA receptors. It also burns up more Ach by enhacement of its receptors. Obviously you'd need to supplement with choline to counter this. But you are afraid of hypercholinergic effects? I don't know why, they are rarely that serious unless it has something to do with your disorder which admittedly I know very little about. The last time I was hypercholinergic I just remember feeling a little nauseous and vomitting. My bigger concern is that piracetam lowers seizure threshold and that may be problematic for you. But even so, I don't think there is any serious interaction with what you're taking and piracetam. Most racetams have a half life of 4 hours so anything unpleasant would be short-lived. I think you're being overly cautious and hooter there gave you a scare.

[BlindingShape]

Thanks for your thorough and thoughtful response.

I've been sick for too long, and have gone through too many prescription medications and supplements, to expect any one supplement now to be a silver bullet. I was hoping a racetam might be an effective building block toward health, seeing as it is most often prescribed for those (such as myself) with neurological problems. I've also read piracetam has been to protect against damage from hypoxia. While my brain hasn't exactly reached hypoxic status, there sure isn't enough blood up there.

Yeah, I was afraid of cholinergic issues. There are different stages of having too much acetylcholine. The first is where you would indeed feel nauseated as your intestines are more stimulated than usual; increased CNS activity. The second stage is called cholinergic crisis and mimics the absence of acetylcholine; muscles become weak and respiratory depression or cessation occurs. It's that last stage I'm worried about. Once I took too much of my acetylcholinesterase inhibitor and had a trouble moving and breathing. Perhaps a choline supplement or the ACH-stimulating properties of aniracetam are too minimal to cause this with me, but I tend towards excessive caution when it comes to health.

I didn't know that about the lowering of seizure threshold. That could definitely be problematic as I've had spells resembling partial temporal lobe seizures in the past. At the end of the day, I did try a single dose of aniracetam, spaced out some hours away from my other medications (which also have very short half lives), and did feel something. I've experienced hypomania before, and this is what it felt like for about 20 minutes. The next day, for the first half of the day, there was increased brain fog and fatigue. It's difficult to conclude anything from that because it seems people react uniquely.

I have a meeting with my psychiatrist tomorrow and will ask him about racetams. I don't expect him to even know what they are, and if he does I don't expect him to hold a strong opinion, but I am curious.

[UnbelievablePerson]

Piracetams primary mechanism of action is enhancing NDMA receptors.

I think he means AMPARs not NMDARs.Oh and you and hooter are right that this far too weighty an issue to trust an anonymous source. Good luck with your psychiatrist!

Edited by PittedPanda, 10 April 2012 - 10:35 PM.

[kurdishfella]

Expert knowledge changes all the time from old technology/knowledge to current. Can mean two things outdated or known since a long time.