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Dr. Bob is Robert Hsiung, MD,
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Posted by rod on May 29, 2003, at 14:04:50
I made the test at
http://www.dr-bob.org/tips/isse.html
for Subsyndromal Epilepsy and was wondering about the symptoms which are asked for.
Exactly these symptoms made me believe I suffer from psychosis. But there are no classic (positive) symptoms present and I had a complete checkup regarding psychosis, schizophrenia. Results were negative and I also did not respond to olanzapine. My present diagnosis is severe unipolar depression (made by a many hours lasting computer test), but I am not sure about that and doctors aren't either. Current med is Tianeptine which is working somehow, but I am still far away from remission.results from isse are (with subscores):
visual experiences: 50
thought and word interruptions: 100
attentional abnormalities: 89
other memory, experimental, or time disturbances: 100
the rest was: 0Another point is that my father might have epilepsy. He sometimes has muscle convulsions, whole body, (few times per year), but never loses consciousness. But he refuses to visit a doctor for this and my attempts to convince him fail...
I looked up various anticonvulsants and found some interesting connections regarding myself:Na channels: amitriptyline blocks Na channels (4) - Lamotrigine (lamictal) also blocks Na channels (5)
Amitriptline worked best for me.Carbamazepine (Tegretol) monograph: do not take if you have sensitivity to tricyclic antidepressant drugs such as amitriptyline (Elavil).
Maybe just regarding the anticolinergic activity, who knows.glutamate: Lamotrigine (lamictal) reduces glutamergic neurotransmission (5) - Adrafinil makes me worse, maybe due to increased glutamate?
Increased glutamate is known for provigil and since provigil is a metabolite of Adrafinil ..., just my thought.5-HT1A : Lamotrigine (lamictal) downregulates cortical 5-HT1A receptors (1) - Mirtazapine (Remeron) stimulates preferably 5-HT1 (2), Remeron makes me worse - ... elevated 5-HT(1A) receptor density in schizophrenia ... elevation may reflect an abnormal glutamatergic network ... (3)
Of course the drugs mentioned above do much more than I have mentioned. Its just a try to find out what's wrong with me and thereby get the correct treatment. I have once asked for a mood stabilizer/AED, but my doc just said: "you are neither bipolar nor epileptic, so what's the point? I can not prescribe this to you." hmmph! EEG is normal. I will bring the results of the ISSE test to her or I just go to another doc, preferably a neurologist.any comment is welcome
Roland
--------------------------------------------(1) Lamotrigine induced selective changes in 5-HT(1A) receptor mediated response in rat brain.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11792461&dopt=Abstract(2) The effects of mirtazapine on central noradrenergic and serotonergic neurotransmission.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8930006&dopt=Abstract(3) Brain serotonin 5-HT(1A) receptor binding in schizophrenia measured by positron emission tomography and [11C]WAY-100635.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12044193&dopt=Abstract(4) Amitriptyline inhibits striatal efflux of neurotransmitters via blockade of voltage-dependent Na+ channels.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1358657&dopt=Abstract(5) Swiss monograph of Lamictal in german
http://www.kompendium.ch//data/fi_d/dk04001_.htm
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