Update on my Meds

Today I am on my last of 7.5 mg (half of 15 mg tablet) of mirtazapine.

Fifty tablets of mirtazapine are stored with a package of 25 caplets of diphenhydramine in my drawer to be used as sedatives for insomnia only.

Thursday I got a new prescription for gabapentin, which helped bring out the best of me. My meds came from my primary GP, but in retrospect, it would have been less of a hassle to get it from my secondary GP, except that I couldn't get up at 7.30AM to get in to see him.

I got a good result from 200 mg Thursday night, and there was little sedation. The next morning, I took 7.5 mg of mirtazapine and the histamine-related sedation left me with impaired balance and related effects which took me 2 hours to adapt — the gabapentin helped because I took a 100 mg dose about an hour after the sedation hit me.

This morning, gabapentin has sparked a remarkable difference in me. I actually felt friendly and outgoing, and it appears to have reduced the usual shyness I used to have.

Yet much of my behavioral negativities actually has very little to do with the medication, but with being able to try something different.

Although I'd like natural health-food remedies and the like, psychopharmaceuticals are the emergency backup plan. With cognitive behavior therapy, they have worked in my case.

If insanity can be defined as doing the same thing over and over expecting a different outcome every time, then sanity is the ability to do something different.

Here is how I am going to do something different: I am open to responses from the anti-psychiatry crowd. Also, will the people who have tried gabapentin please respond?

Any responses demonizing medication will be ignored; such fear-mongering is based on emotional reasoning, which could lead to cognitive distortions.

If any thought pops in your head before you write, then please reread what I wrote and think through your feelings before responding. I'll try to do my best to think, think and think in kind! :)

Update for 20130116: I'm now on cyclobenzaprine 10 g and gabapentin 200 mg at bedtime.

NOW True Calm and Natures Harmony Rhodiola with Cordyceps

NOW True Calm is an "amino acid relaxing formula" consisting of:

• niacinamide (45 mg),
• pyridoxine (8 mg),
• magnesium (13 mg),
• GABA - gamma aminobutyric acid (200 mg),
• glycine (200 mg),
• taurine (200 mg),
• inositol (100 mg) and
• valerian root (25 mg).

Niacinamide is a derivative of vitamin B-3 can be used for the treatment of arthritis by aiding the body in its production of cartilage.This product is often used for energy drinks. Nicotinamide is a water-soluble component of the vitamin B complex group. Nicotinamide has demonstrated anti-inflammatory actions which may be of benefit in patients with inflammatory acne vulgaris, including but not limited to, suppression of antigen induced-lymphocytic transformation and inhibition of 3'-5' cyclic AMP phosphodiesterase.

Pyridoxine is one of the compounds that can be called vitamin B6, along with Pyridoxal and Pyridoxamine. Pyridoxine assists in the balancing of sodium and potassium as well as promoting red blood cell production. It is linked to cardiovascular health by decreasing the formation of homocysteine. It has been suggested that Pyridoxine might help children with learning difficulties, and may also prevent dandruff, eczema, and psoriasis. It is required for the production of the monoamine neurotransmitters serotonin, dopamine, noradrenaline and adrenaline as it is the cofactor for the enzyme aromatic amino acid decarboxylase. This enzyme is responsible for converting the precusors 5-hydroxytryptophan (5-htp) into serotonin and 3,4-dihydroxyphenylalanine (l-dopa) into dopamine, noradrenaline and adrenaline. As such it has been implicated in the treatment of depression and anxiety.

Magnesium is a vital component of a healthy human diet and deficiency has been implicated in a number of human diseases. Magnesium is readily available in many common foods but studies indicate that many Americans are magnesium deficient. Supplemental magnesium is readily available and it is also difficult to overdose on magnesium. General failure of the Kidneys may also lead to magnesium imbalance.

GABA is an amino acid produced naturally by the brain. It inhibits the over-stimulation of excessive nerve impulses - a condition that often leads to stress, irritability and sleep deprivation.

Glycine is one of 20 amino acids found in protein. It is synthesized in the body from serine using pyridoxal phospate - the phosphate form of Vitamin B6, and is found in collagen, which contains about 35% glycine. Glycine is an inhibitory neurotransmitter in the central nervous system, especially in the spinal cord, brainstem, and retina.

Taurine, or 2-aminoethanesulfonic acid, is an organic acid that is a major constituent of bile, and can be found in lower amounts in the tissues of many animals including humans. There is also evidence that taurine in adult humans reduces blood pressure. It can help reduce body weight. Currently taurine is being tested as an anti-manic treatment for bipolar depression. Taurine is also found in energy drinks, where it may help reduce muscle fatigue.

Inositol, (of which the most prominent naturally-occurring form is myo-inositol, cis-1,2,3,5-trans-4,6-cyclohexanehexol), is a carbocyclic polyol that plays an important role as the structural basis for a number of secondary messengers in eukaryotic cells, including inositol phosphates, phosphatidylinositol (PI) and phosphatidylinositol phosphate (PIP) lipids. Myo-Inositol is classified as a member of the vitamin B complex (often referred to as vitamin B8), and is synthesized by the human body. Some preliminary results of studies on inositol supplements show promising results for people suffering from problems such as bulimia, panic disorder and bipolar depression. Myo-inositol has been found in double-blind studies to be an effective treatment for obsessive-compulsive disorder (OCD).

Valerian (Valeriana officinalis, Valerianaceae) is a hardy perennial flowering plant, with heads of sweetly scented pink or white flowers. Tossing, turning and lost sleep are some of the most common physical byproducts of an unhealthy mood. Valerian is a 100% natural, safe and non-addictive herbal extract that works in the brain by inhibiting the nerve impulses that prevent the body from attaining pure, uninterrupted slumber. It has been used safely for centuries...

Natures Harmony Rhodiola with Cordyceps consists of:

• Rhodiola rosea extract (50 mg), and
• Cordyceps sinensis (250 mg)

Maintains energy, stamina and mental focus.

Rhodiola rosea is a plant in the Crassulaceae family that grows in cold regions of the world. Rhodiola rosea is effective for improving mood and alleviating depression. Russian research shows that it improves both physical and mental performance, reduces fatigue, and prevents high altitude sickness. Rhodiola rosea's effects are attributed to its ability to optimise serotonin and dopamine levels, due to monoamine oxidase inhibition and to its influence on opioid peptides such as beta-endorphins. Substances like these are referred to as adaptogens. They differ from stimulants, and do not have the same health consequences as nicotine, etc.

Cordyceps is a genus of ascomycete fungi that includes thousands of species. The species that parasitizes the vegetable caterpillar — Cordyceps sinensis — is the most famous of these, having long been considered a precious ingredient in Chinese traditional medicines. Some Cordyceps species are sources of biochemicals with interesting biological and pharmacological properties, like cordycepin... Cordyceps sinensis is a species of fungus found in southwest, mountainous China that attacks caterpillars, specifically the larvae of hepialid moths (identified as species of Hepialus or Thitarodes). The entire fungus-caterpillar combination is hand-collected for medicinal use. In Chinese medicine C. sinensis is considered sweet and warm, it enters the Lung and Kidney channels, and the typical dosage is 3-9 grams.

Thiamine at 50 mg good for "mental acuity"

The RDA [for thiamine] ... is set at ... 1.4 mg. However, tests on volunteers at daily doses of about 50 mg have shown an increase in mental acuity.

Not only does thiamine keep the pests like fleas and mosquitoes at bay, it also makes the mind more acute.

"Thiamine is used in the biosynthesis of the neurotransmitter acetylcholine and gamma-aminobutyric acid (GABA)." — Wikipedia entry for thiamine

"One well-supported function of acetylcholine (ACh) in cortex is increased responsiveness to sensory stimuli, a form of attention." It helps improve hearing, sight and body-sense.

Learning and neuroplasticity is dependent on acetylcholine. It also help improves response to behavior cues.

GABA helps in the formation of synapses, thus improving neuroplasticity.

As for toxicity, high doses of thiamine are safe and harmless.

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Reference

Thiamine: http://en.wikipedia.org/wiki/Thiamine
Acetylcholine's role in decision making: http://en.wikipedia.org/wiki/Acetylcholine#Role_in_Decision_Making
GABA: http://en.wikipedia.org/wiki/Gamma-Aminobutyric_acid