Memantine experience so far....

[surferdude123]

Originally Posted by Sentetsu

I'm currently taking Strattera 80mg for ADHD-PI, seven days into taking Effexor 37.5mg - 70mg for anxiety, Ativan 0.5mg - 1.5mg for acute anxiety attacks and Seroquil 50mg for sleep. I'm finding I gain a great deal of energy with the Strattera but my memory, focus, etc, is still absolutely horrible. I would even go as far as to say it's worse, especially because that Strattera seems to heighten my anxiety.

I had the greatest success with Adderrall but became tolerant to it extremely quickly, same with Dexedrine.

From most of what I've read of this topic, Memantine would be a great fit for me as I'm also struggling greatly with academic pursuits and motivation. What would you recommend I talk to my doc about when I next see him with switching around my medications? I'm 99% sure he'd be up for prescribing it as we've already tried a great deal of off the label treatments. Would I be able to continue taking the Effexor?

I understand if all this is beyond the scope of the topic or something I need to speak directly with my doctor about. Thanks in advance!

Effexor is a great med for some, but not for others.

You'd probably benefit from a trial of memantine to enhance overall cognition if your focus is memory improvement.

However, being stressed depressed and anxious wrecks the memory because of overactive glutamate, and a poorly functioning pre-frontal cortex which allows for fluid intelligence, and information integration. Memantine with a stimulant would likely help your anxiety, and memory, but not so much with depression.

You'd likely need to switch to another low dose SSRI, such as Celexa or Lexapro. Seroquel also wrecks the memory as well, and has metabolic consequences - which occurred for me, and I'm a 29 year old fit male and get your lipid panels checked. That's my advice.

[kinglizard]

Originally Posted by surferdude123

I believe medications serve to help people correct valid chemical imbalances, beyond that, they mask the problem.


You'd need to be off MAOIs for at least a month before treating with Memantine and a stimulant, including an SSRI, if that was a route your pdoc wanted to go down.

I'll be off the MAOI 3 weeks before starting Memantine. I feel that should be adequate. With my mood the way it is, I couldn't tolerate waiting any longer.

I was wondering if feeling fatigued/burned out from amps was partly glutamate-mediated, i.e. downregulation of receptors. When I tried Dex while feeling stressed I'd just get spacey and tired. Same with caffeine, etc. My hope is Memantine can help prevent that.

Still concerned about chronic d2/d3 agonism and its relationship to OCD .. I've e-mailed one of the guys involved in the original Memantine trials to see what he thinks.

[surferdude123]

Definitely.

I've come to the conclusion myself (without research, anecdotal thanks to being on memantine for over 2 years) that it's pretty well necessary to stay on Memantine while taking a stimulant, because I feel that after awhile AMPs pretty well CAUSE a dysfunction in glutamate irrespective of any implication relating to Depression, Anxiety, OCD, and Bipolar disorder.

We know that Amphetamines cause Glutamate toxicity, and if people with ADHD and comorbid Anxiety and depression are walking around, the dysfunction in glutamate is going to be even worse.

Recent research (2009-2011) implicates strong Serotonin involvement as well, and specific parts of the brain have been implicated with relating to WHERE dopamine is going. Memantine acts as a mood stabilizer I find as well.

[Verile]

We know that Amphetamines cause Glutamate toxicity

I'm going to google this right now but links please? This seems like an important piece of information to use with a Pdoc.

[reluctant_brain]

I slept through my alarm and completely missed my 10mg memantine dose this morning. I am scheduled to take 5mg this evening. Should I take the 5mg dose, or replace it with a 10mg dose? Which would be more beneficial in maintaining the delicate balances of plasma concentrations and nACR receptor regulation? I want to minimize the impact of the missed dose as much as possible.

[Verile]

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.


http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000250/

[reluctant_brain]

I am aware what the official recommendation is for a missed dose but I want more detailed information that that provides, especially since this is completely experimental off-label usage of the drug in the first place AND my dosage is still being titrated upwards.

What applies to Alzheimer's patients who are on a stable dose doesn't necessarily translate to ADD/OCD/anxiety patients who have not yet reached a stable dose.

Thank you for reading my question and responding to it though.

Question still stands: 5mg or 10mg this evening? Total daily dosage is currently 15mg, today so far I have taken 0mg. Tomorrow morning I will be taking 10mg at 8am.


Insight from anyone who has dealt with this before and/or has a better understanding of pharmacodynamics, pharmacokinetics, glutamate, nACR, plasma concentration, dopamine, NMDA, and receptor regulation than myself would be greatly appreciated.

[reluctant_brain]

Well, I went ahead and took 10mg a few minutes ago and will resume regular dosing schedule tomorrow morning. I'll post an update tomorrow.

[Verile]

What applies to Alzheimer's patients who are on a stable dose doesn't necessarily translate to ADD/OCD/anxiety patients who have not yet reached a stable dose.

Sorry, I should've explained my reasoning. It does translate because even though your disorders are different the goal of titrating the medication is the same for achieving a steady level. Since you missed the dose there really isn't anything else you could've done. I either would've done the same as you and taken the 10 mg in the evening or taken the 5 mg as soon as I woke up, depending on how much time I missed the dose by.

It ultimately shouldn't matter that much though. It's not like it all just disappears if you miss one dose and have to start all over again.

[justchillin4now]

Adderall- 40mg ir-decreased to 20mg because of anxiety, still anxious
Effexor- 75mg
Armour 60mg
Tegretol 200mg was on 400mg but lymphs were low (17) as opposed to 25, treats my headaches but doesnt help moods at this level.
Klonopin .5 mg

I'm a mess, hi everyone, that should be my screen name lol. 43 yo just diagnosed. I should have known earlier because I have one son and a mother adhd, and another son with severe autism. I think I was too concentrated on the son with autism to recognize anything about myself. I lost my job due to severe panic attacks which the adderall sometimes makes worse. I just lost my job due to having to leave from panic. I am a nurse. Everyday is exhausting for me. getting off the benzos cause I dont have a short term memory from one day to the next sometimes I feel brain damaged, but always get good grades in school. (I love school so continuallly go back) I am going to ask pdoc for namenda see what he says. If I dont take my adderall there is absolutely no sequencing, I cant even make a recipe, the ingredients are all jumbled up in my head and forget about packing. My kids think I am crazy

[reluctant_brain]

I don't know what is going on; I slept through my alarm and for an additional 4 hours today missing my 8am dose once again. (slept midnight to noon... really??) Thankfully I didn't have anywhere important to be this morning.

I just took all 15mg for today at once (12:15pm). I'll try again tomorrow to get back to schedule.

[Verile]

Originally Posted by reluctant_brain

I don't know what is going on; I slept through my alarm and for an additional 4 hours today missing my 8am dose once again. (slept midnight to noon... really??) Thankfully I didn't have anywhere important to be this morning.

I just took all 15mg for today at once (12:15pm). I'll try again tomorrow to get back to schedule.

Do you have a smartphone? Try using a loud, persistent alarm. Mine is a jarring metal song. It plays for 2 minutes and auto snoozes for 2 minutes so that I can't just get used to it and sleep through it. It also doesn't allow me to turn it off without solving a math problem.

App for phone is called Alarm Clock Xtreme.

[reluctant_brain]

It actually was the default alarm on my phone. That is a good idea! Thank you for the suggestion *heads over to Google Play*

[surferdude123]

I would've just left the dose until the next day personally. That's happened to me here and there, and I'm fine.

Currently taking 15mg.

[reluctant_brain]

Back on schedule today... now just debating how many days to wait before upping the memantine dose again.

8am: 10mg memantine, 15mg dexedrine spansule, 3g omega-3 efa, 5000IU vitamin D

1pm: 15mg dexedrine spansule

5pm: 5mg memantine, 10mg dexedrine spansule