Memantine experience so far....

[Verile]

Scroll up and read my week 1 summary. I'm only taking Memantine and Vyvanse and I'm discontinuing the Vyvanse for a bit because the Memantine is interfering with it somehow.

[Jshect]

Surferdude, I have a question for you. I know you advise people to get off wellbutrin before starting Memantine. Unfortunately, I am stuck on it indefinitely. When I try to lower the dosage, I get premature atrial contractions and I can get as many as 9 or 10 a minute and feel just awful, so I am working my way up to my previous dosage. So basically I am stuck on it. My psychiatrist doesn't know what to do.
Have you ever had anyone on welbutrin react well to Memantine, ever? I am extremely desperate to try Memantine because my cognitive functioning is extremely bad. Could I try starting at like 1mg and gradually working my way up while on wellbutrin? If I could get off the welbutrin I would but i can't. Do you have any suggestions for how I could get off wellbutrin without getting the crazy PACs?
Thank, a lot. I appreciate this thread.

[Jshect]

Surferdude, Yea maybe a possible solution to getting on memantine while being on wellbutrin would be to start extremely low and then very gradually work my way up: 1mg week 1 and 2, 2.5 mg week 3 and 4, 5 mg week 6 and 7...
Just a guess, but I am desperate to try it and i am stuck on wellbutrin indefinitely.

[kinglizard]

Verile et. al, are you guys taking the brand or generic?

I have inattentive ADD, but severe OCD (with some borderline panic/agoraphobia mixed in) as well. I live in a really stressful home environment (noisy family) and tend to be highly sensitive to overstimulation from noise, emotional displays, etc. Seems to be unique to my environment -- I'm fine when I'm with, er, civilized people my own age (26), but I can't move out unfortunately due to the severity of my anxiety.

Anyway, I tapered off Parnate two weeks ago and my mood has plummeted and anxiety sky-rocketed (not that it was doing much for anxiety anyway). I'm very prone to switching between being overstimulated/running on pure adrenaline and being fatigued, inattentive, asocial etc.

Not sure if I have a question here .. just really feel like what I *need* is something to make me more calm, even and less reactive to everything going around me and suppose I'm really hoping Memantine (which I start next week) will help. Gaba-ergic stuff tends to be helpful (benzos, Neurontin, etc.) for the overstimulation, but I just find the class in general can leave me feeling more down/depressed.

My pdoc has never used Namenda, but is gracious enough to try it as basically a last-resort for my OCD/ADD comorbidity (in combination with Dexedrine). Last time I tried it (3 years ago ..without a stimulant), I recall 10mg being helpful for anxiety/mood, but that at 20mg I grew more depressed.

Is the idea to shoot for the higher doses known to prevent tolerance (i.e. does the stimulant offset any depressive effects?) or should I stick with 10mg and see how I go?

I'll be taking the brand, FWIW. Sleep is also really terrible (has been for the past 3 years due to ongoing depression etc.), so hoping it doesn't cause/exacerbate insomnia.

Anyway, I guess I'll keep everyone updated on my experience. Just praying it does something to help ... I'm losing hope.

[Verile]

I'm only very mildly OCD. I was in your situation. I was extremely stressed and anxious all the time living with others and it eventually lead to depression; this is why I live alone even though it's not cost efficient. My home is my sanctuary. I need to live alone.

I'm taking Namenda. It has greatly relieved any anxiety, stress, and OCD I was having even at just the 5 mg dose. I sleep easy now for the first time in years. But like I said before I wouldn't classify myself as being severely disabled or as having an OCD or anxiety disorder so your milage may vary.

As for dosing, I've been reading around and it seems people are wildly varied. Some report success with as little as 10 mg a day while others claim to need 60 mg daily for the same effect. If I'm seeing results with 5 mg a day I imagine I'll be at the lower end of the spectrum. I don't think the goal is to shoot for higher dosages to prevent tolerance but rather achieving a stable level of glutamate is. I've seen studies on pubmed suggesting that 30 mg - 60 mg is the sweet spot for relieving depression.

I think surferdude has the right idea about slow titration. Spend a 1 week or 2 at each dosage and keep a journal chronicling how you feel it affects you and whatever else you took/did that day. Maybe it wasn't the 20 mg that made you depressed, it could have been the environment. Maybe if you spent longer on it. Maybes, maybes, maybes. Give it time and keep hope. It's worked for others like you so you have every reason to be optimistic.

[kinglizard]

Originally Posted by Verile

I'm only very mildly OCD. I was in your situation. I was extremely stressed and anxious all the time living with others and it eventually lead to depression; this is why I live alone even though it's not cost efficient. My home is my sanctuary. I need to live alone.

I'm taking Namenda. It has greatly relieved any anxiety, stress, and OCD I was having even at just the 5 mg dose. I sleep easy now for the first time in years. But like I said before I wouldn't classify myself as being severely disabled or as having an OCD or anxiety disorder so your milage may vary.

As for dosing, I've been reading around and it seems people are wildly varied. Some report success with as little as 10 mg a day while others claim to need 60 mg daily for the same effect. If I'm seeing results with 5 mg a day I imagine I'll be at the lower end of the spectrum. I don't think the goal is to shoot for higher dosages to prevent tolerance but rather achieving a stable level of glutamate is. I've seen studies on pubmed suggesting that 30 mg - 60 mg is the sweet spot for relieving depression.

I think surferdude has the right idea about slow titration. Spend a 1 week or 2 at each dosage and keep a journal chronicling how you feel it affects you and whatever else you took/did that day. Maybe it wasn't the 20 mg that made you depressed, it could have been the environment. Maybe if you spent longer on it. Maybes, maybes, maybes. Give it time and keep hope. It's worked for others like you so you have every reason to be optimistic.

Thanks for the advice. Yeah, I know I need to leave this environment eventually, but I was hoping it could, at the very least, act as an anxiety/stress buffer for the time being ..

I could only afford 20mg a day max if I was going to stick with brand. Anyway, I hope the lower dose + dex is enough to help my depression as well as anxiety, but like you say, there seems to be evidence that higher doses are required to relieve depression (I think I read a study once saying it acts as an MAO inhibitor at higher doses, so that may be one mechanism).

Anyway, I'll be patient and try to remain optimistic ..

[surferdude123]

Originally Posted by Jshect

Surferdude, I have a question for you. I know you advise people to get off wellbutrin before starting Memantine. Unfortunately, I am stuck on it indefinitely. When I try to lower the dosage, I get premature atrial contractions and I can get as many as 9 or 10 a minute and feel just awful, so I am working my way up to my previous dosage. So basically I am stuck on it. My psychiatrist doesn't know what to do.
Have you ever had anyone on welbutrin react well to Memantine, ever? I am extremely desperate to try Memantine because my cognitive functioning is extremely bad. Could I try starting at like 1mg and gradually working my way up while on wellbutrin? If I could get off the welbutrin I would but i can't. Do you have any suggestions for how I could get off wellbutrin without getting the crazy PACs?
Thank, a lot. I appreciate this thread.

PACs are annoying especially when symptomatic.

I'd suggest referral to a psychopharmacologist, for advanced medication advice this is way out of my league, but physiology wise I would imagine it's due to PNS/CNS hyperstimulation and an interaction with cortisol / dopamine levels.

[surferdude123]

EVERYONE NEEDS TO BE PATIENT WITH THIS.

Problem with 77 pages is that I end up repeating myself 10x over.

[Jshect]

Hey, surfer, I just searched all this link with keyword wellbutrin and read many of comments so you don't have to reply about wellbutrin. It seems Hanzsolo didn't have too many problems with wellbutrin and memantine up until he tapered off of it after about 30 days. Unfortunately, Ideaman noticed the stimulation immediately. I don't know what to do. I am stuck on a Deplin/wellbutrin combo, reducing either of them gives me PACs. I am desperate to try it though, because my life is miserable because of my cognitive issues. I guess the least I could do would be to try it, and like ideaman, if the stimulation is too much go off it. If I notice positive effects with cognition I will try to find a way to get off the deplin/wellbutrin. It just sucks that i am stuck on it. I will almost certainly be overstimulated because I am overstimulated right now.

[Jshect]

Yea, I hear you surfer. This is good forum but ADDforums could still do something to make searching it easier. I wish they would work on it. Not just on this thread, but on all of the threads, how many 1000s of times do you think the same questions are asked and answered.

[kinglizard]

Sorry, I know this has kind of been covered, but I was trying to work out how to integrate Memantine into my current sleep schedule ..

I suffer from delayed sleep phase syndrome (typically sleep from around 1-2am to 10-10.30 am). For a while, out of the sheer boredom accompanying major depression, I was just inducing sleep at 12am with melatonin or benzos or antihistamines. But I've decided to try and follow a more 'normal' sleep schedule, so am letting myself stay awake until 1-2 and then sleeping 'til 10, at least ensuring I'm getting around 8 hours of sleep.

I started 2.5mg of Memantine two days ago and am taking it at 11am. Once I move up to 2.5mg twice a day, what would be the best time to take the second dose, taking into consideration my late bed time? I'm also on 1mg of Klonopin which I take at midnight, but it does nothing to induce sleep .. just relaxes me.

My ultimate aim is to bring my sleep schedule back, but unfortunately this is too difficult with depression (if I wake up before 10am, I'm incredibly fatigued). So far I haven't noticed much with the Memantine .. I had some coffee with my first dose yesterday and felt quite euphoric; today I was really anxious and stimulated, and have crashed into tremendous fatigue around 4pm, but it's hard to know if that's just the Parnate withdrawal/depression returning.

[Verile]

You have a lot of drug interactions and conditions going on so I imagine it'll be hard for anyone to advise you. Is it possible for you to taper off some of the other drugs, especially the ones that are affecting your sleep? You're the first person I've heard of taking only 2.5 mg of memantine a day, maybe step up to 5 mg sooner than later?

For reference, I dropped my amphetamines and took 5 mg of memantine in the morning at 6 AM, with an alarm, and would go back to sleep. I'm at 15 mg now tri daily, every 8 hours, and I've been sleeping like a baby since day 1. It just abolishes stress, the main factor of my insomnia. Before the memantine I was averaging about 3-4 of sleep a night.

What exactly is keeping you up at night?

[kinglizard]

Originally Posted by Verile

You have a lot of drug interactions and conditions going on so I imagine it'll be hard for anyone to advise you. Is it possible for you to taper off some of the other drugs, especially the ones that are affecting your sleep?

Huh? Maybe I gave the wrong impression, but aside from Memantine, I'm only taking 1mg of Klonopin at night. I was on Parnate for several months, but tapered off and stopped completely over three weeks ago, which means it should be completely cleared from my system. Aside from Klonopin, I sometimes use Melatonin or Doxylamine Succinate to sleep, but I'm not on any other regular prescription drugs (I'm not taking any stimulants either).

You're the first person I've heard of taking only 2.5 mg of memantine a day, maybe step up to 5 mg sooner than later?

Focus Pocus started off on 1.25mg. Since I'm sensitive to medication, I was trying to avoid getting trampled by side-effects. I plan on stepping up to 5mg in a few days though.

For reference, I dropped my amphetamines and took 5 mg of memantine in the morning at 6 AM, with an alarm, and would go back to sleep. I'm at 15 mg now tri daily, every 8 hours, and I've been sleeping like a baby since day 1. It just abolishes stress, the main factor of my insomnia. Before the memantine I was averaging about 3-4 of sleep a night.

So you take your 6am dose on an empty stomach? I just don't know how my sleep patterns are ultimately going to end up, particularly once I introduce Dexedrine and my depression (hopefully?!?!) clears up. I don't mind the 10am - 2am cycle, since it's a lot more peaceful around my house after 10pm, but I think I would ultimately like to be on a midnight/1am - 8/9am cycle.

What made you decide on tri-daily dosing? Is it necessary to take the Memantine before your stimulants in the morning, or does it not matter once your blood level is stable? Because if it is important, I guess I should start setting my alarm for 9am and taking it then (so I can take my first Dex dose once I wake up); otherwise, I'll continue taking it around 10-10.30am.

What exactly is keeping you up at night?

I've had delayed sleep phase syndrome since I was a teenager, so just learned to live around it (i.e. worked afternoon/evening shifts, etc.). Once major depression hit 3 years ago, though, my sleeping (quality, onset, etc.) changed; I struggled to fall asleep, the quality was terrible, I had no daytime energy.

Now I guess it's a combination of stress, anxiety, boredom (my cognition is bad and since I can't really concentrate on anything or read, I just end up pointlessly exerting energy on menial tasks like surfing the net and never properly tire out) and depression.

[Verile]

Sorry, I may not have read carefully enough given the time. I saw a lot of drug names being listed and I thought you were still taking them all.

I take it tri-daily just because the goal is to achieve stable plasma levels and it's not inconvenient for me to do so. I figure 5 mg every 8 hours is more evenly distributed than 10 mg in the morning and 5 mg in the evening. It may be insignificant but I figure if the body can be sensitive to glucose and a myriad of other chemicals in much the same way, why not if I can?

I do take it on an empty stomach, haven't had any side effects from it. I don't think it affects the bioavailability one way or the other. I take it at 7 am now with my amps because my work day generally starts at 9 but no, I don't think the timing is important. Maybe Surferdude has more to offer on that. I never really notice memantine alone anymore, the lower levels of anxiety and stress are constant.

Is delayed sleep phase syndrome easily distinguishable from insomnia? I was the same way as a pre-teen till present day but I never thought it was specifically a response to light. The anxiety of starting a new day, the peace and quiet of night, the general allure of being a night owl; those attributed to my staying up all night more than anything. When I introduced amps I got even less sleep because I'd compulsively stay on the computer all night; couldn't tear myself away despite knowing I desperately needed to sleep. Put my head down on my pillow and it would still take hours to drift off. Could never get comfortable, couldn't turn off my brain.

With the memantine and no amps I noticed a difference within the first couple days at 5mg and slept easily. Can't say it'll be the same for you but with any luck.

I think it goes without saying but I want to emphasize I'm no expert, just sharing my experience and thoughts here so take it with a grain of salt. I'm exploring this medication same as you.

[Verile]

2nd day on 15 mg of Namenda taken tri-daily and Vyvanse 50 mg once daily. Life is good. Calculus II makes sense. Body feels like it's undergoing an alchemic change from lead to flesh. Going to stick with this combo for the next week and see how it takes.

Fingers crossed. Back with more later.