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General Medication Discussion This section is to be used for general medication discussion and other medications not broken out in their own respective forums.

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Old 03-22-10, 10:03 PM
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Smile Memantine experience so far....

Hi guys


posted here before various times about various topics. I'm a 3rd yr. medical student professionally diagnosed with Inattentive Type ADD with comorbid Auditory Processing Difficulties and Anxiety (GAD) in my first year.

I've tried Concerta, Strattera, Ritalin, Dexedrine.

Now I am on Adderall XR 25mg daily with a 2.5mg - 5mg Dex "topper" around 6pm, which works wonderfully.




Recently, my Psychiatrist reluctantly prescribed me Namenda after I showed him the evidence of current clinical trials for Namenda in Adult ADHD.

5mg x 1 week
10mg x 1 week

now 20mg after 6 days from starting the 10mg.


What I've noticed.

Side Effects. Almost None.

1) mild brain "fog" initially, which went away on day 2.
2) mild increased urination, probably augmented by all the water I drink

Benefits so far.....

1) complete mental clarity. I am not talking about your very first time on Adderall clear, but absolute look at the green leaves and see green clear. It's great, unlike anything I've felt before.

2) Mood stabilizer. Feel calm, stable. Last night I worked an ER PM shift from 3pm - midnight, and I was just crisp and cut the entire time, treating patients, and was on the ball.

3) Improved Memory, more specifically working memory. Lumosity has this "tiles game" for the iPhone, and before starting Namenda, I could only make it to 10 tiles and that was struggling, but now I frequently make it to 11/12 tiles no problem. My recall and problem solving has also improved I feel.

4) Adderall tolerance. Recently just got over a viral infection, so while I'm sick I only take my SSRI, and no adderall, so I was on a 3 day "holiday" from Adderall, but since I've started Namenda, everyday I take Adderall is like the first day I took it, indicating the Namenda IS in fact superior to Magnesium for preventing tolerance - At least for me, and what I'm doing.


So current medication regimen is.

10mg Lexapro every morning.
20mg Namenda every morning
25mg Adderall XR every morning
5mg Dexedrine PRN (as necessary)

Multivitamins / Supplements include (all in the morning)

75mg CoQ 10
Vitamin B100 complex
1000mg Grape Seed Extract
400IU Vitamin E
1000IU Vitamin D
Omega Fish Oil Supplement


Areas that need improvement.

1) Need more exercise - not getting any at the moment.
2) more sleep and eat better




I've made this post to assist offer an experience for anyone in their quest for a stable, helpful ADD/ADHD regimen. While I'm not suggesting anyone go start Namenda or adhere to my regimen, I just thought it would be helpful for me to provide an experience that has been positive thus far.


Cya!
R

Last edited by surferdude123; 03-22-10 at 10:05 PM.. Reason: addendum.
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  #2  
Old 03-22-10, 10:32 PM
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Re: Memantine experience so far....

Could you point me to any clinical studies on Memantine and ADHD? (I have access to medical journals, etc. online, so if it's a password protected site, that's ok- just point me in the right direction and I'll access it through my University).

Thanks.
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Old 03-22-10, 10:39 PM
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Re: Memantine experience so far....

I'd also like to see some studies. It's worrying that a Alzheimer's drug works for ADD.

Also, what scheduled drug is it?
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Old 03-23-10, 05:07 AM
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Re: Memantine experience so far....

http://www.ncbi.nlm.nih.gov/pubmed/17343551
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Old 03-23-10, 10:11 AM
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Re: Memantine experience so far....

It looks like they're also looking at Amantadine (a Parkinsons's drug) for ADHD, which would make sense too, since Parkinsons also involves dopamine deficiency.

I have a family history of Alzheimers and Parkinsons. I wonder if these medications are being shown to prevent or delay these illnesses in addition to treating them.

Anyway, thanks for the info.
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Old 03-23-10, 10:12 AM
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Re: Memantine experience so far....

Quote:
Originally Posted by Thren View Post
Also, what scheduled drug is it?
Namenda:

CSA Schedule
N - Not a controlled drug
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Old 03-24-10, 08:03 PM
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Re: Memantine experience so far....

FYI for the studies.

I conducted a search on Medline, and Cochrane Library to cross reference.

Memantine was initially developed / discovered in 1968, and it's been used sporadically here and there since.


I suspect you could use Google Scholar as well, if you have access to databases like the Wiley Interscience, Nature, MD Consult, etc.


What I've noticed so far......thats positive.

1) Dramatic improvement in short term working memory, actually remembering bits and pieces from conversations the day before etc.

2) Dramatic improvement in memory (i'm starting to recall random things from my childhood at random times)

3) Improvement in OCD / Anxiety symptoms.


This is only at 20mg, and I'll still remain skeptical, but for now, but I feel some changes are occurring.


Cheers
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Old 03-24-10, 08:23 PM
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Re: Memantine experience so far....

thats good....i have read a lot this might be the AD of the future, so big pharma wants it out of the spotlight until they can milk out the existing SSRIs they have out there (which iIMO are all full of side effects and crap out after a while, and then they leave you with a pleasant withdrawal gift from hell)

i think i might give it a try.....i have tried 3 pdocs and they are all pretty useless really, very dissapointing experience for me, so i stick with the least worse one which just writes me script for whatever I ask....within reason of course...will aks for htis next time

but hey man, a couple weeks, not sure thats long enough to put a star label on any med....the long run is what counts for me, is not like this ADD crap ever goes away, so whats the use if you only get the usual startup "teasing" then it drops u off a 1,000 foot cliff....so keep us posted...
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Old 03-24-10, 08:24 PM
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Re: Memantine experience so far....

I'm adult with add. Have tried adderall, ritalin both with side effects(wheezing with adderall and high BP with ritalin) until Dr. added klonipin. Now I've been back on adderall with klonipin for a couple of weeks gradually adding up to 15mg.IR 3x a day with no side effects until actually today!!!!! I guess my question to you is did you ever have any side effects with adderall? For me, trial and error is about to get the best of me! When its good, its great but most of the time its not! Thanks in advanced!
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Old 03-24-10, 10:39 PM
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Re: Memantine experience so far....

yes I do experience side effects from the Adderall XR.

Mainly.


1) Tachycardia with resting Heart Rates between 90-140. Bad I know, but while I'm in med school, I'll stay on it, then after med school I'll reevaluate whether I want to stay on it or not, because my ADD primarily affects my academic performance, not my clinical performance.

2) Stimulation leading to Insomnia - for which I take 50mg Seroquel or 12.5mg Ambien CR for sleep periodically, which works fine for me.

3) Dehydration - For which I drink a lot of water.

4) Decreased Appetite - For which I always make sure and graze throughout the day, rather than chugging down 3 big meals etc.
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Old 03-26-10, 03:04 PM
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Re: Memantine experience so far....

Memantine rocks!
- Dramatic improvement in OCD
- Extra feeling of wellbeing
- I can think with more clarity
- Mood is more stable

I only had some brainfog the first few days but that completely disappeared, after that i was completely side effect free! I took it for a month and didnt suffer from any withdrawal after i stopped taking it.

I was at 10mg/day but ran out, going to 40mg a day soon.
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Old 03-26-10, 03:30 PM
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Re: Memantine experience so far....

Interesting... I may bring Namenda up with my doctor next month. It's a long shot, but we'll see what she has to say...

(My grandpa takes Namenda, which is irrelavant to the discussion here, but I just found this out, so I thought I'd mention it for no apparent reason. )
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Old 03-27-10, 03:51 AM
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Re: Memantine experience so far....

I was orescribed Amantadine awhile back while I was on Adderall. I actually was precribed it for anhedonia. Even though it is a weak NDMA antagonist, like Memantine, it actually competes with d-amphetamine for dopamine receptors, and usually will prevent d-amphetamine from working properly.

See: http://www.ncbi.nlm.nih.gov/pubmed/6141587

I had actually though perhaps Amantadine would help with tolerance prevention. but it actually just blocks the therapeutic effects of Adderall, in my opinion. I suppose, like taking Adderall with a dopamine antagonist (like Seroquel,) for example, for long enough,would result in the dopamine receptors being upregulated....the receptors, since they get blocked by the antipsychotic drug, get a "rest", so after awhile, when you quit the blocking drug, it's like the receptors are "virgins" again- and no longer desensitized.

http://www.ncbi.nlm.nih.gov/pubmed/18688210?log$=activity

I've also seen studies that methylphenidate actually upregulates the receptors the become desensitized to d-amphetamine over time:

http://www.ncbi.nlm.nih.gov/pubmed/19587858

The problem I see with adding an antipsychotic or an NDMA receptor antagonist like Memantine or Amantadine....

All these are strong drugs. For the brain. We're already on strong drugs- CNS stimulants, whether from d-amphetamine or methylphenidate or modafinil or whatever.

Plus a lot of us are on other brain modulating drugs, like antidepressants, antianxiety, sleeping meds, etc., on top of our stimulants.

Do we want to keep adding more drugs to make one more effective, possibly, in the long term?

With your Memantine experience, you are a doctor, right? Did someone prescribe the Namenda to you and how does the doctor feel about it? Did he/she already know about these theories or did you bring it up? Just curious.

I thought, for what it's worth, that I could not take amantadine with adderall for two reasons (after trying for about a month). There was additive stimulation- but in a bad way, like, drinking a pot of coffee while on an ampetamine. Jitteriness, nerves, irritation, heart racing, sweating. no good.

The other was, the amantadine bad effects cancelled out any good the Adderall was doing me. I wasn't going to keep taking it anymore just in the hopes that somewhere down the line, the amantadine would have upregulated my receptors and my tolerance would be so lowered that I could save tons of cash on prescriptions!! :}

I guess, if i ever feel like my tolerance is going up so the dose doesn't work, I take a few weeks off. That seems to give them a rest so when I start up again it seems to work like normal.

I don't see how, for me at least, adding another drug with its own side effects to stop tolerance would be any better than just stopping the drug periodically to stop tolerance.

Is there any reason you think that Memantine is more effective than just temporarily abstinence from Adderall?

(boy, reading these links again makes me really want to go back on Ritalin again. Seems like a much safer drug overall/ Too bad my current psych sold his soul to Shire, so he pushes all things addderall. Still. Apparently he hasn't yet gotten the memo about Vyvanse, thank God .
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Old 03-27-10, 11:00 AM
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Re: Memantine experience so far....

Forgive my ignorance, I'm not quite up on all the neurochemical language, but is this medication actually an antipsychotic? Is it related at all to Risperidone? I'm just wondering because of my personal experience with Risperidone, which made everyone else think I was doing so much better, but made me feel like I was going to die. . .
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Old 03-27-10, 12:29 PM
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Re: Memantine experience so far....

Memantine is not a antipsychotic and isnt related to risperdal at all, it's also completely differend from amantadine so experiences with risperdal or amantadine mean nothing when it comes to memantine.
Its a NMDA antagonist wich is usefull in combination with stimulant therapy to counteract the glutamate hyperexcitation caused by amphetamine wich leads to the developement of tolerance by downregulation dopamine receptors in the striatum.
Memantine is also synergetic with regular antidepressants and has been shown in a animal model to prevent tardive dyskenia caused by antipsychotics.

In short memantine is a very usefull augmentation agent and synergizes with all kinds of differend meds.
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