So I have severe (treatment-resistant?) OCD bordering on panic/agoraphobia and comorbid inattentive ADD; also suffered from major depression over the past 3 years. Been on a bunch of stuff .. SSRIs, benzodiazepines, APs, Neurontin, Depakote, Nardil, Parnate, Dexedrine, Ritalin, etc. all with intolerable side-effects or no success.
I managed to convince my psychiatrist to prescribe Memantine in combination with Dexedrine IR as a kind of last-resort, I guess.
Just wondering if anyone here is using the Memantine/stimulant combination?
I did, in fact, try Memantine (as monotherapy) 3 years ago. I recall 10mg producing a really nice sense of calm and mood stability, but things growing weirder at 15mg and then 20mg; basically, I became more depressed, withdrawn, flat, etc. I hadn't received the ADD dx. at that point, and also wasn't aware I was incredibly sensitive to most meds, so gave up after 20mg didn't work (rather than scaling back to 10mg). My current psychiatrist thinks I'm a slow metabolizer and thus seem to need lower doses of stuff to work (about 2.5mg of Dexedrine 3x a day works fine .. exacerbation of anxiety notwithstanding).
Anyway, just wondering if, in order to prevent stimulant tolerance, it's necessary to take a higher dose of Memantine (i.e. one that might induce depression), and whether the side-effect is then offset by the stimulant? Or is it possible a lower dose like 10mg might work?
Also, does the dissociation tend to be temporary? I kind of suffer from dissociation anyway as a result of chronically high levels of anxiety, so wouldn't want anymore.
I tend to react quite well to neuroinhibitory agents (benzos, Neurontin, etc.) w/r/t to anxiety; they just always dull my mood/cognition too much to be really practical. I don't think SSRIs have ever done much for my anxiety. So I'm hoping that Memantine might be able to at least dampen the chronic, unabating fear, hypervigilance, phobic anxiety etc. and allow me to tolerate a stimulant, so I can actually function again.
I'll be taking brand name, for what it's worth. Any concerns I should have about insomnia? Sleep is pretty poor as it is due to ongoing depression, I suppose.
Maybe this is something for advanced drug discussion but also wondering if chronic upregulation of D2/D3 receptors (the assumed mechanism behind the prevention of stimulant tolerance, if I'm not incorrect?) could exacerbate compulsive behaviour, or at least spectrum traits like hyperfocus, stereotypy etc. Would more serotonin be ideal in this scenario? Kind of hate SSRIs, but thought maybe worst case scenario I could get away with a low dose of something ..
Sorry if this is kind of scatterbrained, neurotic, too many questions etc. Just really hoping this combination can help me ..
I managed to convince my psychiatrist to prescribe Memantine in combination with Dexedrine IR as a kind of last-resort, I guess.
Just wondering if anyone here is using the Memantine/stimulant combination?
I did, in fact, try Memantine (as monotherapy) 3 years ago. I recall 10mg producing a really nice sense of calm and mood stability, but things growing weirder at 15mg and then 20mg; basically, I became more depressed, withdrawn, flat, etc. I hadn't received the ADD dx. at that point, and also wasn't aware I was incredibly sensitive to most meds, so gave up after 20mg didn't work (rather than scaling back to 10mg). My current psychiatrist thinks I'm a slow metabolizer and thus seem to need lower doses of stuff to work (about 2.5mg of Dexedrine 3x a day works fine .. exacerbation of anxiety notwithstanding).
Anyway, just wondering if, in order to prevent stimulant tolerance, it's necessary to take a higher dose of Memantine (i.e. one that might induce depression), and whether the side-effect is then offset by the stimulant? Or is it possible a lower dose like 10mg might work?
Also, does the dissociation tend to be temporary? I kind of suffer from dissociation anyway as a result of chronically high levels of anxiety, so wouldn't want anymore.
I tend to react quite well to neuroinhibitory agents (benzos, Neurontin, etc.) w/r/t to anxiety; they just always dull my mood/cognition too much to be really practical. I don't think SSRIs have ever done much for my anxiety. So I'm hoping that Memantine might be able to at least dampen the chronic, unabating fear, hypervigilance, phobic anxiety etc. and allow me to tolerate a stimulant, so I can actually function again.
I'll be taking brand name, for what it's worth. Any concerns I should have about insomnia? Sleep is pretty poor as it is due to ongoing depression, I suppose.
Maybe this is something for advanced drug discussion but also wondering if chronic upregulation of D2/D3 receptors (the assumed mechanism behind the prevention of stimulant tolerance, if I'm not incorrect?) could exacerbate compulsive behaviour, or at least spectrum traits like hyperfocus, stereotypy etc. Would more serotonin be ideal in this scenario? Kind of hate SSRIs, but thought maybe worst case scenario I could get away with a low dose of something ..
Sorry if this is kind of scatterbrained, neurotic, too many questions etc. Just really hoping this combination can help me ..
