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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Rick on June 5, 2002, at 19:15:38
A couple years ago AndrewB posted that Ondansetron, a 5HT3 serotonin receptor antagonist, can be useful in reversing psychotropic - easpecially SSRI -- induced memory loss. Apparently it can be useful for fatigue and anxiety as well. The link to that post is below.
I haven't heard much about this since then.
Does have any first-hand reports?
Posted by Rick on June 5, 2002, at 19:44:16
In reply to Ondansetron for Psychotropic-Induced Memory Loss?, posted by Rick on June 5, 2002, at 19:15:38
Posted by omega man on June 5, 2002, at 23:51:41
In reply to Ondansetron for Psychotropic-Induced Memory Loss?, posted by Rick on June 5, 2002, at 19:15:38
I was on the UK trial for ondansetron ten years ago as an anti-anxiety drug...it had a real profound effect...but I was so ill I needed harder drugs..and just used them occasionally...I think I had the only tub in the UK...
I found a sort of clear headedness...very much like buspar..but they are heavy on the guts in that you can't feel your stomach muscles which was too strange a sensation...perhaps they bloat the stomach too much.
Posted by Ritch on June 6, 2002, at 10:01:59
In reply to Ondansetron for Psychotropic-Induced Memory Loss?, posted by Rick on June 5, 2002, at 19:15:38
> A couple years ago AndrewB posted that Ondansetron, a 5HT3 serotonin receptor antagonist, can be useful in reversing psychotropic - easpecially SSRI -- induced memory loss. Apparently it can be useful for fatigue and anxiety as well. The link to that post is below.
>
> I haven't heard much about this since then.
>
> Does have any first-hand reports?
>
> http://www.dr-bob.org/babble/20000822/msgs/43509.html
Rick,I didn't know about its potential for use for SSRI memory loss, etc. However, I was personally more interested in its use to combat SSRI-induced diarrhea and acid reflux. I took it in the hospital post-op after thyroid surgery (with morphine) and was sitting up eating soft food and juice just a few hours later and didn't have any trouble at all with nausea or reflux. I wonder when the patent is to expire on it? Remeron also is a potent 5-HT3 antagonist, and I felt particular relief from IBS and GERD symptoms while taking Remeron, but its other pharmaco activity made me confused and forgetful as can be.
Mitch
Posted by Rick on June 6, 2002, at 21:58:48
In reply to Re: Ondansetron for Psychotropic-Induced Memory Loss? » Rick, posted by Ritch on June 6, 2002, at 10:01:59
Mitch -
Interesting. I didn't know SSRI's could cause acid reflux. I'd imagine that's a fairly uncommon side effect, as opposed to things like nausea and diahrrea. And I never would have guessed Ondansetron or Remeron would treat reflux!
Do you find the ususal meds completely ineffective for GERD? Proton Pump Inhibitors like Prilosec seem pretty effective for most people, at least for awhile (more on that in a moment).
Was/is your GERD the kind with the classic heartburn and fire-in-the-throat symptoms, or of a different nature? I'm curious because even though Prilosec has been a "wonder drug" for me for years, for the last few months I've been suffering from this out-of-control, relentless, feel-like-I'm-choking-to-death postnasal crap, and the ENT guys swear it's due to GERD -- even though the classic burning and piercing sensations are rarely in evidence anymore and I'm down 40 pounds.
Rick
Posted by Ritch on June 6, 2002, at 23:43:15
In reply to Re: Ondansetron for Psychotropic-Induced Memory Loss? » Ritch, posted by Rick on June 6, 2002, at 21:58:48
> Mitch -
>
> Interesting. I didn't know SSRI's could cause acid reflux. I'd imagine that's a fairly uncommon side effect, as opposed to things like nausea and diahrrea. And I never would have guessed Ondansetron or Remeron would treat reflux!
>
> Do you find the ususal meds completely ineffective for GERD? Proton Pump Inhibitors like Prilosec seem pretty effective for most people, at least for awhile (more on that in a moment).
>
> Was/is your GERD the kind with the classic heartburn and fire-in-the-throat symptoms, or of a different nature? I'm curious because even though Prilosec has been a "wonder drug" for me for years, for the last few months I've been suffering from this out-of-control, relentless, feel-like-I'm-choking-to-death postnasal crap, and the ENT guys swear it's due to GERD -- even though the classic burning and piercing sensations are rarely in evidence anymore and I'm down 40 pounds.
>
> RickRick,
Celexa is the SSRi that causes the worst reflux for me. Prozac probably a close 2nd. Zoloft didn't bug me that way very much, however. Paxil and Luvox I never took for very long to get a clear correlation (the "GERD" I have is the classic symptoms you mention). I have never tried Prilosec. I was on some Prevacid a year or so ago and it worked really well. But it was $$expensive and I found if I just take some OTC H2-antagonist it works almost as well. However, if I don't take an SSRI-I don't need an H2-antagonist! Wow, "relentless choking-to-death postnasal crap", do you mean burning, or does it seem like a smooth muscle spasm or something? I mention that, because I know two other people who are on different SSRI's and they seem to choke on food easily (not big-time choke-but needing to clear their throat at times while they eat). I speculate that it is a mild EPS-like symptom (dysphagia), from the mild dopamine interference of SSRI's. My throat muscles also feel "tight" (lump in throat) with SSRI's, with exception to Zoloft (and it mildly inhibits DA reuptake), but it messes up my bottom "half" (diarrhea, restless legs). If the ENT's "insist" that it is GERD reflux symptoms... You might try adding a little Remeron (that is if you can stand it), and see how it affects your GI symptoms. The 5-HT3 receptors are most prominent in the GUT, that is why I replied to your post originally. I did hear about Odansentron being used in a study to reduce alcohol cravings as well (a TV report). If it can change mental cravings-well, there must be more to the story than just the GI tract.
Mitch
Posted by Rick on June 7, 2002, at 1:30:28
In reply to Re: Ondansetron for Psychotropic-Induced Memory Loss? » Rick, posted by Ritch on June 6, 2002, at 23:43:15
>I have never tried Prilosec. I was on Prevacid a year or so ago and it worked really well. But it was $$expensive and I found if I just take some OTC H2-antagonist it works almost as well.
Prilosec is going generic very soon, so it will be a lot cheaper. But maybe not as cheap as OTC stuff.
>Wow, "relentless choking-to-death postnasal crap", do you mean burning, or does it seem like a smooth muscle spasm or something?
No, just a continual flood of mucous. Post nasal drip hell. (Sorry if this is getting kinda disgusting...) People often don't realize that constant cold-like symptoms can really be caused by GERD that doesn't produce any of the usual burning-sensation symptoms. In fact cold-like symptoms are how I first learned I had GERD 6 or 7 years ago. I didn't realize that my "never-ending cold" stemmed from the same problem that was making me pop ten or fifteen Tums a day. Back then all I knew about was "heartburn," had never heard of GERD. But this postnasal thing that started building five or six months ago -- even as I continued my longtime large daily dose of Prilosec -- is now so extreme that my bet is there's really something more going on. I doubt it's psychotropic related, although my Klonopin and Provigil (the only psychotropic meds I'm on at the moment) may make it worse with a drying effect. In fact, one of the ENT's looked at my record and said, "Klonopin? Serzone? Jeez, no wonder you have this problem". But his verdict was that the otherwise asymptomatic, Prilosec-treated GERD was causing the mucous, and poor voice usage -- resulting in two small nodules on the vocal cords -- was causing the hoarseness. (Now you have me wondering if he meant the psychotropics were directly worsening the GERD, although I doubt that was the implication.) One treatment recommendation was to see a voice therapist, which is interesting since one of my primary physical social phobia symptoms is shaky voice. But of course, it's been a far smaller problem since my SP treatment.
>I mention that, because I know two other people who are on different SSRI's and they seem to choke on food easily (not big-time choke-but needing to clear their throat at times while they eat). I speculate that it is a mild EPS-like symptom (dysphagia).
I had that, and to the point where I ended up in the ER the first time thinking I was choking. Food would get caught in the esophagus at times. Turns out it came from a narrowing of the esophagus (stricture) that was exacerbated by GERD. A simple widening procedure using a balloon, followed by continued Prilosec, took care of that. It wasn't med related. But as for many people, it was very clearly worse when I was anxious (the muscles would tighten up). So the psychotropics actually help keep that problem from coming back.
What's EPS? Extrapyra-whatever (can never spell that) symptoms? If so, I didn't know dysphagia fit in that category. It's certainly a mscle-control disorder, so I guess that makes sense.
>My throat muscles also feel "tight" (lump in throat) with SSRI's, with exception to Zoloft (and it mildly inhibits DA reuptake), but it messes up my bottom "half" (diarrhea, restless legs).
I recently ran across a Medline abstact of a small study showing that Wellbutrin helps restless legs. Since certain dopamine agonists are the most popular treatments for this, perhaps that's evidence that Wellbutrin really does have dopaminergic activity?
>If the ENT's "insist" that it is GERD reflux symptoms... You might try adding a little Remeron (that is if you can stand it), and see how it affects your GI symptoms. The 5-HT3 receptors are most prominent in the GUT, that is why I replied to your post originally. I did hear about Odansentron being used in a study to reduce alcohol cravings as well (a TV report). If it can change mental cravings-well, there must be more to the story than just the GI tract.
I've often been intrigued by Remeron for a variety of reasons, but right now avoiding any more meds that can cause fuzzy-headedness (or looking for ones that can enhance cognition) is a priority for me.
Rick
Posted by Ritch on June 7, 2002, at 8:28:37
In reply to Re: Ondansetron for Psychotropic-Induced Memory Loss? » Ritch, posted by Rick on June 7, 2002, at 1:30:28
> >I have never tried Prilosec. I was on Prevacid a year or so ago and it worked really well. But it was $$expensive and I found if I just take some OTC H2-antagonist it works almost as well.
>
> Prilosec is going generic very soon, so it will be a lot cheaper. But maybe not as cheap as OTC stuff.
Thanks, I will have to check into that.
> >I mention that, because I know two other people who are on different SSRI's and they seem to choke on food easily (not big-time choke-but needing to clear their throat at times while they eat). I speculate that it is a mild EPS-like symptom (dysphagia).
>
> I had that, and to the point where I ended up in the ER the first time thinking I was choking. Food would get caught in the esophagus at times. Turns out it came from a narrowing of the esophagus (stricture) that was exacerbated by GERD. A simple widening procedure using a balloon, followed by continued Prilosec, took care of that. It wasn't med related. But as for many people, it was very clearly worse when I was anxious (the muscles would tighten up). So the psychotropics actually help keep that problem from coming back.
>
> What's EPS? Extrapyra-whatever (can never spell that) symptoms? If so, I didn't know dysphagia fit in that category. It's certainly a mscle-control disorder, so I guess that makes sense.
>
Dysphagia is difficulty swallowing due to inadequate contraction of the smooth muscles. That was just a wild guess, because I do have mild EPS (extrapyramidal) symptoms from SSRI's-restlessness, tongue spasms/stiffness, stiff neck/throat muscles, posture changes, etc. Thanks for mentioning the "balloon" procedure. At some point I may need to get that done.
> >My throat muscles also feel "tight" (lump in throat) with SSRI's, with exception to Zoloft (and it mildly inhibits DA reuptake), but it messes up my bottom "half" (diarrhea, restless legs).
>
> I recently ran across a Medline abstact of a small study showing that Wellbutrin helps restless legs. Since certain dopamine agonists are the most popular treatments for this, perhaps that's evidence that Wellbutrin really does have dopaminergic activity?Unfortunately, Wellbutrin didn't help with that very much. Some speculate that it does inhibit DA reuptake, however, some here have mentioned that it inhibits DA *release*. Interestingly, my reflux and IBS problems were improved by Adderall.
>
> >If the ENT's "insist" that it is GERD reflux symptoms... You might try adding a little Remeron (that is if you can stand it), and see how it affects your GI symptoms. The 5-HT3 receptors are most prominent in the GUT, that is why I replied to your post originally. I did hear about Odansentron being used in a study to reduce alcohol cravings as well (a TV report). If it can change mental cravings-well, there must be more to the story than just the GI tract.
>
> I've often been intrigued by Remeron for a variety of reasons, but right now avoiding any more meds that can cause fuzzy-headedness (or looking for ones that can enhance cognition) is a priority for me.
>
> Rick
I hear you on that one! Remeron was wonderful for sleep and IBS, but I couldn't do simple math correctly half the time.Mitch
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