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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Kimbersaur on June 21, 2009, at 2:33:16
I've been on Memantine for 6 weeks now and I don't think it has changed my OCD at all. It is hard to say for sure if it is helping or not since I also just started CBT, but I haven't had any significant improvement the way I do with SSRIs.
How long should I keep taking the Memantine in order to ensure that I gave it a fair trial?
Posted by g_g_g_unit on June 21, 2009, at 6:39:20
In reply to How long is a fair trial? (Memantine), posted by Kimbersaur on June 21, 2009, at 2:33:16
what dose are you taking? i've also been on Memantine for about six weeks, and am finding it really difficult to pin down its exact effects. my working memory is terrible at the moment; my guess is that this isn't a s/e, since my attention span has sucked ever since coming off SSRI's - but since the med has been approved for ADHD, i thought it might exert some benefit in that area. it's improved long-term memory, though (i think). at 20mg, i was finding it was making me feeling a little wired, which worsened sleep & subsequently mood. one thing to keep in mind is that its metabolized differently based on the pH of your urine, so you may have bypassed - or failed to reach - your optimal dose. i've dropped back down to 15mg, which has proved to be a lot more calming. i may even try going down to 10mg as a maintenance dose, since it seems pretty good at reducing the intensity of any negative thoughts (pain, OCD, or stress-related), but yeah, as mono-therapy, it definitely ain't a miracle
Posted by Phillipa on June 21, 2009, at 13:03:50
In reply to Re: How long is a fair trial? (Memantine), posted by g_g_g_unit on June 21, 2009, at 6:39:20
I thought it was for Alzheimers so would think should improve memory???? Phillipa
Posted by Kimbersaur on June 22, 2009, at 19:12:59
In reply to Re: How long is a fair trial? (Memantine), posted by g_g_g_unit on June 21, 2009, at 6:39:20
> what dose are you taking? i've also been on Memantine for about six weeks, and am finding it really difficult to pin down its exact effects. my working memory is terrible at the moment; my guess is that this isn't a s/e, since my attention span has sucked ever since coming off SSRI's - but since the med has been approved for ADHD, i thought it might exert some benefit in that area. it's improved long-term memory, though (i think). at 20mg, i was finding it was making me feeling a little wired, which worsened sleep & subsequently mood. one thing to keep in mind is that its metabolized differently based on the pH of your urine, so you may have bypassed - or failed to reach - your optimal dose. i've dropped back down to 15mg, which has proved to be a lot more calming. i may even try going down to 10mg as a maintenance dose, since it seems pretty good at reducing the intensity of any negative thoughts (pain, OCD, or stress-related), but yeah, as mono-therapy, it definitely ain't a miracle
I've been taking 20mg. The only effects I have noticed are slight trouble falling asleep, lower appetite (lost 5lbs), and slightly delayed orgasm. As for my OCD I'm not sure if it is doing anything at all.
I don't understand what you mean about the dosing. Could 15mg actually work better for me? Could you explain the metabolization thing to me?
Thanks for your response!
Posted by g_g_g_unit on June 23, 2009, at 0:37:49
In reply to Re: How long is a fair trial? (Memantine) » g_g_g_unit, posted by Kimbersaur on June 22, 2009, at 19:12:59
to be honest, i don't have a great understanding of the science behind it, but i'll give it a shot. so @ 20mg, a person with a normal drug metabolism would be excreting enough of the drug so that that 20mg would stay at a relatively constant level in their blood on a day-to-day basis, at least after you've been on a given dose for about a week - in other words, they could be assured that they're taking 20mg. but what if you were removing less of the drug from your body because your urine has an abnormal pH? then, because it has such a long half-life, it would begin to accumulate, meaning you could be taking 20mg, but in effect be 'overdosing' (not in a dangerous sense), but just be taking more than you think you are because its not being excreted from your body at a consistent rate. i wouldn't worry about it too much, but it just means that you could have missed your optimal dose. i'm withdrawing from the drug at the moment, but staying at each dose on the way down for about a week just to make sure. so far 15mg still isn't improving things much, but i might see what 10mg is like. if that doesn't work out, i'll ditch it.
Posted by Kimbersaur on June 23, 2009, at 2:03:11
In reply to Re: How long is a fair trial? (Memantine), posted by g_g_g_unit on June 23, 2009, at 0:37:49
> to be honest, i don't have a great understanding of the science behind it, but i'll give it a shot. so @ 20mg, a person with a normal drug metabolism would be excreting enough of the drug so that that 20mg would stay at a relatively constant level in their blood on a day-to-day basis, at least after you've been on a given dose for about a week - in other words, they could be assured that they're taking 20mg. but what if you were removing less of the drug from your body because your urine has an abnormal pH? then, because it has such a long half-life, it would begin to accumulate, meaning you could be taking 20mg, but in effect be 'overdosing' (not in a dangerous sense), but just be taking more than you think you are because its not being excreted from your body at a consistent rate. i wouldn't worry about it too much, but it just means that you could have missed your optimal dose. i'm withdrawing from the drug at the moment, but staying at each dose on the way down for about a week just to make sure. so far 15mg still isn't improving things much, but i might see what 10mg is like. if that doesn't work out, i'll ditch it.
Interesting. So, by missing my optimal dose you mean that a smaller dose could potentially be more effective? Maybe I should try that before giving up on the drug altogether.
Posted by g_g_g_unit on June 23, 2009, at 15:58:12
In reply to Re: How long is a fair trial? (Memantine), posted by Kimbersaur on June 23, 2009, at 2:03:11
> Interesting. So, by missing my optimal dose you mean that a smaller dose could potentially be more effective? Maybe I should try that before giving up on the drug altogether.Yeah. I mean there's also OCD studies that used 15mg, and i've read reports of people on 10mg. not sure if lower doses would necessarily be more effective for OCD per se, especially if you've noticed zero benefit at all so far; i'm just hoping it might clear up my brain fog a li'l, which it seemed to be doing at lower doses
Posted by Kimbersaur on June 23, 2009, at 16:12:34
In reply to Re: How long is a fair trial? (Memantine), posted by g_g_g_unit on June 23, 2009, at 15:58:12
>
> > Interesting. So, by missing my optimal dose you mean that a smaller dose could potentially be more effective? Maybe I should try that before giving up on the drug altogether.
>
> Yeah. I mean there's also OCD studies that used 15mg, and i've read reports of people on 10mg. not sure if lower doses would necessarily be more effective for OCD per se, especially if you've noticed zero benefit at all so far; i'm just hoping it might clear up my brain fog a li'l, which it seemed to be doing at lower doses
>
>Well thanks for the conversation and good luck with your dosing. It gave me a few things to think about.
Posted by SLS on June 23, 2009, at 17:25:34
In reply to Re: How long is a fair trial? (Memantine) » g_g_g_unit, posted by Kimbersaur on June 23, 2009, at 16:12:34
Memantine 20mg makes my bipolar depression noticeably worse. I have no OCD issues. I don't know what to say regarding a fair trial of memantine for OCD. However, it takes at least twice as long for a SSRI to help with OCD than it does for depression. If I were able to tolerate 20mg, I think I would want to give it at least 2 weeks at that dosage, understanding that this does not include the titration period. I'll hunt around to see if there are any study protocols that specify a longer period of treatment.
- Scott
Posted by Kimbersaur on June 23, 2009, at 18:01:10
In reply to Re: How long is a fair trial? (Memantine), posted by SLS on June 23, 2009, at 17:25:34
> Memantine 20mg makes my bipolar depression noticeably worse. I have no OCD issues. I don't know what to say regarding a fair trial of memantine for OCD. However, it takes at least twice as long for a SSRI to help with OCD than it does for depression. If I were able to tolerate 20mg, I think I would want to give it at least 2 weeks at that dosage, understanding that this does not include the titration period. I'll hunt around to see if there are any study protocols that specify a longer period of treatment.
>
>
> - ScottThanks SLS. That's a good point about it SSRIs taking longer for OCD.
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