Posted by Chairman_MAO on October 26, 2005, at 11:51:36
In reply to Re: Anyone who had rapid cycling and got it to sto » Chairman_MAO, posted by SLS on October 26, 2005, at 8:40:28
As you can see, it is reasonable of me to assert that clonazepam would treat positive symptoms. However, it worsens, negative symptoms. So, read on after this abstract ...
1: Int J Psychosom. 1991;38(1-4):17-20.
Adjunctive clonazepam in the treatment of chronic schizophrenia.
Herrera JM, Alvarez WA, Freinhar JP, Lawson WB, Sramek JJ.
Mount Sinai School of Medicine, Elmhurst Hospital Center, N.Y.
Clonazepam was added to the neuroleptic regimen of 3 treatment-resistant
schizophrenic patients with schizoaffective features. Manic symptoms improved
but returned following discontinuation of clonazepam. The drug appears to
benefit positive psychotic symptoms but worsens negative symptoms.OK. So we need to work on the negative symptoms? Let us add galantamine:
1: Clin Neuropharmacol. 2002 Sep-Oct;25(5):272-5.
Adjuvant galantamine administration improves negative symptoms in a patient with
treatment-refractory schizophrenia.Rosse RB, Deutsch SI.
Mental Health Service Line, Department of Veterans Affairs Medical Center,
Washington, DC 20422, USA.Because of the demonstration of a selective alpha nicotinic receptor abnormality
in patients with schizophrenia, galantamine was added to the stable regimen of
atypical and other antipsychotic medications in a 43-year-old man manifesting
severe and persistent positive and negative symptoms, as well as mood
disturbance and cognitive dysfunction. Galantamine is an inhibitor of
acetylcholinesterase and a positive allosteric modulator of nicotinic
cholinergic receptors (with a FDA-approved indication for the treatment of
patients with mild to moderate Alzheimer disease (AD) under the trade name
Reminyl). Galantamine HBr was initiated at a dose of 4 mg po BID, which was
maintained for the first week of adjuvant therapy, and eventually was increased
to 12 mg po BID during the final weeks of his 2-month trial. Remarkably, within
1 week of its initiation, there was a dramatic and clinically significant
decrease of negative symptoms, as reflected in formal ratings on the Scale for
the Assessment of Negative Symptoms. Moreover, within a few days of galantamine
discontinuation, negative symptoms worsened, returning to the baseline level of
severity. In addition to targeting memory dysfunction in AD,
acetylcholinesterase inhibitors may have an expanded range of targets and
clinical indications, including behavioral and psychotic symptoms. Galantamine
is distinguished from other acetylcholinesterase inhibitors by its positive
allosteric modulatory properties, improving the efficiency of transduction of
the acetylcholine signal at nicotinic receptors. This latter property may have
contributed to the observed improvement in negative symptoms observed in this
patient. Importantly, positive symptoms were unchanged during this 2-month
trial.(7)Keep in mind galantamine alleviates cognitive impairment/myorelaxation from high-dose clonazepam. and that clonazepam will mediate the agitation/discomfort that galantamine could cause in high doses. This combination is a baby of mind that I hope to somehow see through to use in the clinic someday, either by me or someone else.
Comments, please.
poster:Chairman_MAO
thread:570802
URL: http://www.dr-bob.org/babble/20051024/msgs/572091.html