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Dr. Bob is Robert Hsiung, MD,
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Posted by Optimistic on June 15, 2002, at 9:23:26
Any one suffering with major depression, anxiety and also have Tourette's Disorder. If so I would appreciate any input as to experiences, treatment, suggestions etc. Which meds if any have you found to be helpful or harmful?
Thanks for your help.
Posted by LostBoyinNC1 on June 15, 2002, at 11:26:13
In reply to Depression and Tourettes, posted by Optimistic on June 15, 2002, at 9:23:26
> Any one suffering with major depression, anxiety and also have Tourette's Disorder. If so I would appreciate any input as to experiences, treatment, suggestions etc. Which meds if any have you found to be helpful or harmful?
> Thanks for your help.I supposedly have Tourettes (mild) along with severe depression. Unless the Tourettes is severe and results in regular disability, usually its not even treated. If its severe and results in a lot of problems, anti-psychotics are indicated for treatment. Also I have read about nicotine patches being used to treat Tourettes and some doctors will use a blood pressure medication called Clonidine to treat it, Clonidine is a sedating old time BP med which doesnt exactly have the best side effect profile.
But like I said, unless the Tourettes is severe and you are just twitching all over the place and yelling out obscenities in public places and freaking people out, usually they dont bother to even treat it.
Also, many people with Tourettes have OCD, but it tends to be an "atypical" form of OCD.
LostBoyinNC
Posted by avid abulia on June 11, 2003, at 19:36:55
In reply to Re: Depression and Tourettes, posted by LostBoyinNC1 on June 15, 2002, at 11:26:13
mecamylamine was the first oral antihypertensive agent to be developed, and is no longer in use for this indication very often because of severe side effects. i have the severe kind of tourette`s requiring treatment, but i can`t use antipsychotics because i also have a seizure disorder. clonidine and tenex were only marginally useful and the effect faded very fast.
mecamylamine (sold under the trade name Inversine) is a nicotinic acetylcholine antagonist that preferentially acts on the CNS as opposed to skeletal muscle. because it is an antagonist, it is sort of the oral equivalent to a nicotine patch--nicotine is a partial agonist, so a real quick dose like from a cigarette acts as more on an agonist most of the time, whereas a slower form of ingestion like transcutaneous patches or transmucosal gum act more as a modulator... some people with tourettes who respond poorly to the patch (like me) do well on inversine because it has little stimulating qualities. it works mostly in the subset of touretters with depression, and score on depression scales positively correlates with improvement on mecamylamine in general. it has some effect on tics, but is primarily a potentiator or antipsychotics in that regard... but it does do a lot for mood. it is being investigated now for bipolar disorder and chronic fatigue syndrome, among other conditions, now.
because it is a nicotinic ACh antagonist, it lowers cortisol levels by inhibiting stimulation of release of corticotropin-releasing factor by acetylcholine, as well as noradrenaline and dopamine. i have not had time to find what, if any, effects it has on other hormones, second-messengers, and other neurotransmitters besides ACh, DA, and NA.
the effective dose for tourette`s is about 1/10 that normally used to lower blood pressure. (2.5-6.25 mg per day). it has a half-life at normal ph of 12 hrs; like nicotine, increases in ph will increase half-life and vice-versa.
yeah, i know, old thread, but here you go.
This is the end of the thread.
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