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20003388 tn?1515169640

Very technical medication question

Hello everyone, I have a very technical medication question. I have been prescribed Provigil from my sleep specialist to help me stay awake during the day. I also have anxiety and panic disorder. Now, the provigil is a novel stimulant and doesn't work in quite the same manner as ritalin, adderall or even caffine. Because of this it doesn't increase my anxiety. I do, however, still have anxiety from life in general. My psych doc wants me to take Buspirone. The problem is, Provigil partially works by re-uptaking dopamine and Buspirone is a D2, D3 and D4 antagonist. I am afraid that the buspirone might block the effects of the provigil by preventing the increased dopamine from binding to the dopamine receptors. Now, my understanding is that, at least for the D2 receptor, it is an autoreceptor and supposedly increases dopamine in a certain part of the brain. The whole thing is just a tad beyond me. I just want to make sure the buspirone doesn't block my provigil, if it does I will be falling asleep at random times during the day. Thanks for any help.
6 Responses
973741 tn?1342346373
I'm wondering why your doctor would choose that drug at all to be honest (the buspirone).  Have you tried any other anxiety medications?  Is this because others haven't worked?  Do you have narcolepsy?  What I've read is that the Provigil is more likely to cause the buspar not to work verses the other way around.  But the best source of information is a pharmacist who fills your prescriptions or the prescribing doctor who you should feel free to ask as many questions of as you need to feel confident.  REmember, medication is just a small part of what doctors do---  they take not all that much pharmacology during med school and the rest is what they read/hear/experience.  A pharmacist specializes in this information so that would be my next stop for info!  good luck
1 Comments
Yes, I am also on Prozac 20 mg, Cymbalta 60 mg prescribed. Currently down to 30 mg (tapering off) and Lamotrigine 200 mg. I was just switched from Paxil to Prozac. I gained nearly 80 lbs in less than a year on Paxil. I also discovered that the Cymbalta and Paxil and now the Cymbalta and Prozac blunt the effect of each other due to being competitive inhibitors of liver enzyme CYP2D6. That is why I am tapering off the Cymbalta. This should allow the Prozac to work better and I will be requesting a dose increase tomorrow. As I mentioned in the other post on here, my doctors and even my pharmacists don't seem to understand the mechanisms of action of medications. They seem to only know what the literature handed out by the pharmaceutical companies say. Pharmacology is a hobby of mine. I love learning about how medications work, which neurotransmitters they affect, what neurons they bind to but I, in no way, have any formal education. It's pretty sad when I have a better grasp of how my personal medications work than my doctors and my pharmacist. I finally found a few people on the Buspirone and Provigil combo and it seems that it does in fact blunt or flat out block the effect of Provigil. To answer your question, I haven't been diagnosed with narcolepsy but I wouldn't be surprised if I had it. I have severe obstructive sleep apnea. My first sleep study I stopped breathing 180 times an hour, worst case the sleep doc I was seeing said he ever saw. I use a CPAP every night and have for quite some time. Despite only having between 1-4 apnea episodes a night (they say as long as you are under 5 than your treatment is effective), I am just so exhausted during the day. I fall asleep at random times doing random things and it really disrupts my life. My fatigue clouds my head. I can't think clearly or concentrate and it doesn't help that I have ADHD subtype I and OCD (which gets worse the more tired I am). They prescribed Provigil and it has been a godsend. I am awake during the day. I can think clearly and function. My ADHD is better and my OCD is better. I don't know what I would do if the Provigil didn't work. I'll have to do some more research and rethink my approach to tackle the anxiety. I have other, real life stressors that I am trying to deal with as well. Fortunately my psych doc, despite being a bit uninformed about mechanism of actions, is a nice guy who is willing to listen to me and take my suggestions to heart. I have been on psych meds for 22 years so I have a pretty extensive personal history with them and he takes that in to account at our appointments. Thank you for the response though. I seemed to have finally found my answer online but I still appreciate the time you took to answer. Sorry for the long winded post.
Avatar universal
What did your psych doc say about these issues you are concerned about?
2 Comments
Unfortunately my doctors don't know the mechanisms of how medications seem to work. They only know what the literature given to them by the pharmaceutical reps say. Same for the pharmacists around here. It really isn't much help. I've been scouring the internet to see if anyone takes these two medications together and other than a few stories it doesn't seem like a common combination. The stories seem to indicate that Buspirone does indeed blunt, if not fully block, the effect of provigil. It's kind of disappointing but I'll have to take another approach for the anxiety. Provigil is the only stimulant type medication that keeps me awake and doesn't cause anxiety and or panic attacks. I do also take Prozac and Cymbalta but the Prozac and Cymbalta are blunting the effect of each other due to liver enzyme competition. I am tapering off the Cymbalta and will be asking for a dose increase of my Prozac tomorrow since I'm only on 20 mg.
You can call the manufacturer.
Avatar universal
My understanding is that, theoretically, Buspar works by targeting serotonin.  But before you do this, if you have any concerns, research the research on Buspar -- it very seldom work.  It didn't work in clinical trials.  It keeps being tried for different things, trying to find a market.  Right now it's only wide usage is when an ssri isn't working well enough to augment it.  Now, a lot of people take it, and obviously many like it, but this is a very short half life drug that is more like a benzo than an antidepressant.  I really doubt it will counteract your other drug, because it just doesn't work that well, but again, if you have any doubts, do your homework and decide if it's really worth it.  Nobody on here is a scientist.  Your pharmacist isn't a scientist but might know of drug interactions between these two.  Your psychiatrist isn't a scientist, but should have experience using various drugs together.  My own experience, long and sorry, is that most doctors including psychiatrists are really pretty clueless about the drugs they prescribe and how they actually work.  This is made worse by the fact that many of the drugs we take have unknown reasons for why they work, if they work, and most don't beat placebo by all that much in clinical trials (I'm not sure Buspar has ever even beaten placebo).  My take is, if you get any scientific inkling that the drug you need works and Buspar might conflict with it, well, you probably weren't going to benefit much from it anyway, though you might be one of the few who do.  The drugs that do work for anxiety, however, are generally sedating, but some antidepressants are very stimulating and if your anxiety is a byproduct of depression, and it very often is, they might help both problems.  Two example are the snri category and wellbutrin, but if anxiety is your main problem, these can be too stimulating for many people.  Good luck in your search.
7 Comments
By the way, your own analysis of drugs might not be factual.  And it might be.  The reason you're finding your docs don't know how the drugs work is that nobody knows how these drugs work.  Consider that none of them attack the underlying cause of your problems, they just tackle symptoms.  That's because nobody knows the underlying causes.  Many of these drugs are just accidents.  The brain is way more complex than current science, and the fact drugs affect theoretically certain receptors doesn't mean a whole lot in reality because most of the information behind these drugs is not available to the public -- once a drug becomes part of the proprietary marketing process of making money off of it and out of the hands of general researchers where most drugs begin, they don't have to tell you everything they know and if they did, any other company could then just do it too.  To get a patent, they have to give certain information to the FDA, but not all the information because of the profit making state of our economy and that it is applied to medication.  And you're also on a very contradictory stew of meds already -- most would not put you on an anri and an ssri at the same time because of the risk of serotonin syndrome, and Buspar will only make that even more of a possibility.  Prozac and Cymbalta are both rather stimulating antidepressants and therefore not the most effective for primary anxiety, with Cymbalta being more stimulating than Prozac.  This stuff is very complicated, and if you find someone who really understands it good luck to you.  But there are psychopharmacologists who are psychiatrists who go a bit further on their drug study, and there are also a class of psychiatrists who call themselves functional physicians who actually treat you not just as psychiatrists but also as doctors.  They are hard to find and don't take insurance, but they know more.  But once you decide to take medication, it's going to be trial and error because no matter how a drug is designed, it might not be absorbed by your body well or you might have odd reactions to it.  General information is useful, but won't necessarily apply to you.  You're already on a stew that one might find frightening, but you're sailing through it.  You quit Paxil without much trouble, which is amazing.  You are the only you.  And I agree with you, it's amazing truly that with just a little homework we become more knowledgeable than our psychiatrists.  Makes you wonder how they continue to charge so much for so very little.
As far as Buspirone, I have been on it several times and it has always worked for me. The Provigil is more important to me however. Without the Provigil I literally cannot stay awake during the day. Anxiety sucks but sleeping all day or falling asleep at random times sucks even more. I'm not too concerned about serotonin syndrome however, I have been on 5 serotonergic drugs at once before and never had an issue. Either I am severely low on serotonin or my body just handles the extra serotonin well. I do know that I have an un-reversable defect in the way my body produces and handles serotonin. The leading theory is that my brain was altered from being on SSRI's at such a young age. I started when I was 12. Now there are warnings against prescribing for under 25. I have also had great success in the past with Prozac. Like I had mentioned, the Prozac and Cymbalta are competive inhibitors of the same enzyme and as such blunt the effect of each other. In fact, I noticed that as I have been coming down off the Cymbalta the Prozac seems to be getting more effective. While some mechanisms of actions are just theoretical and not known we do know what receptors these medications affect based on animal studies and other methods. They have ways of imaging the brain in a manner that they can see what receptors are affected when a medication is taken so we do know that. In what action this causes, beyond the obvious, well, that becomes more of a mystery. But generally antagonists block an action and agonists mimic the neurotransmitter. Autoreceptors are a bit different and have a negative feedback action. While I don't have any formal pharmacological training I have researched and done the same work one would go through in school so I'm pretty educated on medications, plus my own life experience having been on them for 22 years. Some things remain a mystery, clearly but I would think at the very least my pharmacist should know the mechanisms of action. That is pretty clinically important information.
But pharmacists are not clinicians.  They will, in fact, refuse to recommend or explain how drugs work because they will be fired if they do so.  Their job is to sell medication, and in order to do that they have to know how to properly dispense it.  But they don't treat patients and aren't, therefore, trained in how to do that.  Again, all the study you can do in the world will not tell you how a drug will affect you.  It will tell you the general theory of the person who first instituted the research, but by the time a drug hits the market and you can get access to it a major pharmaceutical company has purchased the rights to it and they ain't talkin' until they get sued and discovery happens in litigation.  Much of what we know of how these drugs affect people, such as withdrawal and serotonin syndrome, came from lawsuits, which is why right wing politicians want to bar these lawsuits -- bad for business.  It is what it is.  As for quantity of serotonin, and this isn't for you, but for others reading this, there is a big misunderstanding out there that these drugs make our bodies produce more serotonin.  They don't.  If you didn't have enough serotonin being produced by your body, which uses tryptophan and B6 plus other co-factors to manufacture serotonin, these drugs wouldn't work well.  What they do is take the serotonin you have and make it wash longer in the targeted receptors by preventing the breakdown of serotonin -- the body prefers fresh serotonin, not used serotonin.  Most of your serotonin isn't in your brain, it's in the digestive system and in other parts of the body.  So I doubt you have any less serotonin than anyone else and even if you did that wouldn't necessarily result in depression -- although altering the way the brain uses serotonin can make us feel better, it isn't the cause of depression or anxiety.  Nobody knows what that cause is biologically.  There are theories being considered, but so far all of the ones that have been proposed through the years have turned out to be wrong.  Where this serotonin notion comes from isn't science but from Eli Lilly when they first came out with Prozac, and a supporter probably in their pay who wrote a bestseller about the miracle of Prozac.  So while I get it you have studied a lot about this, you admit that your brain isn't responding the way the science suggests it should, which is you should have been overdosing on serotonin. You didn't because, again, you are the only you.  I do agree that starting too young might be a big problem -- not much data on this -- but starting on these drugs when your brain isn't yet fully developed might in fact damage it for life.  But I don't know if there's any hard evidence of this or even if anyone is looking all that hard for it.  The reason this concerns me enough to comment like this is that my life was destroyed by one of these drugs, and the reason was nobody explained the dangers of them to me.  My problem wasn't starting too young, but stopping one of them.  That's why I think experiential knowledge is just more important in this field than knowing the science, because the science still won't tell you what will happen to you if you take one of these drugs.  Only trying it and time will tell you that.  It ain't like gravity. I'm glad you're doing better as you go down on the Cymbalta -- that drug has liver toxicity and is a whole lot harder to stop than Prozac, so you're way better off with Prozac working for you.  Peace.
I should add, the other non-targeted receptors in the brain shut down and don't try to reawaken until you stop taking the drug, causing a lot of what we call withdrawal.  
While I respect your opinion I have to disagree with you. There are studies that show, without a doubt, which receptors are activated by any specific medication. It's true that serotonin being the cause of depression and/or anxiety is just a theory. Another theory is a deficiency of norepinephrine and dopamine. Some people respond to SSRI's, some to SNRI's and some to NDRI's. Some people, like me, typically only respond to a combo of an SSRI and an SNRI. But again, there are studies done by, and peer reviewed by, the national institutes of health, an official government agency, that show what receptors certain medications activate or deactivate. They can even show how strongly a substance binds to these receptors. As far as serotonin, I know that SSRI's don't actually increase  the total amount of serotonin. At least not in a traditional sense. They do, however, increase the amount of synaptic serotonin. They prevent the reuptake thus keeping serotonin in the receptor longer to exert it's effects. The reason why it takes weeks for an antidepressant to work, and why a lot of people have increased depression and/or anxiety at initiation, is because the receptors take time to downregulate. This downregulation helps to prevent the extra synaptic serotonin from overstimulating the receptors. And yes, I am also aware that around 95% of the body's serotonin is found in the gut. That is why a lot of people have successfully treated anxiety and depression with pro and prebiotics. I have tried every natural method to treat my anxiety and depression and have only had success with medications. I am also aware that SSRI's alone can decrease both norepinephine and dopamine. I'm sorry you had a bad experience with meds but a lot of people do benefit from them.
This argument is a very important one, or I'd give it up as you can't be budged.  But you're missing the point -- yes, of course there are studies that show the targeted receptors do what is intended.  If not, none of these meds would be FDA approved or have a patent.  So that's a given.  What it doesn't say is how many people have this happen successfully, meaning, does the drug actually do what is intended, which is to reduce depression and anxiety.  In the studies submitted by those seeking FDA approval, in all cases, this only happened a little bit above placebo.  What does that tell you?  What does anything else matter?  It helps one decide when the risk of taking a medication -- any medication -- is worth it or not.  If you just look at the science, it looks like a miracle, but in practice, it isn't -- it's an improvement over what we had before medication, maybe.  As for the the theory of depression, the main area of current study is glutamate receptors, not dopamine or serotonin which are yesterday's news.  Or at least right now, because yesterday's news in science can also be tomorrow's news when better studies are done.  For anxiety, it's something in the communication between the amygdyla and the adrenal glands that's the main area of current research, not yesterday's research.  But it's been going on for awhile and so far nothing better than what we have.  And again, while the targeted receptors are washed in serotonin longer, all the other receptors that would normally be involved either go sporadic or shut down altogether, meaning, there is no more serotonin activity, there might actually be less overall, but the concentration in the targeted receptors indeed works for a lot of people, including me.  My bad experience was quitting Paxil, not being on medication, which I still am and have been for many years and probably will be until I die, which isn't going to be that long from now as I'm getting on in years.  Why is any of this important?  To save people like you from being put on antidepressants in the first place at such a young age, or when someone has a breakup or suffers grief or has a hormonal imbalance.  They are way overused and are very dangerous drugs for too many people (and aren't dangerous at all for others).  Another thing underplayed is the growing body of research that shows that once you've been on one of these drugs for an extensive period of time, many people will never again be able to function without one.  The brain simply can no longer function properly without medication.  With benzos, research shows that after being on them for awhile, which I have, the brain can no longer adapt to stress without them.  It just forgets how to do it.  Science isn't fact; it's the pursuit of fact.  Virtually every modern scientific theory of medicine has proven to be wrong within an astoundingly short period of time in one way or another.  Am I against taking these drugs?  Of course not, I take them.  Therapy didn't work for me.  Natural medicine is a very complicated thing to do and is often just not strong enough.  Therapy has no better record of working than medication.  It is what it is, we live when we do.  As for probiotics, this is another area of growing study.  Serotonin has nothing to do with them, but antibiotics and other toxins do.  Some gastroenterologists are now going so far as to do fecal transplants, and they often work for digestive disorders.  We may be heading there for mental illness as well in at least some cases.  For many people, mental illness can be traced to an event, and we can usually treat that in therapy.  For those of us who can't trace it to anything, sometimes we can if we're strong enough, but often we can't and the medication we have today is often the best we can do.  But all I'm saying is, the "first, do no harm" maxim must be applied to mental illness as it is to other illnesses.  Basically, I'm not disagreeing with you on anything pertaining to the science you so well describe, I'm only disagreeing with you that the science actually applies in practice to an individual human being.  Sometimes it does, sometimes it doesn't, which means we really don't know what we're doing yet.  Peace.
Don't get me wrong, I agree with you, antidepressants are WAY over prescribed. They give them out for anything. Seasonal effective disorder, relationship breakups, insomnia, pain relief. It's ridiculous. They talk about the opioid epidemic but they should also be talking about the antidepressant epidemic. I strongly feel that had I not been put on SSRI's at such a young age I wouldn't be as messed up mentally as I am. I blame the lousy studies of the time, the FDA for allowing children to be placed on these meds (at the time) and the doctor's who placed me on these meds. I am angry that they did this with very little information and studies to back up their use. I feel regret for ever taking these medications. Unfortunately, I am now dependent on these medications to function. I feel for you with the paxil withdrawal. I have been through it. I was taken off cold turkey when I was 16. I suffered from a migraine headache and nausea 24 hours a day for about 8 weeks. I spent most of my time in bed. Nothing touched the headache or the nausea. After the 8 week period I was weak and lethargic for another 12 or so weeks. It was pretty hellish so I totally understand where you are coming from. If I remember correctly something like 30% of all people placed on SSRI's even respond to them. The other 70% have no response. In other words, they only work on a small population of people. I guarantee you that a great number of those people also take something as an augment agent. I, personally, only respond well when I have an SSRI+SNRI combo. This indicates to me that my issues are most likely linked to both serotonin and norepinephrine, or at least something they directly or indirectly affect. I also have improvement with dopamine re-uptake as well. One of the mechanisms of action of Provigil is dopamine reuptake. When combined with my new med regiment I start to feel almost normal. My doc just increased my prozac to 40 mg and swapped my cymbalta for effexor and it has already made a difference. I hope I wasn't coming off as an ***. I just didn't fully agree with some of your statements but I think maybe I was misunderstanding the point you were trying to make.
1530171 tn?1448133193
I read the entire thread and then more, trying to make sense of  things.
We all know how inadequate & dysfunctional the medical system is and that's part of the reason we gather here.

All the technical mumbo jumbo is TOTALLY useless, when nobody can answer with any degree of certainty how these drugs work (or don't) on jwright84
Please read on:

This is a particularly complex case and unfortunately many important details in this post were left out!

No, jwright, I cannot see how you  only had success with medications, when from what I read, you are forever dropping, adding, switching, adjusting medications, which BTW, at present, have Twelve Drug Interactions between them, out of which 5 are Major Interactions!!! (you are at an increased risk of Serotonin Syndrome, but your prescribing doctor and your pharmacist should know this, right?)

In addition you are on 5 Central Nervous System (CNS) Drugs, when the recommended maximum is only 3
(taken concurrently). And also on 2 Anti-depressants, when only one at a time is the recommendation.

Perhaps, your doctors have a very good therapeutic intention for prescribing all these meds, understanding the possible consequences and implications, after doing a thorough risk-benefit analysis. But I doubt that.

Here's my honest opinion, which I'm offering, in order to help you get on the path to better health and recovery.

I don't think your body needs another drug to help you stay awake during the day.
As much as you want to fix some things in your life, you need to go deeper, beyond just fixing issues that may have to do with drug side-effects, drug interactions or symptoms of unresolved imbalances/conditions.

It sounds that you have a sleep debt and a major factor
is likely the sleep apnea.
Sleep apnea brings its own set of anxiety,stress and other symptoms.


Your 2 diagnoses are distinct and treated separately, yet treatment must be in concert, as well.

Being obese is a factor in both anxiety and apnea.

Also obesity causes Vitamin D "functional" deficiency, -even if your vitamin D levels test normal- in the form of vitamin D resistance (VDR). Much higher levels of D are necessary to make up for VDR.

Chronic pain is another source of stress.
There could be a strong connection between obesity,
Vitamin D deficiency and your Spinal abnormalities.

A functional deficiency of calcium is highly suspected, where calcium is leaching out of your bones faster than
deposited, as calcium intake is mostly un-metabolized.

To make matters worse, a magnesium deficiency is also highly probable, which is vital in optimizing calcium deposits in the bones and joints, dealing with stress and anxiety, increased energy etc.

Other things to consider, which might be going against you are:
*Leptin-Resistance, High Cortisol (or Low Cortisol, depending on how long your adrenals have been stressed), hypothyroidism possibly type 2 (thyroid-resistance), lack of a neurotransmitter assessment.

* Disregard the ones which might have been already PROPERLY addressed and/or ruled out.


There's very little hope that your meds, will do any more than just maintain you, which will continue being an
ongoing battle, unless the underlying issues are properly addressed.

The natural approach you mentioned, needs to be very comprehensive and under the guidance of an experienced Practitioner.
Getting some supplements, ACV and other suggestions
from internet sources or acquaintances etc, does not constitute a professionally designed natural treatment plan.

If I were you I would also look into  genetic analysis,
since there seems there might a genetic component in some of your conditions. Some genetic mutations can
be influenced by specific targeted nutraceuticals and
many can be totally reversed (in combination with
eliminating other environmental/lifestyle contributing factors)


I just lost a friend of mine in September to cancer, who
for many years had been on at least 15 different meds, also with a great number interactions and dublications, from sleep medications to pain killers and statins, diuretics, SSRIs, PPIs, ACE inhibitors Tylenol 3 ...
He never really trusted his doctors; I knew that, even if he didn't openly expressed it.
But he was afraid to initiate significant change, just in case!

You are still quite young. and you now have a daughter.
Congratulations!
If she's not enough of a  motivation factor for you to turn things around drastically,.I don't know what is.

Best wishes,
Niko


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3 Comments
I've gone periods of months without being on any medications at all. I have had every test under the sun done. Vitamin D is normal but I still take 5000-10000 IU a day. Magnesium is normal but I still take a magnesium supplement. Everything is normal with the exception of sodium which was 1 point higher than it should be and low testosterone which I have been on TRT for nearly 3 years and my T levels are all within normal range now. Thyroid has been checked half a dozen times in the last 2 years, always comes back as normal. I've had EKG's, ECG's and cardiac stress tests, all normal. I use a CPAP machine every night and have for years now, I average 1-4 events per hour which fall under the normal category. Last night I was actually down to .8 events an hour. I know the tiredness isn't fully medication related because, again, during periods of no meds I still had the fatigue issue, despite using my CPAP. I admit that I am considered obese, mostly as a side effect of Paxil but when I was a healthy 190 lbs and not on meds I still had all the same health issues. I've tried natural treatments under a qualified professional and had to give up after nearly a year of no response. I have a healthy, balanced diet. Don't drink soda or juice. The worst thing I drink would be unflavored carbonated water. As far as my current meds, I take 40 mg Fluoxetine, 75 mg Venlafaxine XR, 150 mg Lamotrigine (down from 200, tapering off) 15 mg delayed release Lansoprazole and 100-200 mg a day of Provigil. I take  a whole food (none of that chemical crap) multi-vitamin, 3000 mg a day high quality Omega-3, 5000-10000 IU per day Vitamin D3, 2500 mcg Vitamin B12, 200 mg chelated magnesium and 120 mg magnesium L-threonate and occasionally 2.5-5 mg of Melatonin on the rare occasion I get insomnia. So far, everything chemical-wise and nutrition-wise in my body is all normal and my heart, lungs, kidneys and liver are healthier than they have any right to be for my age and weight. Apart from obstructive sleep apnea, a bulging spinal disc, a degenerated spinal disc and being overweight there is nothing , seriously, wrong with me physically. Genetic tests show that my liver enzymes all function normal but I am pre disposed for depression, anxiety and schizophrenia (my father has it but I have so far been spared). All the specialists and doctors have been stumped as to the cause of my unhealthiness. The leading theory, at least for my sleepiness issues, is that I have some kind of issue with my histamine and orexin system. Fortunately Provigil increases both histamine and modulates orexin which could explain why it works so well for me. It's a hodgepodge of problems that doesn't seem to have any kind of source or link. The new problem is, with my insurance, I can't get any new tests done because I've had them all and they haven't shown anything so insurance doesn't want to pay for them anymore. At this point the only option I truly have is to try and treat the symptoms because I have no methods of trying to find the cause of the problems. As far as serotonin syndrome, while serious, it is quite rare and as I mentioned before, I have been on nearly half a dozen serotonergic substances at once and never had an issue. I'm sure some people are more prone to it though, I just don't appear to be one. This is one reason doctors are so willing to prescribe multiple anti-depressants for me, especially considering that is what it takes to control my symptoms.
My two cents worth on this is, some of us just don't respond to certain things.  I ended up on drugs reluctantly, but therapy never helped, I was already meditating twice a day when I got my agoraphobia, exercised regularly, yada yada yada.  So I do understand the difficulty for some people of finding anything that works, and as I say, I'm on meds even though they've never done a whole lot for me.  My Paxil withdrawal left me with a rare condition called Protracted Withdrawal Syndrome, and one of the things it did to me was suddenly I started getting paradoxical reactions to natural remedies.  Relaxants made me nervous, for example.  And it's never gone away -- 13 years of withdrawal because I decided to stop the drug while I had a quack for a psychiatrist.  So while I philosophically agree with LightSeeker, I also know that sometimes the things we would tell everyone else to do to spare them what happened to us won't work for us.  I would say, though, that's too much vitamin D.  1000iu a day is as much as you should be taking.  More can be a problem long-term.  The B12 might be interfering with your levels of folate and B6, which are actually more important to your mental health than the B12, though the B12 can be energizing.  As for weight, personally, I did lose most of the weight I gained on Paxil, but I was already very athletic -- not good at it, just loved doing it.  As for chronic pain, I have that now, probably because of the Paxil and whatever it did to my system, but know that bulging discs don't necessarily -- and usually don't -- cause pain.  Everyone has them, most don't notice.  Very few have a problem that is responsible for pain -- much more often it's muscle problems and posture problems and the like that over time lead to chronic problems.  Man, life is just complicated.  My only horse in this discussion was to protect people who haven't done as much homework from losing track of what's important.  I have no illusions I can help you get better, but LightSeeker often sees through things in a way that deserves some notice.  Good luck to all.
First off, let me say, I'm sorry about your issue with Paxil withdrawal. I've heard that Paxil is the worst med to withdrawal from, especially cold Turkey. Having been through it myself, albeit not as bad as you, I can say its pretty bad. I've cold turkeyed from just about every SSRI and Effexor as well. I've come off Lamotrigine, Gabapentin, Zyprexa and Seroquel cold Turkey as well (not by choice) and Paxil was, by far, the worse withdrawal. I appreciate all the input from both of you. It's good that you guys are giving me suggestions of things to do or have checked in case there was something I hadn't considered. As far as the vitamin D3, my levels actually fall within normal range with the supplementation that I take. That probably means without supplementing I would probably be low. My doc is ok with the supplementation and checks periodically to make sure my levels don't get too high. Same with the B12 and magnesium. Honestly, I wish I could just come off of all my medications but whenever I have tried I fall apart and simply can't function. Unfortunately with a 2 year old I have to be able to function, at least as best I can. I hope I haven't come off as too combative or too much like a jerk, it wasn't my intention. The whole situation is just very frustrating for me. Being tired all the time sucks. Without the Provigil I have no energy, my head is foggy and I have no motivation whatsoever which hasn't helped the weight issue. At this point I am willing to have whatever tests I can get done and have whatever needs checking checked if it would mean getting some kind of answer. As far as my back, generally degenerated and bulging discs cause little to no pain, or so I was told by a 2 different pain specialists, but for some people they can. I also have mild to moderate spinal stenosis. I have permanently lost feeling in two toes on my right foot and one toe on my left. When I looked up the cause the most common one was a pinched or impinged nerve at L5 which, ironically, is the spot of my bulging disc. The toe numbness has been an issue for about 6 months, my last imaging was over a year ago. If it is the disc at L4-L5 than it means my issue has gotten worse. I am going to ask my doc for a referral to get a nerve conduction study to find out the source of the issue. It may not even be in my spine. If the conduction study shows it is in the spine I am going to ask my doc for new imaging. I've been on and off pain meds for the last 10 months to control my pain which gets quite bad but frankly, I would rather have surgery to correct the issue or at least make the pain more tolerable. At the very least I would like the nerve issue to be addressed. I know surgery is risky but rather that than be on pain meds. The pain meds make the sleepiness and foggy headedness worse. I rarely take them now. If you guys have any more suggestions for things to get checked I'm all ears. I just want to know what the heck is going on so I can address the issue and stop treating the symptoms. I should mention, I also have problems with my short term memory. I can forget conversations I've had 10 min prior. I attribute some of that to the fatigue and foggy head but I think there is another contributing factor as well. I have an appointment with a neurologist next month to investigate that issue as well. I kind of wish there was a forum dedicated to medication discussions, lol.
1530171 tn?1448133193
Well, I'm going to be brief and to the point w/o much detail and I would encourage you to do your own online searching for verification and  to get further details or instructions.

-- Your D3 intake should be accompanied by adequate K2 and Magnesium(transdermal mg oil daily), as I think your mg usage is very high and you won't be able to handle high amounts of oral mg, which BTW has very poor absorption.
You're probably metabolizing calcium that ends up in the wrong places!
Calcification is a very bad thing!!!
-- Mg (conventional serum) testing is useless as it shows almost always normal at 1-1.5% and tightly controlled.
Get an RBC mg test instead.

-- Methylocobalmin B12  is great. Add also Methylfolate and avoid any unmethylated forms of these 2, b.cause they plug the respective receptors
Alternatively try SAMe supplements.
Toss your multi-vitamins if they contain folate/folic acid and cyanocobalamin.
Watch for vitamin- fortified foods since the vitamin quality is low and the form wrong. Simply avoid them.

Your methylation will improve drastically if you follow the above. This is HUGE!!!  Google it! It has to do with a gazillion biochemical reactions in the body and almost nothing goes right when methylation is impaired!
Note: Contra-indication if  COMPT genetic mutation homozygous or heterozygous.

--Lansoprazole could be a source of many issues.
Are you taking it for GERD?
Low stomach acid could result in low absorption of vitamins, nutrients and minerals and lead to numerous deficiencies, many of which are not diagnosed due to
flawed testing or simply not tested!
The majority of GERD sufferers have low stomach acid!!!
Follow the $$$$. This class of drugs is a huge profit center for Pharmaceuticals!

--Thyroid tests TSH and T4 are simply flawed.
They only indicate serum levlels
You need Free T3, Free T4 AND Reverse T3 to test for Thyroid function in your cells!!!
Note: Caution in treating low thyroid function if your Cortisol levels are high! You need a stress profile saliva test 4 x cortisol and DHEA (see BioHealth Labs site for details.)

-- Most Doctors don't bother to suggest detox, but you should look into it, starting with colon cleansing.

--Finally genetic testing. I have dealt with 23andme, online and I can decipher most of their reports (they come w/o analysis and there also a few other websites where you can get your results analysed for very little.
But I think 23andme  genetic testing is no longer available within the US.
(Fearing some people might do their own diagnosis and treatments according to their genetic profile and eventually screwing up, or simply seeing these types of tests as a threat to "their" business?) Hmm
I live in Canada, but my test was done in Holland.

This can reveal invaluable information, specially in light of all your imbalances and your medications.
One great benefit would be the ability to target your treatments better and to bypass genetic mutations where possible.

Cheers,
Niko.

20 Comments
I agree that normally magnesium doesn't have the best absorption but chelated magnesium is actually one of the higher quality magnesium supplements. The supplement I take has been shown to have an absorption rate of around 75-80%. Magnesium L-threonate is a newer (and much more expensive) form and also has a very high bio-availability with the advantage of being able to cross the blood brain barrier and directly exert it's effects on the brain.

It was also recommended that I take 400-500 mg of magnesium a day, mainly because I take Lansoprazole which is known to cause hypomagnesemia. Is the RBC test a specific one for magnesium or just a general red blood cell count? My red blood cell count is normal every time but if there is a way to actually test magnesium that is more accurate I will definitely look into that.

My multi-vitamin does have (or at least claims to) a decent amount of K2 in it. The B12 supplement I take is trans-lingual Methylcobalamin, been taking it for years now so at least I made the right choice on B12 type. I will look into Methylfolate as well. I've looked into SAMe before but it's too expensive for me unfortunately. I only make $735 a month and with rent and bills I am a bit limited with what I can spend as far as supplements.

As far as the Lansoprazole, I don't have a choice. I have to take a proton pump inhibitor, probably for life and Lansoprazole had the least interactions with my medication cocktail. I have a moderate hiatal hernia. I have been assessed and it was determined that surgical repair was an unnecessary risk. Without the PPI I have extreme heartburn. It got so bad at one point they were afraid I was developing Barrett's esophagus.  They put me on a PPI and after a couple months everything healed and looked normal.

Without the PPI I literally get stomach acid backing up into my lungs. I wake up choking and coughing. It burns like hell, like trying cough out napalm. Takes about 90 min for things to settle down enough for me to go back to sleep. I usually end up with a sore throat from it for about 4-5 days. I did everything to reduce the heartburn. I changed my diet, made sure I didn't eat within 4 hours of bed and even lifted the head of my bed up and it didn't make a bit of difference. So, unfortunately I am stuck on the PPI.

I do believe that when I had my thyroid checked they checked free T3 and free T4 but I've never heard of reverse T3. I'll bring that up with my doc when I see her. I have also never had my cortisol checked. Will look into that as well.

I have seen commercials advertised for 23andme so I think it is still possible to get the tests done through them. I will definitely look into it and see if I can save up to have a test done. Thank you for the suggestions. Like I said before, any suggestions that can help me determine what is going on so I can correct it is very much appreciated.
This is very complicated stuff because you have so many long-term issues that have been treated with medication for so long if you wanted to try things another way it would take a lot of effort and probably pain.  Take your GERD med, it suppresses stomach acid.  When you do that, your stomach just produces more because you have to have it to digest protein and minerals.  So you take more medication and your stomach produces more acid.  This is called rebound acidity, much like taking sleeping pills or other meds for sleep causes rebound insomnia that is worse than the original problem.  It's far better to have treated it by changing you diet and using much gentler natural remedies that work well, such as DGL and several others, but at this point you have so many issue I wouldn't know where to begin.  As for stopping your multi because it contains B12 and folate, unless you're taking some super duper high dosage multi, and you express you're taking a whole foods one, don't worry about that -- the dosages are very low.  As for magnesium, all minerals are chelated.  The question is which chelation works best for most people.  For magnesium, that tends to be citrate because of its acidity, but many people with anxiety or stress like taureate, but yours is probably fine as well.  Just don't take it at the same time as you take meds that have to cross the blood/brain barrier -- they use the magnesium channel to get there and so can block magnesium absorption and vice versa.  I take mine before bed because my original reason for supplementation was muscle cramps, a common side effect of taking antidepressants.  It's usually best to take it with food, as is the case with minerals in general, but with all the meds you're taking you do have to be careful about timing.  As for testing, the best way to get tested is to see a holistic nutritionist and get tested several times over a period of time -- one test once in a awhile doesn't give a good picture of nutrient levels because they differ.  The best way, of course, to get your balanced calcium and magnesium is to eat plenty of green leafy vegetables.  One of the problem with magnesium levels in our society is the huge number of people taking drugs that use the magnesium pathway and the overconsumption of dairy products (which can also cause GERD) -- they are very high in calcium but deficient in magnesium.  As these are electrolytes, they are in electrical balance, which should be about 2:1 calcium to magnesium.  Too much dairy overdoes the calcium, which is one of the reasons for osteoporosis -- most Americans get way too much calcium but magnesium is just as important for proper bone strength.  And folate isn't the only consideration when you take a lot of B12, so is B6 -- these are also in a balance in a normal body.  But again, you've been on meds a long time, I'm not going to go out on that limb and say you can do what someone else might be able to do.  If you're functioning well, it ain't broke.  Changing might just break it, and there's no guarantee you'll find a good alternative.  None of us on here are going to fix this, but again, there are practitioners of integrated medicine out there and functional physicians who study both natural body function and medication body function who might be able to help if you can afford to pay for it -- they don't take insurance.  I've never been able to afford it.  You might be able to.  I agree with you, you do need to have a life, and if what you've been doing is giving you a life, who is to say you can do better at this point?  You can't undo what doctors did to you already.  But if you ever have the time to fight back, then you have some suggestions here for further research, and you obviously like to do research.  Anyone reading this would love to take you and start all over again, but the world doesn't always allow for that.  Peace.
Have a look into chiropractic treatment/adjustments for Hiatal Hernia.
I've heard good things about this.

--Magnesium Oil which consists of about 50-50 magnesium chloride flakes and water, when taken transdermally, offers one of the safest ,least expensive and best ways to supplement with Mg.
It totally bypasses the digestive track and goes straight into the tissues.
Just spray on the entire body, leave on for 20-30'  to absorb and then shower.
The threonate is a better oral form than most others, however the claims for its absorption are grossly exaggerated! And it's expensive.

--The Methylocobalamin and Methylfolate in combination are
vital methyl donors to restore the methylation pathway.
Perhaps SAMe is less expensive
than the above 2 (methylfolate is rather expensive) and it will give similar results.
But you still may need the methylocobalmin. though.
You can do the math.
There's also the less expensive option of taking TMG, which may
work, but likely not as efficiently as the other 2 options.

--In the absence of infections or other temperature reducing factors, hypothyroidism can be tested by doing Dr Barnes Basal Temerature
test, however, you must follow the simple online instructions precisely
for more accurate results.

For lab tests, you need all 3-->
Free T3, Free T4 and REverse T3.

Cheers,
Niko

I meant to type :
In the absence of  infections or other temperature ALTERING factors.
These are all great suggestions. Unfortunately I'm a bit limited with what I can do. Financially I can't afford to do too much and my insurance kind of sucks. They won't cover things like chiropractic because they see it as an elective profession. I believe the magnesium supplement I take with the threonate is glycinate. These were both highly recommended and rated and have some great studies to back up their uses. I'm a bit of a nerd, I like to do research and read a lot of studies from the national institutes of health. As far as my PPI, 15 mg seems to work well for me, I never have to change my dose and it controls my symptoms well. I know it isn't the best thing to take long term but with no other treatment options available to me it's the best I can do. I am in a bit of a tough situation medication-wise. I am actually trying to remove as many as I can without causing too many issues. Currently tapering off Lamotrigine. It never helped with my anxiety, I actually think it increases it. It also causes me to have dull chest pains. Both my anxiety and pains have improved as I have gone down in dose. The doctor's I was seeing just kept stacking on more meds. Finally got fed up and changed docs. I ended up with the opposite problem. The new doc I was seeing wanted to remove me from all my meds cold turkey. I know from experience that is a terrible idea, especially when more than one medication is involved. I finally found a prescriber that I like. We are removing meds that seem unnecessary but doing so at a safe rate to minimize withdrawal.
You actually shouldn't take SAMe, as it affects serotonin -- it's main usage is as an antidepressant.  You don't need another serotonin targeting substance.  If you want it for any other purpose, MSM does pretty much the same thing at a much cheaper price without having the antidepressant problem, but make sure before taking either of them you don't have a sulphur allergy.  TMG can be very stimulating to anxiety sufferers, as can DMG.  They can be useful if they're not stimulating, but this is a caution.  As for the hyatal hernia, again, this is a digestive problem and this can be treated with natural remedies.  They won't get rid of it, but they can get rid of the problems of having one by stopping the acid problem without suppressing it.  As far as I'm aware, magnesium does not get in the body transdermally, though it's so often suggested it does.  The only way I can imagine doing this is by combining it with DMSO, but the body gets magnesium by eating food.  A supplement works best that most approaches the way it is found in food.  Lots of people think Epsom salts get magnesium into your bloodstream, but there's no evidence this is true -- the real help here, which is temporary, is the hot bath.  
And why not look up a guy named Yass or something like that, he's a physical therapist who has gotten quite popular.  A guy who used to be a regular on some other forums I'm on wanted surgery desperately because of a bad back supposedly caused by disc problems but couldn't get it because of the development of a blood clotting problem.  He used an inversion table and the program by this doctor and at 71 was in the gym weight lifting 5 days a week.  I've had bad discs for years, but never have been recommended surgery -- always sent to rehab.  It takes a lot of time and motivation but the reason is, nobody ever knows if the structural problem is causing the pain or not, and usually it isn't.  But sometimes it is, and you might be one of those people.  
- The Magnesium RBC Test is specific for Mg testing and available from LabCorp at at cost of $49 USD last time I checked. You can also check Walk-in
Labs (I think their stilled owned by LabCorp)

- Threonine Mg is good but is  probably overrated as I mentioned already.
I have been on Mg forums and many people have experienced similar results from other Mg forms.
I don't want to push Mg2Cl2 on you, but I should note that the chloride part of it helps absorb it better. This a great benefit on top of the low cost.
It costs me less than $20 USD to make my own Mg Oil (50-50 solution with water) for a year.
In your case (daily use at first, then every other day) count $30-$40 USD annually.
Perhaps consider a combo of transdermal Mg2Cl2 and oral Threonine Mg at first.


--The Basal temperature test costs nothing (thyroid testing) other than the cost of a glass thermometer.

--Ditch the multi-vitamin if the B12 and folate or folic acid are not the bio-available methylated forms (unless you have the COMPT mutation).
They saturate the respective receptors and amplify the deficiency!

Since your budget is so low, the TMG
might be worth a trial, instead of the higher priced Methylfolate or SAMe.
It should still help, as a Methyl donor, to facilitate Methylation.


--Any changes you make, I suggest you make them ONE at a time.
Because of the multitude of drugs and supplements going into your body, it's quite a challenge to know with certainty what does work or does not work, when making frequent changes.

--Search YouTube for DIY adjustments for mild/moderate H Hernia.

--In regards to genetic testing, the federal gov't has been taking action
against Labs, offering direct to consumer diagnostics and disease risk prediction to their clients.
So if you consider genetic testing,
(I certainly would if I were you),
save up for it (it cost me about $150
USD a couple years go from Canada) and then either send your results to related forums' members, or sites like genetic genie, or myself.
You can also immerse yourself into Genetics and learn on your own.
At first, like everything else, it might feel a little overwhelming, however,
after a while is becomes easier.

And finally, yes, one must be always proactive with doctors.
Some of them are simply reckless
and unfortunately the consequenses
of their actions are usually affecting only their patients :(

Best wishes,
Niko

I have looked into the L-methylfolate. I have to say, after doing some research I am intrigued. Most of the symptoms of low folate seem to apply to me. I can't help but wonder if that has been my issue this whole time. After reading studies and reviews I found a supplement that isn't too expensive on amazon and ordered it to give it a whirl.

I am keeping my fingers crossed. If indeed it helps me than maybe I can start tapering off some of these other meds. I will, of course, do things safely and make 1 change at a time. I have dropped off meds cold turkey and made multiple changes to them in the past and it never ended good. Not willing to go through that again.

I find it very interesting that studies show L-methylfolate can actually augment SSRI's and SNRI's quite well. They seem to, in studies, make the antidepressants work better AND help them to work quicker. Ideally I would be off of the antidepressants but I'll take an augment that works over nothing.

I'm a bit surprised this folate issue was never suggested to me before. I would love to have a genetic test to see if I am one of the individuals who has the folate genetic mutation. Anywho, I should have my supplement on Saturday. Gonna start with a very low dose than work my way up. I'll keep checking here for more responses from you guys but I'll post back in maybe a week or so from Saturday with an update on how the supplement is (or isn't) working.

I hope this is, finally, a step in the right direction for my health/mental health. Ideally I would like to get to a point where I can treat my issues with natural remedies instead of chemical concotions. I tried St. John's wort once (not with any meds) and it didn't end too well for me. That doesn't mean there aren't other natural things that won't help.

Oh, the multi-vitamin I take contains methylcobalamin for the B12, only a small amount though, something like 50 mcg. But I take a tranlingual B12 supplement, usually about 2500 mcg (as suggested by my doctor). It also looks like the Folate is 5-MTHF which I think is the methylfolate. It only contains 100 mcg though. I'm not sure if I am allowed to post links but this is the multi-vitamin I take:

https://smile.amazon.com/gp/product/B01CQ3DUO6/ref=oh_aui_detailpage_o03_s00?ie=UTF8&th=1
Try reading a book called Natural Highs by Hyla Cass, a psychiatrist at UCLA who uses natural medicine in her practice.  It's a pretty good overview of how natural medicines are combined and dosages for best results, though she's not an herbalist or trained natural physician.  Then you can move on to books by herbalists and naturopaths.  To do the natural approach requires combining a lot of remedies, not just taking one, when a problem is as chronic as yours, and again, it would require going off all of your meds for best results, which is not going to be easy!  And again, be very careful with magnesium supplementation of any kind when you're on these meds as it will interfere with the absorption of the drugs if you take too much or take it too close in time to the time you take your meds.  And vice versa.  Also, you have no idea if you are actually lacking in folate, and if you're not, taking more might help or might make it worse by, again, interfering with your B6 absorption, which is in a very delicate balance with B12 and folate.  The proper balance is found in homocysteine control formulas, but you won't find the high dosages you're experimenting with.  B6 is far more involved with mental health than either folate or B12, as it's an essential co-factor in the production of both serotonin and GABA.  I'm still advising caution and consulting professionals in the field because this is an area that's hard to become knowledgeable in and very hard to mix drugs with natural remedies safely and effectively.  As I said, a good functional physician or practitioner of integrated medicine would be good for you to consult, as they have studies both forms of medicine.  And always be wary of ordering from unknown companies on Amazon -- most are multi-level frauds.  Folate is always inexpensive and is made by many good quality trusted sources, as is B12.  But whatever you try, and you're someone who does need to try something different, I so much hope it helps you.  If anything does, do let us know, as I'm in a pickle too.
Let me say, I managed health food stores for 18 years in better days and though I'm not formally educated, I did get a lot of training in an earlier form of the industry before it became big business and before so many charlatans entered it -- heck, even Trump tried to get into after it got popular.  I was trained by most of the people who wrote the best books, as they then started supplement and herb companies, and they were a lot more honest in those days.  Peace.
I should say, not formally educated in natural medicine!  I have way too many degrees otherwise!
Some good points from Pax.

Let me add my daily 2 or 3  cents
worth of wisdom, lol!

Any changes you make, must be single or synergistic with others (if only recommended to do so, ie D3 + K2)
in small increments whether tapering down or up  gradually and ONLY after careful analysis and research.

Paying attention to the finest details will also pay dividends, but I recommend logging all of them as they take place.

There's a  wearable button which has voice to text capability technology and it sends your voice to your smart phone (with an app) in a text file and under the category you want it.
Example you say: "Supplements (category)
Magnesium Threonate 200 mg,
Loose stool shortly after taking it."

It would go under your supplements
file with date, time and your details,
all in text

It's called MYLE--> Make Your Life
Easier

Anyway, as long as you record these details and start paying a lot of attention to everything, you will eventually be able to discern between a Herxing healing effect
and an adverse reaction or negative side-effect.

There's a good likelihood you're a hypo-methylator, which warrants a careful trial of any of the 3 supplement options already discussed earlier.

To confirm 100% prior to doing the trial, you need either the MMA test
(which should be repeated after a few weeks) or the genetic profile.

If you have the methylation gene
mutations, unmethylated forms
of B12 and Folate regardless of
quality, will make matters worse.

Modern medicine is still in the dark ages in this area, but Epigenetics
(mark my comment somewhere,lol!)
will be the next revolutionary field in
medicine,treating millions of people, suffering unnecessarily from various
serious chronic conditions related to
genetics.
Example: Epigenetic Regulation of a single gene may control stress and drug response!

Cheers,
Niko

PS. This part of the forum is fairly
liberal and posting some "innocent"
and relevant links is usually no problem whereas in other forums
your link vanishes and you get a warning.
I'll have a look at it later.


They don't like links because they don't want to have trouble with putting copyrighted info on here.  A guy I was friends with on the natural medicine forums has been kicked off 3 times for posting too much from other websites that may or may not be accurate and may or may not contain copyrighted info.  Also it's important to recognize that a genetic mutation of this kind doesn't mean a person has the problem, it means the person is more likely to get the problem.  We're a long long way away from genetic medicine being more than a sideshow, and when we get it, why would we expect it to any more accurate than any other form of medicine?  They all sound great in the beginning, and then the problems appear in the guinea pigs who did the stuff first.  It's a long, slow game to figure out the best way to health.  
I guess we need to consider the fact that most people, including doctors, will be still vulnerable to flawed medical science and botched medical studies,in the era where discoveries  and advancements in genetics can make significant contributions toward improvement or even resolution of
many chronic conditions.

Follow the $$$.!
SAMe, Glutathione, Vit. C, D, K, etc.
along with detoxification, proper nutrition,exercise and other lifestyle changes, can alter certain gene
expressions and possibly make a significant difference in many people's health outcome, however the lack of profit potential for the medical/pharmaceutical industry, is
unfortunately the big hurdle.

Genetic testing in the US has been targeted since a few years ago.
I fear, it presents a real threat to the current multi-trillion dollar medical drug and treatment business, when so many people can bypass  genetic defects by
properly addressing the factors which influence genetic mutations to become genetic defects in the first place (where possible).

Fascinating field of study, though!
More to follow another time...

Cheers,
Niko


Paxiled, I'm curious if you have any links to any sources about magnesium interfering with antidepressants. I can't find any sources online anywhere that talk about this.
I don't do links.  MedHelp frowns on it, and I always believe it's best to do your own homework and make up your own mind about things.  But on this question, it shouldn't be hard to find --  in order to get past the blood/brain barrier, these drugs had to be engineered in a way the body didn't block.  This is one of the hardest part about drugs -- they are foreign to our evolution and so you have to force them in.  The magnesium pathway was the one chosen.  I'm sure you'll find it but you have to get deep into research on how these drugs work to find it.  Keep digging, but it really isn't that important, I only mention it in case you decide to do what LightSeeker recommends, which I personally wouldn't do but you might.  He's does a lot of research into things that are very interesting but I've just seen too much of this kind of stuff with so many years in the natural medicine business.  Everyone has a theory and nobody has double blinded studies or peer-reviewed studies that prove it works in actual humans.  Now, I use some stuff that fits this category, but mostly I use the things that have been used century after century.  I'm more cautious on the modern pharmaceutical things such as isolated minerals and vitamins because balance can be thrown off so easily.  For example, I take my magnesium in the citrate form before going to bed, a long time away from when I take my meds.  Peace.
And let me add, I take a combination of magnesium and calcium so I don't throw off my calcium by taking too much magnesium, but I take twice as much magnesium as is recommended and half as much calcium.  In that way I won't end up treating my muscle cramp problem and creating osteoporosis.  But you might find a completely different set of things suits your body than what suits mine -- natural medicine as practiced correctly looks at everyone as a unique individual, not a generalization.  Peace.  
Okay, I took a quick look, and darned if I can't find a single article on Google discussing how the drug gets to where it's going.  Maybe if you look into it a thousand pages!  This is something I learned a long time ago, prompted by someone who used to post on here a long time ago.  I researched it at that time but not recently.  I have found that over the years Google has gotten harder and harder to use because it so gamed.  So I can't help you here.  LightSeeker?
Still couldn't find anything about magnesium and antidepressants but I'll take your word for it. Clearly someone, at some point, found some kind of a connection/interaction. I'll make sure I take my magnesium far apart from my meds. Something of note though, I got my Methylfolate in the mail today. I had read to start low so I cut the 5 mg pills in quarters and took a quarter this morning with my Methylcobalamin. I feel amazing. I feel better than I have in a very, very long time. Maybe it's just a placebo effect, I don't know but I feel great. I seem to have noticeably more energy and my mood seems to be much better. I don't know if one dose could do that but I don't know what else to say. About 40 min after taking it the persistent headache I have had for nearly a week just melted away. Even my anxiety just kind of faded. Again, maybe it's just a placebo effect. This makes me very hopeful though. I won't get my hopes up too high but I hope this is a sign that this is what I have been needing. I have a doctor's appointment on Wednesday and apparently the doctor's office I go to has a person that specializes in natural treatments, stuff like St. John's wort, lavender, etc. My doc said she would set me up to see this person.The doc is ok with me starting the Methylfolate but wants me to keep it low until I meet with the natural remedy person (can't remember what the doc called her specialization). Anywho, I am excited that maybe I am finally making some progress healthwise that won't involve more medications. Thanks for all the help and advice guys. I'll post again when I get some new updates.
1530171 tn?1448133193
Your lost your keys in your house.
"Why do you look for them across the street under the street light? "
---"Because there's a total power outage at my house."

The question about magnesium interfering with anti-depressants kinda reminded me of the above,lol

Here's some articles' titles (just search under the titles)
pertinent to magnesium which may help answer your question:

1. Magnesium deficiency in plants: An urgent problem.
2. Magnesium deficiency and stress: Issues of their relationship, diagnostic tests, and approaches to therapy.
3..Interactions between magnesium and psychotropic drugs.

Magnesium, being already low, due to stress, anxiety and soil depletion should be supplemented rather aggressively when on certain medications including anti-depressants. This will add significant therapeutic value to your current treatment.
The real question is: Will oral Mg (even in the best form)
be able to make up for the 3-legged deficiency and reach optimum therapeutic levels?
Personally if I were you (jwright) I would also do the transdermal, as an adjunct.

And BTW I used the Interaction Checker and  besides your 12 major and minor interactions between your drugs, the only other ones worth mentioning were with alcohol, caffeine intake and also it made a note of increased BP with SSRIs. No mention at all of Mg.

Of course, judging from all the " junk " medical papers,
articles and studies I have personally come across, I wouldn't be surprised, should Mg be found guilty of causing some dangerous consequences.

Cheers,
Niko
11 Comments
I just read your recent comments.
Great news, placebo or not!
I wouldn't be too surprised,  if it was the methylfolate which does work fast, since this form of folate totally bypasses the whole folate metabolic cycle, however...
This also could be a bad thing, since
the controls are also bypassed, so you must exercise extreme caution in dosing, as excess methylfolate will cause over-methylation.
More is not necessarily better!
This could lead to possible unwanted effects.
Also you cannot take it all the time and forever. You should take a day off it here and there, or skip a weekend or whatever your body will accept w/out much trouble.
Also avoid anything made with fortified flour, since it contains folate.

Please note that methylfolate might enhance the effects of anti-depressants, in which case lowering the antidepressant dose,might be necessary.
Finally taking a very small dose of niacin, would help reduce side-effects.
The natural medicine practitioner next week, may be able to help you
with this further.
I bumped into an article that discussed supplements that were good to take if you were on drugs for mental disorders.  This article did stress magnesium as one of them, saying these drugs deplete the body of it.  I originally believed that to be true, but then ran into the magnesium pathway.  Whatever the reason, I know that for me and many others on here over the years one of the most common side effects of taking drugs that affect brain neurotransmitters are muscle cramps when sleeping, nerve pain, head pressure, etc.  For me, supplementing magnesium orally did get rid of the muscle cramps, so at least on that drug, imipramine, oral taking of it worked.  I still take it, but I have so many other sources of pain now that it's a much more complicated situation.  But I do know that oral taking of magnesium in the proper forms is used by almost everyone who works in medicine that uses minerals, including veterinarians, and it does show up in blood tests.  It just needs to be in the right form.  I have also read that topical application does not work and does not show up in blood tests.  Doesn't mean that's the last word on it, just another person who has read different info.  This article also recommended highly methyl folate, so there you go.
Also, consider that the best way to get any nutrient is through food, and obviously that is taken orally.
Hmm, interesting view, however, this information is what they want us to have.
You must be aware that  Pfizer, Unilever, Novartis, GlaxoSmithKline and other big pharmaceutical firms make or sell the majority of supplements.
Big Pharma and Big "Herba" are now almost indistinguishable, lol!
(not an original comment , I read it  somewhere in a newsletter, I think)

Here's the kicker: Magnesium Chloride flakes are sold in bulk and the only 2 brands I know of are Ancient Minerals and Zechmag, both owned by small families and no connection to big Pharma.

Naturally, there would not be any major studies to support the effectiveness of transdermal magnesium therapy.

There might some small studies, "disproving" the effectiveness or simply questioning it due to the lack of  proper studies,
But you know how all this works.

And finally, if the transdermal pathway is bogus, should we ditch ALL our creams, lotions, ointments, liquid rubbing compounds, including
prescribed ones?
I'm keeping all mine, and unless someone proves to me 100% that the transdermal pathway EXCLUDES only magnesium, I'm also going to continue doing Transdermal Magnesium.

The RBC magnesium test, not any standard blood test, is necessary to
indicate true Mg status
A regular blood test will only diagnose Hypermagnesiemia caused mostly by kidney failure or in very rare cases Hypomagnesia.
We are mainly concerned with "functional" Mg status, not serum levels which  are tightly controlled.

Pax, you should read the book titled
"The End of Food", with all the data, properly researched.
You will never make another statement like your last one:
"Also, consider that the best way to get any nutrient is through food, and obviously that is taken orally."

This could be very true perhaps 50- 100 years ago. Cannot rely exclusively on this anymore!

Our world as we once knew it, will never be the same.
And this includes how we farm, grow, process, treat, preserve, store and
prepare foods.
It's almost frightening!

Now if you grow and raise your own
food, under ideal conditions and practices, kudos to you my friend!

Cheers,
Niko
Most creams and topical treatments work only on the surface of the skin.  So of course they work there.  They don't penetrate past the layers of skin; in many cases if they did they would be toxic.  Calendula cream can be very effective for itching and scrapes, but if you want to use it internally, you take it internally, you don't rub it on your skin.  Some topical treatments are completely bogus, such as vitamin E -- it oxidizes on contact with air.  To use vitamin C on skin, they had to invent an artificial form of it, ascobityl palmitate, because the natural forms again oxidize before they can do anything, but this does not increase the vitamin C inside your body -- for that you take it internally or eat something that contains it.  If you have a fungal infection on your skin, you can use topical antifungals for it, but if you have a fungal infection inside the body, you take the antifungals internally.  The only way I know of to get things past the skin is to mix them with DMSO.  As for who makes most supplements, it's definitely not the major pharmaceutical companies.  Frankly, they don't manufacture much of anything -- they buy licenses for a lot of things from smaller companies because they control completely the marketing of drugs, but as to supplements, who manufactures them depends on where you're buying them and what the supplement is.  Many common supplements are made by labs that do that, and they are not owned by the major pharma companies.  There's much too little money in it for them.  They're all about the patents, and you can't patent anything that occurs in nature.  As for relying on food, growing your own food would actually not give you all the nutrients you can get now.  While it is true that food is old when you buy it and therefore degraded, if you buy organically grown food the soil will have the nutrients in it, and even commercially grown food is loaded with nutrients, though with other things as well you don't want.  But when people grew their own food, they didn't have refrigeration and they didn't have access to foods shipped from far away.  In the winter, they had nothing but jarred food.  So yes, you have to eat more of the good foods you want, but supplements are for two reasons:  for additional amounts of nutrients for optimizing your nutrition and for medicinal purposes.  So yes, supplementation can be useful, but without a food base supplements are not very well absorbed by the body.  That's why the doses are high.  The manufacturer is very important for many supplements, and when you get to herbs, the best companies are never ever going to be major pharma, they don't even know what the stuff does.  Why would you think GlaxoSmithKline would ever manufacture supplements when it can sell patented drugs for whatever price it wants to?  Magnesium is cheap, and you're never going to get your stock bonus if you waste your industrial output on that.  The best tincture company is probably Herb Pharm, and they grow most of the herbs they use themselves.  It's important and I always mention that people shouldn't just buy something on Amazon -- they should first buy everything at the best health food store they can find in their area and see what's on the shelves, and see who sends their supplements out for independent lab analysis and who makes their own tinctures and what's owned by herbalists and what's owned by the con man down the street.  Quite frankly, if major pharma did make our supplements they would probably be of a consistently higher quality, but they don't.
And I say that because, if you use medication, the name brands made by major pharma are of a much more consistent quality than the generics, which are not made by major pharma but by large generics companies.  
Pax you like to have the last word, which is fine as long as it makes sense and it can be realistically substantiated, not just for for the sake of making YOUR point.

MAXNutrition is owned by GlaxoSmithKline.
Bayer makes the One a Day supplements
Wyeth makes the Centrum vitamins.
and so on.
They all source their materials from the least expensive suppliers.
Profitability is their primary objective and not your health and well-being.
As long as they comply with the rules and nobody gets hurt or dies as a direct cause of ingesting their products.
The generics effectiveness vs brand name drugs is a different issue all together

As for the transdermal delivery, it's not all that simple.Too many factors influence the rate of absorption.
Like type and size of molecules, temperature, duration of exposure, concentration, carrier agents, exact place of application, area/size of application and so on.

Ever tried washing your hands after handling garlic, using warm water?
You know the answer to that one, I'm sure.

You cannot exclude the thousands of products and remedies
like hormone replacement creams, essential oils, essential oil based creams & lotions, Voltareren, A535,
BenGay, nicotine patches, Mg Oil,
fentanyl patches, Epsom salts, Aloe Vera gel ...
on the basis of oxidation or on the basis that they only work on the surface of the skin or external injuries.

Cheers,
Niko.

Forgot to post the following :

Research Article

"Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia:a feasibility study"

"A pilot study to determine the
impact of transdermal
magnesium treatment"

Just do a search under the above titles
None of the topical products you mention penetrate beneath the skin, so I'm a little confused.  The are all topical skin treatments.  Ben Gay feels good because it's hot, but it doesn't treat anything.  Using cayenne can deaden nerves for a time, much as clove oil can do on a sore tooth, but it just wears off and you still have the problem.  Epsom salts do not get absorbed; it's the bath that temporarily feels good.  If any of these truly penetrated to the source of the problem they would be cures, not just temporary palliatives.  Aloe vera gel?  It just works on the surface, LightSeeker.  If you want it to work internally, you drink it.  It has nothing to do with me wanting to get the last word, it has to do with you continuing to post things that people might try that might be a waste of their time when they could be doing something that might actually have more of a basis for working.  I have no problem with anyone following your advice, but you pose as an expert and you're not.  Neither am I.  We're just folks on here with life experiences.  I have a real desire for natural medicine to work because pharmaceutical medicine is very dangerous, more dangerous than people on this forum are willing to lean about.  But having been on the marketing end of that business, I know only too well the limitations of it.  I also know that it does work way more than allopathic medicine makes it seem.  As for the vitamins you mention, Wyeth bought Centrum from another company.  They don't make Centrum.  Centrum makes Centrum.  The company that originated it also bought Solgar, once a respected manufacturer of supplements but it was destroyed by the company, which I think was called American Home Health.  The fact these mega companies have purchased distressed companies doesn't mean they make the products.  I also wouldn't recommend any of those drug store brands to anyone because they are inferior products for the reasons you mentioned, but even in the health food field, most companies do not make their own supplements.  They contract with labs that do and tell them what they want.  So do most packaged food companies, especially anything with a store brand name.  There are, I believe, two labs in the world that make all the amino acids and all the vitamin C and all the Vitamin E and probably a lot of others as well, but anyone can contract with them and offer them under their name.  The only reason this matters to anyone reading this is to be careful what they buy so they can maximize the possibility of something working.  The preliminary study you cited is fine, there are billions of preliminary studies out there, but few done by the appropriate scientific standards of peer review and double blinded testing on humans because of cost problems.  Many of these studies are done by graduate students because they need to have a study in order to graduate, or by companies that are trying to sell a product -- yes, natural supplement companies do this too.  And we should end this with an acknowledgement that most "natural" medicine isn't natural at all, it's pharmaceutical medicine, such as your methyl folate supplement.  That doesn't occur floating around in nature the way an herb does.  It took modern science to isolate it and then sell it.  For all of history people got their folate from the folic acid found in food and the body did the rest, sending it where it needed to go.  We're now trying to improve on nature because so many people get sick.  But it's not really "natural," it's just not patentable.  But as I said above, I basically gave you your props on what you've been saying on this thread and think the poster would be well served by trying what you suggest.  Just don't go beyond what you think to making it seem like you know -- neither of us knows and neither does anyone else.  We all long for the day when we do.  I wasn't warring with you, and if you respond, I'll give you the last word any time as long as there aren't things in it that might be deceptive to people looking for help.  Peace, Niko.  
Hmm, I guess you did not read the artlcles I sent in my last post.

Would you say the positive results after the transdermal Mg  treatment  for fibromyalgia is 100% placebo effect, according to your theory?

And the results from the other study,
transdermal Mg raising Mg levels IN the body, placebo effect again, right?

And why did you conveniently leave  all the transdermal prescribed drugs, like hormonal creams, nicotine patches etc. OUT of your last comments?
Perhaps, it disputes your own
erroneous explanations.
Deceptive? Who's kidding who, here?

Peace to you too Pax
(Pax: Peace in Latin)

BTW, my final entry on this subject.

Cheers,
Niko

Kind of ironic, eh, that the drug that is the hardest of all to stop taking took the name for peace for it.  I'll let you have the last work, LightSeeker -- we've said it all and it is food for thought for anyone who stumbles on this thread.  
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