10 replies to this topic

[yowza]

I've always thought of memantine as decreasing cognition rather than enhancing it with the antagonistic effect that it can have along NMDA gluatmate receptors. Any heightening of cognition, it would seem would be purely for damage maitenance for those whose brain is physically deteriorating. However, check out the following article; note the area I've put in bold.

http://www.jaoa.org/.../full/106/6/358

Memantine: The Next Trend in Academic Performance Enhancement?
KEN S. OTA, OMS III; TINA GODWIN, OMS II

Western University of Health Sciences College of Osteopathic Medicine of the Pacific Pomona, Calif

To the Editor: Although memantine hydrochloride is currently known as the latest treatment for moderate-to-severe Alzheimer disease (AD),¹ we entertain the idea that it might also come to be known as a memory enhancer among healthy high achievers.

The drug acts by noncompetitively binding to the N-methyl D-aspartate (NMDA) receptors of neurons in brain tissue to prevent overstimulation by glutamate.² When this excitatory neurotransmitter overactivates NMDA receptors in a tonic manner, an excessive influx of neurotoxic calcium ions follows.² The resultant excitotoxicity may play a role in the impairment of memory and cognition in AD.³ Because memantine has a low-to-moderate affinity for NMDA receptors, it does not seem to block normal glutamate transmission; rather, it reduces abnormal neurotransmitter-mediated activation of the receptors,⁴ thereby potentially reducing excitotoxic neuronal damage. This form of neuroprotection may explain the improved cognition in patients with AD reported in the literature.^5–7

Can transient low-level, nonpathologic, glutamate-mediated neuronal damage occur in the brains of normal individuals? And, if so, could memantine's neuroprotective effect antagonize the damaging effects and enhance memory potential in these individuals? Future research should address these issues.

Memantine's suggested neuroprotective effect^2,8 may also increase brain levels of the neuronal marker, N-acetyl aspartate (NAA). Because NAA is found primarily on neuronal axons in the brain,⁹ perhaps the neuroprotective effect of memantine can be measured by quantifying the change in NAA concentrations in brain tissue via magnetic resonance spectroscopy. Magnetic resonance spectroscopy has demonstrated that patients with AD show a decline in NAA relative to normal controls.¹⁰ The reduction in excitotoxicity via memantine's mechanism of action may allow affected neurons to regain some level of physiologic functioning, such as growth of neuronal processes and synaptogenesis, which is fundamental to learning and memory formation¹¹—a process that is damaged in AD.²

Moreover, a direct relationship has been observed between NAA levels in the brain and intelligence. Healthy individuals with high levels of NAA appear to have higher scores on intelligence tests than healthy individuals with lower levels of this marker in brain tissue.¹² It may be possible that the higher levels of NAA indicate an increased presence of neuronal processes and their synapses.

The effects of drugs that have cognitive-enhancing potential have been studied in healthy individuals. Acetylcholinesterase inhibitors (some of which are used to treat AD), such as donepezil, huperzine , and physostigmine, have been shown to improve memory and cognitive tasks in normal subjects.^13–15 Another medication that enhances cognitive performance is methylphenidate, a drug commonly prescribed for attention deficit hyperactivity disorder (ADHD) but increasingly used by healthy university students nationwide as an academic performance–enhancing agent.¹⁶ A recent national survey¹⁷ reported that ADHD medications have much higher rates of abuse in colleges with higher admission standards. In light of all of the mentioned factors and the recent reports regarding the misuse of anabolic-androgenic steroids for the enhancement of athletic performance,^18,19 the misuse of memory-enhancing drugs to improve academic performance by some ambitious students may not be a far-fetched conjecture. The purpose of this letter is to raise a medically and ethically relevant question: If transient low-level, nonpathologic, glutamate-mediated neuronal damage can occur in normal brain tissue, and neuroprotection against this occurrence could promote neuroplastic processes such as synaptogenesis, could memantine be misused by students for academic performance-enhancement in the near future?

Anyboydy here try memantine. What was your subjective experience with it?

[medievil]

I'm planning to ask my doc for it next week before i add in amphetamine to block any tolerance. A few ppl here tried it and they noticed that it decreases short term memory but this could as wel be temporary. I tell you one thing, memantine is one hell of an interesting drug. Its also been shown to block neurotoxiticy of MDMA and amphetamine deratives and block tolerance to opiates and amphetamines. As well as being neuroprotective.

[Pike]

all of the short term verbal-based memory side effects that i've experienced with memantine thus far subsided after 6 weeks of continuous use.

if you're going to use memantine, don't use it on an as-needed basis, or else you'll never adapt to the side effects. it should be taken consistently. don't go over 20mg, or else you will start to interfere with normal glutamate activity. it takes a long time for the initial side effects to lighten up/go away, but after that it's hardly noticeable at all. i'd say it's made a humongous difference in my ADHD stack. I try to take my 10mg at every 10 o'clock, so that the administrations are evenly spaced out and it doesn't interfere with my sleep. combined with selegiline (which also takes a while to get used to), i barely ever use my prescription amphetamines now.

[doctordog]

i wonder if the key might be dosing (cf. the long - 80-hour? half-life). i tried the drug as monotherapy for OCD: a low dose (5mg) made me a little manic, slightly higher (10mg) was pleasant and calming, but 20mg just made me foggy (i stuck with it for about 3 weeks). there don't seem to be any long-term success stories, outside of those combining it with amphetamine-type stuff. during withdrawal though, i again experienced those wonderful states of peace, which makes me wonder if i might do well on a mood-stabilizer in general and/or potentially be bipolar.

[Pike]

i wonder if the key might be dosing (cf. the long - 80-hour? half-life). i tried the drug as monotherapy for OCD: a low dose (5mg) made me a little manic, slightly higher (10mg) was pleasant and calming, but 20mg just made me foggy (i stuck with it for about 3 weeks). there don't seem to be any long-term success stories, outside of those combining it with amphetamine-type stuff. during withdrawal though, i again experienced those wonderful states of peace, which makes me wonder if i might do well on a mood-stabilizer in general and/or potentially be bipolar.

or maybe if you wanted to go with memantine then perhaps dosing, as you said, is the key

ever thought about low dose lithium? i know that if you take it, you need to get regular blood tests because it can become toxic if left unchecked, but from what i understand, it's supposed to be an effective mood stabilizer.

[FunkOdyssey]

all of the short term verbal-based memory side effects that i've experienced with memantine thus far subsided after 6 weeks of continuous use.

if you're going to use memantine, don't use it on an as-needed basis, or else you'll never adapt to the side effects. it should be taken consistently. don't go over 20mg, or else you will start to interfere with normal glutamate activity. it takes a long time for the initial side effects to lighten up/go away, but after that it's hardly noticeable at all.

+1

low dose (5mg) made me a little manic, slightly higher (10mg) was pleasant and calming, but 20mg just made me foggy

Sounds like 10mg was your dose. Did you consider just staying at 10mg for a longer period of time? Maybe you are more sensitive to memantine's effects than average or maybe you metabolize it more slowly. Also, during the withdrawal from 20mg you again had a period where you felt better, presumably as the serum concentration of the drug was reduced to your individual "sweet spot".

Edited by FunkOdyssey, 09 November 2009 - 05:42 PM.

[yowza]

Is "brain fog" an initial side effect that's typically felt at 5-10mg dosaging?

Does it make you disorientated; lower spatial+visual memory?

Based on subjective experiences, how does memantine effect left brain vs. right brain related memory?

[Pike]

Is "brain fog" an initial side effect that's typically felt at 5-10mg dosaging?

Does it make you disorientated; lower spatial+visual memory?

Based on subjective experiences, how does memantine effect left brain vs. right brain related memory?

personally, the problems i had with memantine at first (can't stress that enough) were problems with short term memory when it came to verbal things. never really cleared until 6 weeks into consistent use. those initial side-effects reared their head the most when i would be in class trying to take notes and not being able to write down what the professor said, despite just hearing it. i also kind of annoyed some friends because they started to think i wasn't paying attention to them, but i suppose having ADHD made it a little more excusable.

didn't make me 'disoriented' so much as just... slower. wasn't so quick on the tongue, loss of verbal fluidity, answers popped up in my head a little slower than the normally did (couldn't keep pace while watching Jeopardy). but that's my own personal experience. everything cleared up at 6 weeks. from that point, i haven't had any side effects yet. but this is only my exp with memantine.


if you ARE going to take it/incorporate it into your regimen, i'd like to make a big suggestion to begin taking it during a vacation/holiday of some kind. you DON'T want to be going through your breaking-in stage of memantine while you have important things that you need to keep pace with (i.e. work, projects, school, whatever). If you're a bit of a massochist, i suppose you COULD just flat out begin at 20mg a day and deal with some of the un-titrated memantine based side effects, but i wouldn't recommend it, because starting too quickly with memantine can supposedly induce side effects that mimic some of the negative symptoms of schizophrenia. so be good to yourself and titrate up to 20mg from 5mg, adding on 5mg each week.

hope that helps!

[doctordog]

low dose (5mg) made me a little manic, slightly higher (10mg) was pleasant and calming, but 20mg just made me foggy

Sounds like 10mg was your dose. Did you consider just staying at 10mg for a longer period of time? Maybe you are more sensitive to memantine's effects than average or maybe you metabolize it more slowly. Also, during the withdrawal from 20mg you again had a period where you felt better, presumably as the serum concentration of the drug was reduced to your individual "sweet spot".

yeah, but even at 10mg those "sweet spots" would appear and disappear from day-to-day. i mean, maybe my ideal was 10mg every second day. who knows. i should've kept a more detailed record.

after years of battling with incompetent pdocs, i finally met a competent psychologist who's tentatively diagnosed me as having both ADHD and OCD (which explains why SSRI's were always such a jail sentence). the good news is i finally have an answer explaining the psychological double-bind i've been living with - terrible impulsive/addictive tendencies constantly at war with a rigid, controlling mindset - but it seems like finding a decent treatment might be next to impossible. i wish i had known sooner, because i honestly functioned better prior to SSRI's, though the damage has been done and living drug-free isn't really an option at this point.

the only hope i have is in finding someone who will be willing to combine a stim with memantine. unfortunately, stims are heavily regulated where i live - with ritalin/concerta as the go-to drug, and instant-release d-amphetamine employed in cases where the former fails (for some reason, extended-release dex is banned here). i'm seeing an ADD specialist next week, and can say with almost complete certainty that i'll fit the criteria. i am considering omitting the details about my OCD, and trying to combine a stim with Memantine myself (i can still get Memantine through my regular GP).

ethical problems aside (i've dealt with too many botched treatments + unsympathetic doctors to sit pleading for an entirely hypothetical treatment plan .. my guess is he'll just push Effexor or something instead), does anyone have experience combining Memantine with various different stims? a friend with ADHD said ritalin and concerta are a lot harsher than dex and might just create dysphoria or something, which probably wouldn't be that great for my OCD/anxiety issues. does Memantine help regulate the harshness of stims? also, outside of a prolonged 'high', is there any genuine anti-depressant effect to the combination?

[doctordog]

alternatively, Funk were you ever able to confirm (theoretically, or by personal account) whether Memantine helped with Wellbutrin tolerance?

[ocean.soul]

I took memantine for like 3 months starting from 10mg up to 20mg.... I didnt feel any change... my memory did not improve, adhd nothing, learning nothing... I dont know.... I guess my levels of glutamate are normal? or where it is supposed to be....