# Galantamine and Nardil to Improve Cognition?



## hworth (Mar 31, 2013)

I've read on Dr. Bob various reports mostly from Chairman_MAO about the effectiveness of Galantamine to negate the sedation from benzos and other meds including MAOIs, so I would like to start taking Galantamine with my Nardil and start on an extremely low dose (2.5mg) to enhance my really s***** Nardil-induced memory problems and slowed thinking, without causing worsened depression or other issues.

However, I'm still in the process of waiting for Nardil to "kick in", so does anyone know if supplementing with Galantamine will prevent the full effects from ever happening? Or should it be fine since it is simply an Acetylcholinesterase inhibitor?


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## Jawi96 (May 15, 2012)

hworth said:


> I've read on Dr. Bob various reports mostly from Chairman_MAO about the effectiveness of Galantamine to negate the sedation from benzos


I just read that it can help with the cognitive issues and thought it was because of it being an Acetylcholinesterase inhibitor, but then that wouldn't make any sense...
But you're saying Galantamine affects GABA receptors/GABA in some way? This is really REALLY good..

Where'd you read this?


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## hworth (Mar 31, 2013)

Here:
http://www.dr-bob.org/babble/20040127/msgs/307090.html

Seems like Galantamine could be a magical superdrug of infinite awesomeness combined with Nardil.. thanks for (partially) clueing me in on this Jawi! You're my hero :3


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## Jawi96 (May 15, 2012)

I'm just a bit confused about how this all works.. Benzos potentiate the inhibitory effect of GABA (makes GABA stronger and with bigger muscles), and it's this that causes the anxiolytic and sedation effects. All this benzo-GABA jargon is also what I think causes the cognitive issues, as Nardil also has similar effects, although with Nardil, it's by inhibiting GABA-T

So, if Galantamine can kick benzo (and Nardil) sedation and cognitive issues' butts, why doesn't it say anywhere whether or not Galantamine has a Blocking/antagonizing/inhibiting effect on GABA or GABA receptors?

(Also, if Nardil sedation is caused by GABA build up, but is only a temporary side effect [possibly due to receptor up-regulation], wouldn't that mean that the cognitive issues from Nardil should disappear after a few weeks or months too?)


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## hworth (Mar 31, 2013)

I know ChopSuey (and others I believe) say the sedation does indeed tend to lessen/disappear after a while, and you're probably right about it having something to do with upregulation of receptors or whatever lol

I found some interesting articles on PubMed on maybe why Galantamine works for it, don't quite fully understand them cause I'm currently in my Nardil haze haha but here they are, probably worth a good read:

- http://www.ncbi.nlm.nih.gov/pubmed/21498956

Interesting Line: "Since galantamine is a rather weak acetylcholinesterase inhibitor, but has additional allosteric potentiating effects at nicotinic receptors, it affects not only cholinergic transmission but also other neurotransmitter systems such as monoamines, glutamate, and γ-aminobutyric acid (GABA) through its allosteric mechanism. It is likely that these effects may result in more beneficial effects."

- http://www.ncbi.nlm.nih.gov/pubmed/19272425
"Galantamine and nefiracetam have been shown to potentiate the phasic activity of nicotinic acetylcholine receptors (nAChRs) in the brain. Stimulation of nAChRs is also known to cause release of various neurotransmitters including glutamate and gamma-aminobutyric acid (GABA)."

- http://www.ncbi.nlm.nih.gov/pubmed/11961141
" In rat hippocampal and human cerebral cortical slices, 1 microM galantamine, acting as a nicotinic APL, increased gamma-aminobutyric acid (GABA) release triggered by 10 microM acetylcholine (ACh). Likewise, 1 microM galantamine, acting as an APL on presynaptically located nicotinic receptors (nAChRs) that are tonically active, potentiated glutamatergic or GABA-ergic transmission between Schaffer collaterals and CA1 neurons in rat hippocampal slices."


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## Jawi96 (May 15, 2012)

If Galantamine can release/potentiate GABA, isn't that actually a bad thing? I thought that it was the increase of GABA that caused the cognitive issues in the first place?

Oh.. I can smell those smug Parnate users sneering at us from their pedestals..

Well, it said it can help with benzo sedation, and we know what causes benzo sedation, so can we just agree that it's worth trialing? My brain hurts..


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## Jawi96 (May 15, 2012)

Okay, so, from what I got.. 3 things can possibly be used to eliminate Nardil's cognitive side effects.. First is Galantamine; second is possibly some kind of GABA antagonist, like Flumazenil; third is, and GOD FORBID, just switching to Parnate..


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## hworth (Mar 31, 2013)

Ya screw it, I'm gonna be the guinea pig on this and just go for it.. my Galantamine arrives tomorrow so I'll keep posted on how it goes!


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## Jawi96 (May 15, 2012)

I'd take the leap too, but I just have so much more value as a human being.

GOOD LUCK THOUGH


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## puppy (Jun 27, 2012)

Note that depression can be a side effect of galantamine and that it increases REM sleep which has been associated with depression (Nardil and other antidepressants usually decrease REM sleep).


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## riptide991 (Feb 1, 2012)

Man from what I read of anecdotal reports the sedation only disappears for a small amount of people, the majority are stuck with it.

I was set on Nardil but my research lead me to pick Parnate because the side effects from Nardil are just insane.


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## Jawi96 (May 15, 2012)

puppy said:


> Note that depression can be a side effect of galantamine and that it increases REM sleep which has been associated with depression (Nardil and other antidepressants usually decrease REM sleep).


Yea, Chairman_MAO said Dopamine and acetylcholine (and possibly NE and Acetylcholine) counterbalance each other. we're just suppose to go up slowly, until we can find the right dose.

If Nardil works for us for reasons other than an increase in GABA, then finding that perfect Galantamine dose should keep our brains happy, and smarterer!



kehcorpz said:


> I was set on Nardil but my research lead me to pick Parnate because the side effects from Nardil are just insane.


uhuh? uhuh? yea? yup.. there it is.. WE KNOW. YOUR PARNATE IS NOT WANTED HERE!


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## The Professor (Jul 31, 2011)

It's pretty tricky. Some say acetylcholinesterase inhibition helps negate apathy in patient's with Alzheimer's. But does this mean it will help apathy in patients with depression? Maybe, maybe not. Then, more often you hear reports about the "over cholinergic activity" types of depression, and also how many people seem to feel more depressed when on cholinergics (and the "dumb-drug euphoria" phenomenon seems to back this up further). 

The best you can do is try it and see how you feel. I would definitely wait til your nardil is fully kicked in before adding galantamine. 

I just decided about an hour ago that I'm going to add an acetylcholinesterase inhibitor/GABA transaminase inhibitor to my MAOI (Emsam). So I'll try to remember to post back here with the effects I notice. Just started first dose an hour ago.

EDIT: btw, in case you guys were wondering, "Melissa" is what I will be taking for those two actions mentioned above.


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## Jawi96 (May 15, 2012)

Okay wait, I think theres been some misunderstanding here. For just me, really..

Am I the only one here that thinks that the cognitive issues are caused by anything that has any positive GABA on the GABAa receptor?

I mean, more acetylcholine sounds great and all, but I don't think that'll do any cognitive issues murdering, and that's just unacceptable.


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## The Professor (Jul 31, 2011)

too tired to think how this will interact with nardil, but ill just throw this out there... Bacopa to help with cognition and memory deficits? (if this means anything to you, SAS member "Euphoria" says that bacopa is the one herb he took that had a significant effect on him)

all im concerned about is 5ht2c receptor upregulation in the hippocampus. only one study showed this, and I question it's validity.... if anyone knows more bout this, let me know.


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## Jawi96 (May 15, 2012)

The Professor said:


> too tired to think how this will interact with nardil, but ill just throw this out there... Bacopa to help with cognition and memory deficits? (if this means anything to you, SAS member "Euphoria" says that bacopa is the one herb he took that had a significant effect on him)
> 
> all im concerned about is 5ht2c receptor upregulation in the hippocampus. only one study showed this, and I question it's validity.... if anyone knows more bout this, let me know.


I don't just want to improve cognition; I want to undo the cognitive issues that Nardil causes. I wanna know what causes them, then do the opposite.

If it was because of a lack of REM sleep from a deficiency of acetylcholine, then why do benzodiazepines seem to cause similar cognitive issues like Nardil's? They don't have any significant effects in decreasing ACh.

I'm not disagreeing with you, I'm just super confused on whether the cognitive side effcts are ACh, or GABAa receptor related


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## The Professor (Jul 31, 2011)

Jawi96 said:


> I don't just want to improve cognition; I want to undo the cognitive issues that Nardil causes. I wanna know what causes them, then do the opposite.
> 
> If it was because of a lack of REM sleep from a deficiency of acetylcholine, then why do benzodiazepines seem to cause similar cognitive issues like Nardil's? They don't have any significant effects in decreasing ACh.
> 
> I'm not disagreeing with you, I'm just super confused on whether the cognitive side effcts are ACh, or GABAa receptor related


My first post was just referring to the general effects on mood of combining an ACh esterase inhibitor, like galantamine, with a MAOI. I mean if it cancels out too much of nardils benefical effects on depression then is it worth it? or if it ends up being synergistic by reducing MAOI apathy then great! that's what we'll all have to just test out.

Honestly I forget the details behind nardil's cognitive blunting effects. I don't remember it being an extremely common side effect though. Maybe you won't even have trouble with this, which is why it may be best to give nardil a shot by itself first, or with a low-ish dose of galantamine. it's up to you though. Nardil's effects on gaba are what makes it such a great drug for social anxiety, so personally, I would not want to directly counter-balance this... maybe partially if you find that it is causing you some trouble.

I have had extreme cognitive issues from drugs that antagonize acetylcholine. So if I was going to start a drug that I knew would affect that, I would definitely want to counter-act it, I hear you on that. Have gaba-ergics really affected you badly in the past?


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## Jawi96 (May 15, 2012)

The Professor said:


> My first post was just referring to the general effects on mood of combining an ACh esterase inhibitor, like galantamine, with a MAOI. I mean if it cancels out too much of nardils benefical effects on depression then is it worth it? or if it ends up being synergistic by reducing MAOI apathy then great! that's what we'll all have to just test out.
> 
> Honestly I forget the details behind nardil's cognitive blunting effects. I don't remember it being an extremely common side effect though. Maybe you won't even have trouble with this, which is why it may be best to give nardil a shot by itself first, or with a low-ish dose of galantamine. it's up to you though. Nardil's effects on gaba are what makes it such a great drug for social anxiety, so personally, I would not want to directly counter-balance this... maybe partially if you find that it is causing you some trouble.
> 
> I have had extreme cognitive issues from drugs that antagonize acetylcholine. So if I was going to start a drug that I knew would affect that, I would definitely want to counter-act it, I hear you on that. Have gaba-ergics really affected you badly in the past?


No, GABA-ergics haven't done, me wrong, I hope.. Although, Im already benefiting from Nardil but my MAIN problem is the cognitive issues right now. I hate how every 2 minutes I can just ALMOST remember what I was gonna say. Nardil's busting my vocabulary chops.

Okay, I know how to settle this in my head. If you could just answer these..

1. What causes BENZODIAZEPINE cognitive issues?

2. If Nardil antagonizes acetylcholine, does Parnate as well?


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## hworth (Mar 31, 2013)

_________________________________________________________


Jawi96 said:


> 1. What causes BENZODIAZEPINE cognitive issues?


I think I may have found an answer for this one...

Read this *Dr. Bob* forum thread: http://www.dr-bob.org/babble/20040602/msgs/353141.html

"I believe that benzodiazepines decrease acetylcholine release. Acetylcholine, for the uninitiated, is vital for cognition. The galantamine helps compensate for decreased cholinergic activity."

So that would explain why Galantamine works for Benzos, anyways!



Jawi96 said:


> 2. If Nardil antagonizes acetylcholine, does Parnate as well?


I think Nardil _does_ in fact decrease acetylcholine, but probably not by any directly antagonistic function, read this Social Anxiety Support thread:

"*Nardil an anticholinergic?*"
http://www.socialanxietysupport.com/forum/f30/nardil-an-anticholinergic-69618/

Interesting quotes:

-"I know for sure some serotonin and dopamine receptors inhibit acetylcholine (Nardil obviously increases activation of both), plus Nardil increases GABA which exerts powerful inhibitory effects on acetylcholine release. So my answer: yes, Nardil is anticholinergic, but I've never heard anything about it directly blocking cholinergic receptors."

-"It inhibits acetylcholine release in at least some areas of the brain, that's all I know. The pattern of inhibition is probably different to a direct anticholinergic drug."
________________________________________________________

This gives me HUGE hope that Galantamine will really help with the cognitive side effects of Nardil! I just wonder if I will feel any different from the first dosage, or if it takes a while for the Galantamine to start doing anything.. hopefully it's instant

(Forgot to mention, I saw a list of side-effects caused by low acetylcholine.. almost every single one I've had from Nardil is listed. Could just be false hope but I'm thinking at least a few will/should be fixed by Galantamine, like:

-Memory Problems
-Urinary Retention
-Orthostatic Hypotension
-Slightly blurred vision
-Mental confusion (brain fog) )


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## riptide991 (Feb 1, 2012)

Jawi96 said:


> uhuh? uhuh? yea? yup.. there it is.. WE KNOW. YOUR PARNATE IS NOT WANTED HERE!


I was just saying 

Remember I made a Nardil thread and was actually going to go on it, but before seeing doc I did a butt load of research hehe.

Anyways, Nardil is still the best for SAD which I don't really have if my GAD is managed. I only have Depression/anhedonia/Gad.


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## Jawi96 (May 15, 2012)

hworth said:


> _________________________________________________________
> 
> I think I may have found an answer for this one...
> 
> ...


OMIGOD I LOVE YOU SO HARD RIGHT NOW! If we we're a sitcom, you'd be like, my under appreciated secretary who does most of the work and always gets his name spelt wrong in the credits.

I was just wondering if there was any basis to the "GABA which exerts powerful inhibitory effects on acetylcholine release", because, after all, THAT line is the holy grail of this thread so far, and it's just a post by some guy. So, here's what I found: http://www.ncbi.nlm.nih.gov/pubmed/20493090

Quota quote "GABA and isoguvacine inhibited [(3)H]ACh release and these inhibitions were reversible by (+)bicuculline. Furthermore, the release of [(3)H]ACh was also inhibited by (+/-)baclofen."

(baclofen=GABA agonist)
(Bicuculline=GABA antagonist)

So, all is well in the world! Cognitive issues are caused by Acetylcholine antagonism and NOT (directly) GABA, or GABAa receptors. Even further confirmed by the fact that ACh is also inhibited by Baclofen, which only activates GABAb receptors.

Galantamine should be the most perfect thing ever forever and and ever ever!

My only regret is SAS not having a Chairman_MAO of it's own..



kehcorpz said:


> I was just saying
> 
> Remember I made a Nardil thread and was actually going to go on it, but before seeing doc I did a butt load of research hehe.
> 
> Anyways, Nardil is still the best for SAD which I don't really have if my GAD is managed. I only have Depression/anhedonia/Gad.


I just went with Nardil because it has a higher incidence rate for causing hypomania, which I've been correlating with the SUPERIOR antidepressant.

You gotta start saying "butt" less, man. For godsakes, you're on the internet!


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## hworth (Mar 31, 2013)

Jawi96 said:


> OMIGOD I LOVE YOU SO HARD RIGHT NOW! If we we're a sitcom, you'd be like, my under appreciated secretary who does most of the work and always gets his name spelt wrong in the credits.
> 
> I was just wondering if there was any basis to the "GABA which exerts powerful inhibitory effects on acetylcholine release", because, after all, THAT line is the holy grail of this thread so far, and it's just a post by some guy. So, here's what I found: http://www.ncbi.nlm.nih.gov/pubmed/20493090
> 
> ...


Nice find on the Benzo evidence, that's exactly what I couldn't find!!

Now, I only have a couple of worries left..

first, I wonder if Galantamine continues to work like it should for a really long time of usage, or if you can build up a tolerance to it's effects?

and second, will it make me more nervous than usual by somehow negatively counteracting the axiolytic effects of Nardil's GABA increase?.. but I doubt it

I'm excited to try it for the first time in a few hours! If it works amazingly I might go back up to 75mg where I had even better anti anxiety but terrible confusion + sedation, and just counteract it with Galantamine! We may have stumbled upon the holy grail of med combos my friend..


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## Jawi96 (May 15, 2012)

hworth said:


> first, I wonder if Galantamine continues to work like it should for a really long time of usage, or if you can build up a tolerance to it's effects?


I thought this same thing! I'll try looking it up a bit tomorrow, but I'm just way sleepy now. It's gotta be somewhere; Galantamine is a thing in the disorders scene (us), the nootropics scene, and to those lucid dreamer wierdos



hworth said:


> and second, will it make me more nervous than usual by somehow negatively counteracting the axiolytic effects of Nardil's GABA increase?.. but I doubt it


Well.. Chairman DID say:
"Choinergics can worsen depression because, on a neurological level, dopamine and acetylcholine (and I think norepinepherine and acetylcholine, too) counterbalance each other (the real picture is way more complex than I will ever understand). On a psychological level, which often makes more sense when talking about drugs that affect the MIND, "if you think too much, you're gonna be depressed", hehe.
I'd imagine this might not be as bad on Nardil because it increases DA activity to some extent. I used galantamine for months, and found that there was quite a discernable line between enhanced cognitive function and outright thought-frenzied depression. The difference was night and day, and seemed to occur if I exceeded 15mg/day."

and I'm like 90% sure he was on 105mg-120mg when he was on Galantamine, and 90mg or less before, so if he could only get to 15mg/day of Galantamine, then.. actually this all depends on your ability to metabolize it.. Just go up REAL SLOW then, I guess..

He also takes D-amphetamine which releases DA and NE. The apparent "counter balance"-er's to acetylcholine, so my GUESS is that you would probably start getting depressed between 10mg-15mg of Galantamine, but it's really all up to your individual response



hworth said:


> I'm excited to try it for the first time in a few hours! If it works amazingly I might go back up to 75mg where I had even better anti anxiety but terrible confusion + sedation, and just counteract it with Galantamine! We may have stumbled upon the holy grail of med combos my friend..


Remember, Galantamine is just a AChE inhibitor, and just prevents ACh breakdown and allows it to build up. Now, I have NO IDEA how long it takes for ACh to build up to the right levels, especially if you slowly titrate up (to lower risk of acetylcholine-related depression). The speed of these things is usually pretty individual to the person too, so just don't be surprised if it takes longer than a week after hitting at least 4mg to 8mg.

(one more thing you might wanna look at: http://www.dr-bob.org/babble/20051024/msgs/571856.html)

it's Chairman again. He mentions adding levetiracetam as well. Again, NO BLOODY IDEA what that is as of now. ill look it up tomorrow. I still have to study for these stupid grade 8 tests about cooking. Surely cooking is more important then all this. If I don't know my cooking, I might end up like hitler, or be denied entrance into heaven or something!

EDIT: OKAY, so the Levetiracetam is apparently very likely both GABAeargic AAAND (possibly) Cholinergic as well.. This means that is increases GABA (inhibits ACh release) and at the same time releases ACh? Well, seeing as Chairman said that this has an antidepressant effect, I would say it's possibly more GABAergic than it is Cholinergic, and would be defeating the purpose of adding the Galantamine in the first place.

So yea, just trial the Galantamine, and screw the Racetams


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## puppy (Jun 27, 2012)

You guys are a couple of fiddlers on the roof. Just wait a year and all your Nardil side-effects will be gone, I promise.


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## Jawi96 (May 15, 2012)

puppy said:


> You guys are a couple of fiddlers on the roof. Just wait a year and all your Nardil side-effects will be gone, I promise.


Cognitive side effects and some others that are likely caused by ACh inhibition remain with you unlike some many other Nardil SE that go away with time

Even if you are right, what's wrong with some extra Galantamine given brain power?


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## puppy (Jun 27, 2012)

Jawi96 said:


> Cognitive side effects and some others that are likely caused by ACh inhibition remain with you unlike some many other Nardil SE that go away with time
> 
> Even if you are right, what's wrong with some extra Galantamine given brain power?


You won't know that until you try. I've been on Nardil for over a year and my memory is back to normal.


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## puppy (Jun 27, 2012)

Or actually better than ever, but I had below-average working memory and short-term memory to begin with.


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## puppy (Jun 27, 2012)

Also, as a guy who gets severe restless legs and auditory hallucinations after half a Benadryl, I can say that I haven't noticed any antichollinergic-feeling effects of Nardil.


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## hworth (Mar 31, 2013)

Jawi96 said:


> Cognitive side effects and some others that are likely caused by ACh inhibition remain with you unlike some many other Nardil SE that go away with time
> 
> Even if you are right, what's wrong with some extra Galantamine given brain power?


I completely agree. If this is a perfectly fine solution for cognitive impairment caused by Nardil, what's the point in waiting a year for it to _maybe_ disappear on it's own?

Besides, I doubt it will cause any permanent therapeutic changes or worsened depression if I keep the dosage low.

Now I'm just debating whether I should play it safe and start on 2.5mg daily for a week, or if that's not even enough to cause noticeable effects and just start with an "attack" dose of *gasp* 5mg daily 0.0


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## Jawi96 (May 15, 2012)

hworth said:


> I completely agree. If this is a perfectly fine solution for cognitive impairment caused by Nardil, what's the point in waiting a year for it to _maybe_ disappear on it's own?
> 
> Besides, I doubt it will cause any permanent therapeutic changes or worsened depression if I keep the dosage low.
> 
> Now I'm just debating whether I should play it safe and start on 2.5mg daily for a week, or if that's not even enough to cause noticeable effects and just start with an "attack" dose of *gasp* 5mg daily 0.0


Whether you start on 2.5mg or 5mg, it's really just a few weeks difference, which should be nothing in the long run. You just HAVE to watch your mood on the higher doses; a cognition for depression trade-off was never the point of all this.

I don't know if anyone else thought about this, but there is one more potentially BIG issue with trialing Galantamine. More specifically - Trialing Galantamine NOW.

If we start the Galantamine trial now, when neither of us have actually stabilized on the med yet, it would be VERY difficult to see exactly HOW galantamine effects our mood, as it would be constantly changing with Nardil alone. It's also gonna be a pain in the butt getting the correct dosage, as this could also change depending on whatever neuron tables Nardil decides to randomly flip in our heads.

So, the obvious solution would be to wait till we've stabilized (several months), right? Well, this is ALSO a possible trade off.. If you look at stuff the agonizes GABA, you'll probably notice that a lot of them - Ethanol, GHB, Benzodiazepines, and very possibly a lot more - can have LONG-TERM cognitive side effects. Nardil agonizes GABA by inhibiting GABA-T, so it really wouldn't be too surprising if if we wait the extra months it would take to stabilize on Phenelzine, we could possibly have, at least to SOME MINISCULE degree (but possibly more), permanently damaged our brains (From the Nardil, not the Galantamine. Galantamine loves us).

So.. yea.. actually, now that I think about it.. We could just trial now, but only up to maximum of 8mg, then once Nardil stabilizes, we could just adjust the Galantamine dose THEN. YAY FOR BRAINS!


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## hworth (Mar 31, 2013)

Jawi96 said:


> Whether you start on 2.5mg or 5mg, it's really just a few weeks difference, which should be nothing in the long run. You just HAVE to watch your mood on the higher doses; a cognition for depression trade-off was never the point of all this.
> 
> I don't know if anyone else thought about this, but there is one more potentially BIG issue with trialing Galantamine. More specifically - Trialing Galantamine NOW.
> 
> ...


I remember ChopSuey posting a whole bunch of links in his Nardil thread about phenelzine actually being neuroprotective I think? So it's not so much long term damage with Nardil that I'm worried about or trying to avoid, just the REALLY annoying cognitive S.E's.. Ughhh you make a good point about waiting for Nardil to kick in fully though :/

I'm at 7 weeks and 2 days total on Nardil and spent the first half of that time on 60mg, then 75mg for the last half and now for the past 4 days I've been back down to 60 again just because the 75 was absolutely killing me with horrible daytime tiredness/ brain fog and hypotension, so I'm pretty sure Nardil should still kick in just fine right?

Buut now if i'm gonna start Galantamine, I wonder if it would be better to go back up to 75 which is when the brain fog was the worst, just to see how greatly Galantamine negates cognitive issues?..

Really wish i'd have done this experimentation before now since i've only got 6 days before school starts again ahah


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## Jawi96 (May 15, 2012)

hworth said:


> I remember ChopSuey posting a whole bunch of links in his Nardil thread about phenelzine actually being neuroprotective I think? So it's not so much long term damage with Nardil that I'm worried about or trying to avoid, just the REALLY annoying cognitive S.E's.. Ughhh you make a good point about waiting for Nardil to kick in fully though :/
> 
> I'm at 7 weeks and 2 days total on Nardil and spent the first half of that time on 60mg, then 75mg for the last half and now for the past 4 days I've been back down to 60 again just because the 75 was absolutely killing me with horrible daytime tiredness/ brain fog and hypotension, so I'm pretty sure Nardil should still kick in just fine right?
> 
> ...


Going back up to 75mg just to trial Galantamine may not be the best idea.. If you're not having too many cognitive SE on 60mg, and Nardil still hasn't worked for you, then staying on 60mg might be better. No point in having to endure the worst side effects before the benefits kick in, anywho.

Also, Im not sure why, but I get zero response out of the normal dose range (15mg-75mg). Yea, It sucks, but I tried testing 120mg at around week ten for one day, then right before I was gonna give up on that Nardil trial, which was around 6 days after the 120mg, I started feeling REALLY REALLY GOOD, but only for like 3 days, though . So far, I've just been giving the early MAO inhibition of the 120mg I took the credit for that, but I really wouldn't know until I repeat trying it. Right now I've been on 120mg for 3 days, which means if I don't feel better within the next week or two, im totally ****ed.

Wait, umm.. yea.. I said that cause you mentioned you're week 7, I was thinking it might be possible for you to maybe have the same thing (everyone who doesn't respond could, really). Just, if you reach maybe week 12 and still get nothing, try moving up to 120mg and staying there for at least 2 weeks before you decide to quit on Nardil.


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## hworth (Mar 31, 2013)

my dumb *** ordered 8mg Galantamine pills and now i cant measure 4mg worth of it because my gram scale only goes to the hundredths decimel (and 5mg would be .005 i believe?) so do u think 8mg would be fine or way too much to start with? and if it is how can i measure it out with a teaspoon or something hahaha


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## Jawi96 (May 15, 2012)

hworth said:


> my dumb *** ordered 8mg Galantamine pills and now i cant measure 4mg worth of it because my gram scale only goes to the hundredths decimel (and 5mg would be .005 i believe?) so do u think 8mg would be fine or way too much to start with? and if it is how can i measure it out with a teaspoon or something hahaha


Yes, 8mg is WAY too much to start with. I'm pimp slapping you for this.

Well, okay, but 4mg sounds PERFECT, so just.. i don't know.. get your most sacred ancient japanese katana, blind fold yourself, and make sure the camera guy pans on the single droplet of sweat slipping off the side of your head when you decide to strike the pill. I assume that would be a fairly accurate way to cut pills perfectly in half. Don't kill the camera man.

Also, hey, which Galantamine did you get? The 'Nivalin' one Chairman_MAO suggested is crazyface expensive. You think it's any different from the ones I found?


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## riptide991 (Feb 1, 2012)

Is it a pill? If so cut it. Is it a capsule? Open it up and it will pretty much have an even half in each side, if not pour contents of one half into the other. 

I'm curious how this goes. Parnate doesn't give me any problems with the ol' nogging, but i'm still super curious. This stuff has been used in alzheimers patients. But then again memantine is the approved drug for alzheimers. Memantine initially made me super dumb, wasn't on it long enough to decide the final outcome, but people say that part wears off and then you get super smarty hehe.


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## hworth (Mar 31, 2013)

Jawi96 said:


> Yes, 8mg is WAY too much to start with. I'm pimp slapping you for this.
> 
> Well, okay, but 4mg sounds PERFECT, so just.. i don't know.. get your most sacred ancient japanese katana, blind fold yourself, and make sure the camera guy pans on the single droplet of sweat slipping off the side of your head when you decide to strike the pill. I assume that would be a fairly accurate way to cut pills perfectly in half. Don't kill the camera man.
> 
> Also, hey, which Galantamine did you get? The 'Nivalin' one Chairman_MAO suggested is crazyface expensive. You think it's any different from the ones I found?


Lol, it's capsules so unfortunately my years of samurai training have left me defenseless in this scenario.. kehcorpz's advice sounds pretty good tho for measuring 4mg. Why can't you be more like him? Maybe you should switch to Parnate? 

But in all seriousness that Nivalin crap was waay too expensive for me too, so I just went with this Brain & Body brand Galantamine from Amazon:
http://www.amazon.com/Galantamine-C...F8&qid=1377781287&sr=8-2&keywords=galantamine

Ignore the comments from that one idiot who wrote on like half the reviews with "Sigh.. another fake first-time review. I think I'll blow my brains out tonight" or whatever cause literally like all those people he thought were fake now have others reviews haha. Seems like a legit product, I've got the baggy in my hand right now

I wonder when I should take the first 4mg dose? Like if I should take it before or after Nardil or on an empty stomach, yada yada yada



kehcorpz said:


> Is it a pill? If so cut it. Is it a capsule? Open it up and it will pretty much have an even half in each side, if not pour contents of one half into the other.
> 
> I'm curious how this goes. Parnate doesn't give me any problems with the ol' nogging, but i'm still super curious. This stuff has been used in alzheimers patients. But then again memantine is the approved drug for alzheimers. Memantine initially made me super dumb, wasn't on it long enough to decide the final outcome, but people say that part wears off and then you get super smarty hehe.


Capssule, I will just follow your advice and use 1/2 of the capsule's side to measure.

I might be wrong, but I believe Memantine and Galantamine have different therapeutic mechanisms.

- Galantamine is both an acetylcholinesterase inhibitor AND it stimulates + potentiates nicotinic acetylcholine receptors. Memantine is ONLY an antagonist at these nicotinic receptor sites, so it eventually increases acetylcholine too but I think it takes longer. . Also explains why you felt worse initially:
"Memantine acts as a non-competitive antagonist at different neuronal nicotinic acetylcholine receptors (nAChRs) at potencies possibly similar to the NMDA and 5-HT3 receptors, but this is difficult to ascertain with accuracy because of the rapid desensitization of nAChR responses in these experiments. It can be noted that memantine is an antagonist at alpha-7 nAChR, _*which may contribute to initial worsening of cognitive function during early memantine treatment*_. Alpha-7 nAChR upregulates quickly in response to antagonism, which could explain the cognitive-enhancing effects of chronic memantine treatment." (http://en.wikipedia.org/wiki/Memantine)

-Also, Memantine is a dopaminic agonist on the D2 receptor, while Galantamine "was found to increase extracellular levels of dopamine in the medial prefrontal cortex." (http://www.nature.com/npp/journal/v32/n1/full/1301087a.html) by it's stimulation and potentiation of nAChRs. So Memantine probably has much stronger effects on dopamine, but that isn't to say Galantamine doesn't affect it positively either. Lastly, Memantine is an NMDA receptor antagonist, which Galantamine isn't, and it is also slightly Serotonergic through it's antagonistic action on the 5-HT3 receptor, which Galantamine doesn't do either.

BUT Galantamine does act and perhaps increase all the neurotransmitters at least slightly, here's a VERY good article on Galantamine: http://www.life-enhancement.com/magazine/article/2424-galantamine-boosts-neurotransmitter-spiral

Sorry if anyone found this post lengthy/pedantic/boring hahah, I like to write this stuff out in the thread so everyone can read it and also so I can keep it all straight in my head too.


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## hworth (Mar 31, 2013)

OYA, kind of random but forgot to mention this morning I woke up and for the first time in at least like 3 weeks I actually remembered a DREAM..! Is this a bad sign that I should've stayed on 75mg of Nardil instead of 60, since I remember having REM sleep again finally (I don't want MAO inhibition to drop!! But I've only been on reduced 60mg for like 5 days max)? Or could it just be coincidence and totally fine considering I've been on 60/75mg for 7 and 1/2 weeks now plus Ambien for the past week and a half so maybe now I'm finally just getting some lessened Nardil sleep side effects and a little REM sleep back or something? Or just happened to remember a dream finally?

Yes, I am a hopelessly paranoid hypochondriac.

(P.S., Haven't started Galantamine yet so it's not that..)


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## riptide991 (Feb 1, 2012)

Yah I didn't want to wait for the nachr downregulation because the drug was sooo damn expensive. It's generic yet more expensive than a lot of name brand ones I got. It's like they are trying to rip off the Alzheimers community. But yah it did improve mood initially which I believe was as a result of the D2 agonism.


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## Jawi96 (May 15, 2012)

hworth said:


> Lol, it's capsules so unfortunately my years of samurai training have left me defenseless in this scenario.. kehcorpz's advice sounds pretty good tho for measuring 4mg. Why can't you be more like him? Maybe you should switch to Parnate?
> 
> But in all seriousness that Nivalin crap was waay too expensive for me too, so I just went with this Brain & Body brand Galantamine from Amazon:
> http://www.amazon.com/Galantamine-C...F8&qid=1377781287&sr=8-2&keywords=galantamine
> ...


Say what now? My brain just pooped out and I may need a simpler explanation.. This doesn't mean memantine is more promising than Galantamine, does it (with it's fancypants D2 agonism and whatevers)?


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## hworth (Mar 31, 2013)

Whoops, didn't mean memantine was better at all! Just wanted to show the differences, i'm still going with Galantamine.. any ideas on what time of day I should take the 4mg? I havent really seen anything in my research


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## Jawi96 (May 15, 2012)

hworth said:


> Whoops, didn't mean memantine was better at all! Just wanted to show the differences, i'm still going with Galantamine.. any ideas on what time of day I should take the 4mg? I havent really seen anything in my research


Says on Iherb:

ON IHERB! http://www.iherb.com/Life-Enhancement-GalantaMind-90-Capsules/2742

that you should take it at breakfast and lunch. soo.. I guess that means that at 4mg per day (because we're sensitive to depression), it would be 2mg with breakfast and 2mg with lunch. That also kind of answers your empty stomach question. If you're taking Nardil on an empty stomach, maybe you could just wait an hour - eat - then take your Galantamine.

But.. Can we really trust Iherb? DUN DUN DUUUN!!


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## riptide991 (Feb 1, 2012)

Jawi96 said:


> Say what now? My brain just pooped out and I may need a simpler explanation.. This doesn't mean memantine is more promising than Galantamine, does it (with it's fancypants D2 agonism and whatevers)?


Well you know you're comparing a powerful pharmaceutical with lots of research behind it to some over the counter supplement. Even if you wanted memantine you'd need quite the open doctor to prescribe it.


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## hworth (Mar 31, 2013)

kehcorpz said:


> Well you know you're comparing a powerful pharmaceutical with lots of research behind it to some over the counter supplement. Even if you wanted memantine you'd need quite the open doctor to prescribe it.


Yeah that's why I'm trying Galantamine, there's no way at 17 years old a doc is gonna prescribe me that so I need something I can keep buying and using OTC.

Galantamine does actually get prescribed as Razadyne/Reminyl tho and it also has research behind it for Alzheimer's, so it's not like it's just some sketchy supplement.


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## Jawi96 (May 15, 2012)

kehcorpz said:


> Well you know you're comparing a powerful pharmaceutical with lots of research behind it to some over the counter supplement. Even if you wanted memantine you'd need quite the open doctor to prescribe it.


hrrrgghhhhghh..


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## hworth (Mar 31, 2013)

Took my first 4mg Galantamine pill 15 min ago! If i don't go into sudden cardiac arrest or get hit by a car I'll update whether I feel anything in a couple hours but i doubt it'll be that quick

(i noticated the directions on my galantamine packet said take 1 or 2 8mg pills daily.. so i just took all 4mg at once. made measuring so much easier)


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## hworth (Mar 31, 2013)

First day on 4mg on Galantamine was surprisingly very good! I swear I can already feel a difference in energy level and definitely at least my ability to retain memory of today's events was better. No adverse effects that i noticed..Continuing with the trial for sure! 

One thing i'm wondering regarding dosing: I've been reading that Galantamine's half-life is 7 hours, and it can stay in the body for up to 48 hours.. can i take it every day like (we) were thinking I should or will this lead to tolerance build up? Some people on lucid dreaming forums were saying to use it 3 times a week to avoid tolerance but then again they're talking about the lucid dreaming effect it has soo i'm not sure it's entirely relevant to what I'm using it for, if at all.


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## Jawi96 (May 15, 2012)

hworth said:


> First day on 4mg on Galantamine was surprisingly very good! I swear I can already feel a difference in energy level and definitely at least my ability to retain memory of today's events was better. No adverse effects that i noticed..Continuing with the trial for sure!
> 
> One thing i'm wondering regarding dosing: I've been reading that Galantamine's half-life is 7 hours, and it can stay in the body for up to 48 hours.. can i take it every day like (we) were thinking I should or will this lead to tolerance build up? Some people on lucid dreaming forums were saying to use it 3 times a week to avoid tolerance but then again they're talking about the lucid dreaming effect it has soo i'm not sure it's entirely relevant to what I'm using it for, if at all.


Great that it seems to help! Maybe you can start another thread for the trial?

Call it "Jawi and Hworth's Galantamine trial"
or maybe just "Jawi's Galantamine trial"
or you could just call it "Jawi be SO foine" or whatever really.

And as for tolerance.. It shouldn't (?) be an issue.

1st thing I found was this: http://www.ncbi.nlm.nih.gov/pubmed/15353385

"*CONCLUSIONS: *

Results of this open-label extension support the findings from previous galantamine studies and demonstrate the safety and tolerability of galantamine for up to 18.5 months."

Which is cool, because the study was 18.5 months.

But then in the results, you notice it mention the annoyingly vague statement:

"Analysis of the subgroup of patients (N=113) who completed the entire 18.5 months of galantamine treatment showed that cognitive function was maintained up to 14 months."

Meaning, I'm thinking, some people maybe gained tolerance at 14 months? I don't care. I hate these people.

Which too, is cool, because I also found THIS!: http://www.ncbi.nlm.nih.gov/pubmed/10971047

"However, galantamine maintains patients' level of cognitive and daily function for at least 1 year, which has not been reported for other AChE inhibitors. Galantamine's modulatory effects on nAChR may influence transcriptional regulation, resulting in an increased synthesis of nAChR. This may account for galantamine's sustained efficacy."

GALANTAMINE WOOT WOOT!


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## hworth (Mar 31, 2013)

Jawi96 said:


> Great that it seems to help! Maybe you can start another thread for the trial?
> 
> Call it "Jawi and Hworth's Galantamine trial"
> or maybe just "Jawi's Galantamine trial"
> ...


That's great to hear! Maybe I will start a seperate thread

Does anyone know if Galantamine increases prolactin, or has any effect on it whatsoever?


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## riptide991 (Feb 1, 2012)

So I was thinking last night. Why don't you guys add something like Zyprexa (olanzapine) 5mg to help with the cognitive issues? I must say that my cognition was at its best when on this drug. It is one of the only drugs to have a really strong affinity for antagonizing 5-ht6 receptors. Here's a quote from wiki



> Blockade of central 5-HT6 receptors has been shown to increase glutamatergic and cholinergic neurotransmission in various brain areas,[7][8][9][10] whereas activation enhances GABAergic signaling in a widespread manner.[11] Antagonism of 5-HT6 receptors also facilitates dopamine and norepinephrine release in the frontal cortex,[10][12] while stimulation has the opposite effect.[11]
> 
> Despite the 5-HT6 receptor having a functionally excitatory action, it is largely co-localized with GABAergic neurons and therefore produces an overall inhibition of brain activity.[11] In parallel with this, 5-HT6 antagonists improve cognition, learning, and memory,[13] and agents such as latrepirdine, Lu AE58054, and SB-742,457 are being developed as novel treatments for Alzheimer's disease and other forms of dementia.[10][14][15]


Not only that it is also a strong 5-ht2c antagonist. I honestly would still be on this puppy combined with Parnate if it didn't mess with my blood sugar.

These are the 3 antipsychotics that antagonize 5-ht6:
olanzapine, asenapine, clozapine(good luck getting this one )


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