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  1. Front Biosci (Landmark Ed). 2016 Jun 1;21:1314-29. The neurobiology of acetyl-L-carnitine. Traina G. Author information https://www.ncbi.nlm.nih.gov/pubmed/27100509 Abstract A large body of evidence points to the positive effects of dietary supplementation of acetyl-L-carnitine (ALC). Its use has shown health benefits in neuroinflammation, which is a common denominator in a host of neurodegenerative diseases. ALC is the principal acetyl ester of L-Carnitine (LC), and it plays an essential role in intermediary metabolism, acting as a donor of acetyl groups and facilitating the transfer of fatty acids from cytosol to mitochondria during beta-oxidation. Dietary supplementation of ALC exerts neuroprotective, neurotrophic, antidepressive and analgesic effects in painful neuropathies. ALC also has antioxidant and anti-apoptotic activity. Moreover, ALC exhibits positive effects on mitochondrial metabolism, and shows promise in the treatment of aging and neurodegenerative pathologies by slowing the progression of mental deterioration. In addition, ALC plays neuromodulatory effects on both synaptic morphology and synaptic transmission. These effects are likely due to affects of ALC through modulation of gene expression on several targets in the central nervous system. Here, we review the current state of knowledge on effects of ALC in the nervous system. PMID: 27100509
  2. I had a DO as my primary doc. DO is doctor of osteopathy, they are still MD's and he was board certified as an Internist and Allergist. I never noticed the difference. I about to do allergy desensitization with him, again.
  3. notloki

    Topamax add on

    There is Metformin ER which is a time release formulation which really helps with the stomach upset. I take 1,000 mg twice a day and have no problems.
  4. I've had 3 sleep studies, the first one was trash so we threw it out. The second sleep study showed I had severe sleep apnea with many wakings and EEG arousals. Many breathing events including obstructive and central apenas plus hypopneas. Normal amount of REM sleep but very little Stage 3 sleep, about 3 % of total sleep. I did most of my sleeping in stage 2 NREM. The sleep study I had a few weeks ago gave different results. 1 obstructive and no central apenas and a few hypopneas. I don't have apnea. Yea ! No REM sleep or Stage 3 sleep at all. Unique was my oxygen saturation which dropped to 82% for quite a long time. This requires I now be on nighttime supplemental oxygen. I actually wake up more rested on this and feel better now that I am not starving my body for oxygen. My diagnosis is nocturnal hypoxemia (ICD 10 R09.02). The fact that I spent 99.8 % of my sleeping time in stage 2 NREM concerns me. I've got a call into the sleep center to discuss this and the total lack of Stage 2 REM sleep and Stage 3. I know I dream, I do wake up during dreaming or sometimes remember my dreams. The amount of time spent in Stage 3 gets less and less as we age, I understand, but having none at age 55 seems off.
  5. I stick to people who graduated from medical school. Science=Good.
  6. Keep in mind Emsam produces small amounts of levo-amphetamine and levo-methamphetamine, the less active isomers of amphetamine and methamphetamine.
  7. Emsam was not tested for anxiety, I am reading. MAOIs are known to help anxiety in some. One of the benefits of using a transdermal delivery is it reduces the amount of amphetamines created. It seems to run soup to nuts, some get insomnia and anxiety and some find Emsam energising while not producing more anxiety.
  8. We have Emsam, also known as selegiline or deprenyl. No diet restrictions until 9 mg/24 hr and 12 mg/24 hr. It is a patch, there are 4 strengths available. As a patch avoids the gut the tyramine reaction is less likely to happen so some are able to not observe a special diet at 12 mg/24 hr. It is now generic although I don't think anyone has stepped forward to make a generic version. It was moderately successful as an AD, it worked for some quite well. Side effect wise some (18%) are sensitive to the adhesive used on the patches. Very small amounts of l-amphetamine and l-methamphetamine are metabolites, some report insomnia as a result. Selegiline has greater affinity for MAO-B and at the higher doses also MAO-A so some find they need to be at 9 or 12 mg/24 hr to get the full effect of Emsam. Emsam is contraindicated with selective serotonin reuptake inhibitors, dual serotonin and norepinephrine reuptake inhibitors, tricyclic antidepressants, MAOIs, mirtazapine, bupropion, meperidine, tramadol, methadone, propoxyphene, pentazocine, dextromethorphan, cyclobenzaprine, oral selegiline, carbamazepine, oxcarbazepine, St. John's wort, and sympathomimetic amines (amphetamines and cold products as well as weight-control products containing vasoconstrictors)
  9. notloki

    Nightmares from Melatonin?

    Hmmm, maybe tardive dyskinesia, risk of diabetes, weight gain, growing breasts in men are a few reasons.
  10. Simple. It takes 19-60 X 5 hours to clear all the Klonopin but enough is cleared by 6-12 hours that it is no longer effective.
  11. The only reversible MAOI in the USA is Emsam, a patch. There is no need for a special diet until the highest doses, 9 and 12 mg/24h. Some find it effective, I've heard some complaints about the adhesive used on the patch as some are sensitive to it. Emsam, also known as selegiline or deprenyl, does not start significantly affecting MAO-A until 9 mg/24 hr. MAO-A effects serotonin whereas the other MAO, MAO-B does not. So you may have to take the higher doses to make it effective. Some take the highest dose and don't eat a special diet, it is something you will work out between you and your doc. It is definitely on my list to try if my current regime fails to continue my remission.
  12. You need to titrate the Abilify, too. Just as you did when you first started it. Just because you have an appointment in 2 weeks does not mean you cannot call and get one sooner or at least talk to your doc. I call my doc for these kind of things.
  13. notloki

    Lets talk about Vyvanse

    You can only reformulate dextroamphetamine so many times, besides I have never met a extended release formulation that works or is better than just taking IR pills when you need it.
  14. notloki

    Lets talk about Vyvanse

    Well, for what it was worth I took 15 mg dextroamphetamine tabs in the late 90's. For a while in the 90's there was a 60 mg IR tab available. Then I went off amphetamine. I have not seen it again. Present pdoc remembers it. I wish we had a full complement of tabs in many generic strengths. My pdoc said Zenzedi came about partly because there was no 30 mg dextroamphetamine IR on the market. Now as there is a branded amphetamine with a 30 mg tab hopefuly a generic maker will pick up a 30 mg tab. ADZENYS XR-ODT seems to be coming or on market now, looks like it is for kids.
  15. notloki

    No more Xanax. ☹️

    Tranxene made me comfortable but not sleepy and did not sedate me. It's long acting due to the very long half life.