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Saturday, February 25, 2012

Scopolamine for My Bipolar Depression

I wrote a post back in December about seven mostly promising new drugs for antidepressant treatment.  Of the seven I am now looking towards scopolamine as a possible add-on to my current medication treatment.

For the record, each day I take Wellbutrin (450 mg), Cymbalta (120 mg), Lamictal (300 mg), Xanax (0.25 - 1 mg), NAC (2000 mg), multivitamin, fish oil, (300 mg omega-3 fatty acids), and aspirin (81 mg).

Background

Scopolamine has been shown in limited clinical testing to provide rapid, robust antidepressant effects for depression and bipolar depression.  The drug works much faster than SSRI type antidepressants, taking only hours instead of weeks to reach therapeutic levels.

However, it is not approved to treat depression or bipolar depression. Scopolamine is approved for use to control motion sickness and to reduce post operative nausea.  It is most often delivered transdermally (through the skin) using a special patch - a membrane-moderated transdermal drug delivery system.

I read through some online user reviews and ratings of scopolamine.  Not surprisingly, the effects from the patch varies from person to person.

The majority of people commenting say that the patch (scopolamine) works much better than OTC motion sickness medicine they have tried.  Some people wrote of side effects after removing the patch, mostly headache, nausea, dry throat/mouth, and blurred vision.  Most people say the side effects are worth the benefit of not getting motion sickness.

Scopolamine Findings

Based on what I have uncovered I find the following observations to be of interest:
  • Intravenous scopolamine can be a rapidly acting, effective antidepressant.  Additional information is needed to asses the efficacy and tolerability of transdermal delivery.
  • Scopolamine treats unipolar and bipolar depression.
  • Scopolamine can be taken in several forms including orally, intravenously (IV), and transdermally (through the skin).
  • Side effects concerns include memory impairment, dry mouth, nasea, drowsiness, blurred vision, and headache.
  • Scopolamine works better for women than men.  That seems odd?
  • Scopolamine for depression treatment still requires further study to determine therapeutic dosages, delivery mechanisms, side/withdrawal effects, and other relevant factors.  There needs to be more data with statistical relevance (e.g., larger sample sizes) analyzed for treatment efficacy and tolerability.   
The Scopolamine "Test"

So, after digesting several scopolamine studies and other web sources I decided to give it a go!

The scopolamine I received was through the skin (transdermal) by a patch.  This patch has the brand name Transderm Scop and requires a prescription in the U.S.  In Canada they are available from pharmacists without a physician's prescription.  Yay!

According to the package a Transderm Scop patch contains 1.5 mg of scopolamine.  The1.5 mg of scopolamine is programmed to deliver 0.5 mg per day over three days.  This is the approximate equivalent of a 72 hour continuous intravenous infusion at 5 micrograms per hour.  According to fellow blogger Garth Kroeker, a patch dose ". . . would roughly approximate the IV doses [4 micrograms per kilogram) used in several studies . . ."

I didn't have any patches handy but my friend had an extra patch and gave it to me.  It expired in 2001 so I'm hoping it still works.  This clearly is not a scientific study!

I applied the patch at 10 am.  After about 30 minutes I felt a little nausea.  This could be from an empty stomach with psych meds and coffee?

Wow! It's been an hour and I just realized pupil in my right eye is huge!  The left is normal.  I've been rubbing my right eye.  Maybe I got some scopolamine in my eye!  I hope this goes away.  My vision seems fine.

I looked on drugs.com for side effects related to vision.  There was a mention of unilateral dilation being reported suggesting "some ocular events may be due to inadvertent contamination of the eye when there is failure to wash the hands after drug application."

Well that makes sense.  I didn't wash my hands with soap and water after applying the patch.  Note to self: keep scopolamine out of eye and try to follow directions better.

Scopolamine: Final Analysis

Well, results are inconclusive.  The patch had no noticeable therapeutic effect for me.  Also, there was very little trouble (if any) with side effects or withdrawal effects.

I wore it for the directed 3 days.  I wore it an additional 4 days out of concern of withdrawal effects.

The big questions are whether the expired patch I used was effective and if I received a therapeutic dose.  I would guess the patch was ineffective and I didn't receive enough scopolamine.  Need to repeat test.

My next move is to obtain some patches that haven't expired and try this again.

By the way, my dilated pupil returned to normal by the third day.

18 comments:

  1. there are things you can't use while on scopolamine like antihistamines, aspirin, caffeine, or especially alcohol. kinda sucks because i need my baby aspirin and benadryl for nightime. i could get used to drinking only 7up but i will miss my morning coffee. alcohol i don't drink anyway but maybe new years or glass wine for thanksgiving.

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  2. ok so my sister prescribed me some scopolamine patches and these were fresh from cvs. i got 4 patches and for around 8 bucks what a deal cause insurance my copay. so that saying don't try this at home well hmmm. alrighty then so i did 3 patches in a row for a total of 9 days. that's knowing that 1 patch is good for 3 days so when 3 days equals 72 hours then take off old one and replace with fresh new one same location behind the ear. i started this month on feb 6th and ended 9 days later on the 15th.

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  3. i can say that i was still depressed and i got puffy under eye. gave me bags shit made me look older by 10 years. so yea i got a side effect. today 11 days later i feel it. i'm actually happy. talking more on the phone, typing this just actually wanting to communicate which yesterday i still didn't want to talk to anybody. stuck like that bipolar depression for months possibly year and half. ok so i did the guinea pig thing. if considering doing this with patch if i could do it over again i would not have taken patches one after another. i would space them. i reread an article where they gave once a week. the article did say most felt after 3rd dose. they may have used injections. shoot wish i could find it again and paste it dammit

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  4. http://www.npr.org/blogs/health/2012/01/31/146096540/i-wanted-to-live-new-depression-drugs-offer-hope-for-toughest-cases

    i have bipolar 1. i go on spending sprees, talk to complete strangers just go up and talk talk talk when completely manic, charge up credit cards, but things i don't need or things i couldn't possibly afford but did with credit and buying several cars within a 3 month period and then crash from mr popular life of the party to the opposite severely dpressed suicidal. sorry i keep posting anomynous. my name is david. one last thing meds i take:
    cymbalta 60mg
    lamictal 400mg
    seroquel 200mg
    trazadone 100mg

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  5. Hello Anonymous/David - Thank you greatly for feedback on the Scopolamine! I need to get an Rx. for the patch. I guess I'll just ask my pdoc, why not?

    I didn't know about interactions with caffeine and aspirin, hmm. Don't drink alcohol so no problem there.

    As for dosing, not sure here. A Dr. Kroeker (http://garthkroeker.blogspot.com/2012/02/scopolamine-for-depression.html) says use of the patch for 6 hours at a time, every few days, might be a valid strategy. Note that he also has the links to the journal article abstracts. Need to plan this.

    I'm okay with the overall risk, but sure don't want some of the side effects (memory impairment!), yikes!

    Good luck David.

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  6. email me if you like davidaware@live.com. i see that you did some fundraising for nami in ventura county. i grew up in camarillo but moved out here to dallas now 6 years. adolfo camarillo high school class of 89'.

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  7. shoot it's davidaware1@live.com. forgot the 1

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  8. I'm about to give up. I'm on geodon for bipolar I've tried prozac, but it didn't work. I'm still depressed. My friend who is a doctor told me that scopolamine might work. What are the side effects?

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  9. playboyroy69 - Thanks for checking in. Sorry to hear about your situation. Never give up! I'm battling bad depression as well. I've been on many antidepressants until I found a couple that worked. I don't think they're working as well now though. It really sucks but gotta keep moving on.

    From what I've read the most common side effects from Scopolamine are headache, nausea, dry throat/mouth, and blurred vision. It's still mostly untried for bipolar depression so be careful. I recommend getting with your doctor on this.

    I don't have the go ahead from my doc to try it. I'll need that before I give Scopolamine another try.

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  10. I'm interested in hearing all of this since I am desparate to help my younger sisters. One was diagnosed as being bipolar 5 years ago at age 40. She won't stay on her meds.
    The other sister suffers from depression and is going through a really bad episode right now.
    Maybe I can gently suggest the scopolamine to them?

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    Replies
    1. I'm sorry to hear about your sisters Anonymous. You can try suggesting it to them but I recommend they use it only under a doctors care. It's too risky to be trying to do this on your own. I intend to try Scopolomine using the patch in a couple of months, after I finish getting off Cymbalta. I still need to get my psychiatrist's buy in.

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  11. Have any of you tried Ketamine? Curious to know how that works for bipolar.

    http://www.npr.org/blogs/health/2012/01/31/146096540/i-wanted-to-live-new-depression-drugs-offer-hope-for-toughest-cases

    story about this and scopalamine

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    Replies
    1. I have yet to try Ketamine. I've seen the NPR shows from back in January. They are anecdotal mostly. There's more info at my post http://bipolar-living.blogspot.com/2012/04/ketamine-for-bipolar-depression.html which also links to more information outside of this blog.

      Anybody else tried or use Ketamine? What's the experience like?

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  12. Hello everyone. Stumbled onto this blog and find it useful. Im 52 and with Unipoloar depression since my late 20's. Ive been through the run of the mill..sertraline, Cognitive behaviour therapy, interpersonal psychotherapy, mianserin, escitalopram, mirtazipine, quetiapine, lamotrigine. On 4 of them now and max doses. Still get my lows 2-3times a year and cant get to work for 2-3 weeks each spell. Ive been reading through and noticed Ketamine, Scoplamine, Testosterone, thyroxine, NAC, TCM, ECT being discussed. Guess its one long journey with many paths not quite knowing where they will lead you to. You see a lamp-post occasionally and travel that path with hope...only to be met with darkness thereafter. I hope to see more lamps..

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  13. Gautham, Welcome to my blog and thanks for joining us! Your experience is similar to mine: tried many psychology and pharmacology (at max doses) and still battle depression. I too hope one or more of the above treatments can someday be used routinely and be rapid, robust, and safe use qualities.

    Goto this http://bipolar-living.blogspot.com/2012/07/god-of-hope-this-bipolars-right-hand.html?showComment=1344620796535#c2576860934407304616 post of mine and look at the last two comments. Yes, we need to learn more! - Jeff

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  14. although i had good result on scopolamine it did eventually wear out so continued treatment is required. i did get the short term memory side effect and the blurry vision. i would say 3 weeks of treatment and then 3 weeks off. read this somewhere. hey i found something that also works for me for my bipolar depression. it's magnesium taurate. you can buy at vitamin shoppe, vitacost, gnc and many other online such as amazon.com. i take it at night on an empty stomache. would like to hear back if it also worked for you. google magnesium for depression and you will find a wealth of information. good luck

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  15. I am a veteran bi-polarite, at least 40 years of a drama-filled life.I would like to say there is hope at the end of the tunnel. I have made many incremental lifestyle changes, especially nutrition.i discipline myself to stay with only one medication
    Only , Lithium, and use some herbs and some antihistamine for sleeping better. I am writing becauseofScopolamine
    Transdermal.Ii feel there really may bee something there.A fast boost from depression is well worth looking into.I feel the best strategy with mood swings is to intervene very very early.Pair up with someone who notices your little changes.

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  16. Anon - Thanks for sharing that Lithium, herbs, and antihistamines do the trick for you. Most with less lifetime experience with BP aren't there yet, with respect to psychmeds. Keep things cool. - Jeff

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