Glutamate/GABA

[michelew]

Hi, All. I know that I have seen some discussions regarding Glutamate and GABA, and that some of you have your children on some supplements for these two neurotransmitters. I was just wondering if there is a way to test to see whether our kids could possibly have too high or too low of levels. I was reading about how dangerous having too high of levels of glutamate can be, and that having too much can actually cause brain damage by causing brain cells to die (something called excitotoxicity). This really scared me, and made me think that if this is a possibility, then I'd better look into this. My son seems as though he might have high levels of glutamate, based on his symptoms, but how does one know, and what can be done about it if he does? It seems as though having too much glutamate, can sometimes have the same side effects as having too little. The symptoms seems to overlap.

 

Also, he responded terribly to two SSRI's we tried (prior to his PANDAS DX) and also to Ativan (had a complete opposite reaction of what they're supposed to do.) I was wondering if being on an SSRI could actually change glutamate levels, because the psych meds DEFINITELY added to our downward spiral. As a result, I'm terrified to try another psych med, even though my son is still so extremely ill.

 

Thanks for any information.

 

Michele

[MomWithOCDSon]

Hi!

 

I am far from expert on the topic, but glutamate has become something of a "hobby" of mine in recent months. I could be wrong, but my reading of the literature would suggest that few, if any, behaviors common to our PANDAS kids emanate from TOO LITTLE glutamate in the brain. Rather, most of the behavior profiles we see are the result of TOO MUCH extracellular glutamate, i.e., glutamate that is either not taken up properly because the NMDA receptors are overwhelmed or because there are two few functioning receptors. Glutamate excotoxicity is thought to potentially be behind a number of "mental" conditions, and research is underway with glutamate modulating drugs of all ilks for various types of glutamate modulation, either by assisting/protecting the receptors, absorbing the excess, and/or preventing sodium and/or ion channels from manufacturing more than is needed in the first place.

 

It's all something of a circle and a delicate balance, though, as you've suggested because you don't want to knock anything way off kilter by going after it too aggressively and inadvertently swinging the pendulum to the 180-degree other side of the equation! SSRI's generally address dopamine and/or serotonin, both of which are components in the whole brain chemistry cycle, but they aren't specifically designed to address excotoxicity directly, so far as I've read. SSRIs are also tricky in that it may not be necessarily the drug itself but the dosage and/or the dosing schedule that can set a kid off. I'm sure you've seen some of the other discussions here on the board, but "low and slow" is key with our kids. Even then, sometimes the SSRIs still aren't beneficial, but sometimes they are.

 

As for glutamate modulating, there are a number of medications and/or supplements that can help. Beta-lactam antibiotics (amoxicillin, penicillin, Augmentin), for instance, are thought to be glutamate modulating, as are n-acetylcystein (NAC)and melatonin. Some psych drugs that have glutamate-modulating properties income memantine (Namenda), lamictal and riluzole (Rilutek).

 

Recently, there was also a thread about protecting and strengthening the blood brain barrier (BBB) as some scientists in Copenhagen have found that the BBB is responsible for "vacuuming up" excess brain glutamate but can only do so in its healthy state.

 

It's a massive topic, but a knowledgeable psych should be able to help guide you through some of the issues, and there is a ton of research available on the topic, as well. Feel free to PM me if you like.