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[Efficacy and safety of noophen in treatment of CFS in patients with cerebrovascular insufficiency]

Discussion in 'Latest ME/CFS Research' started by Murph, Dec 28, 2017.

  1. Murph

    Murph :)

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    Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(11):31-36. doi: 10.17116/jnevro201711711131-36.
    [Efficacy and safety of noophen in the treatment of chronic fatigue syndrome in patients with cerebrovascular insufficiency].
    [Article in Russian; Abstract available in Russian from the publisher]
    Vorob'eva OV1, Rusaya VV1.
    Author information
    Abstract

    in English, Russian
    AIM:
    To assess the efficacy and safety of noophen in the treatment of chronic fatigue syndrome in patients with cerebrovascular insufficiency.

    MATERIAL AND METHODS:
    Fifty-three patients with cerebrovascular disease, who complain about persistent fatigue, were randomized into two groups. Patients of the main group (n=33) received standard therapy and noophen, patients of the control group (n=20) received only standard therapy. Treatment efficacy was assessed using MFI-20, HADS-A, LSEQ. In addition, cognitive functioning was evaluated using Schulte test.

    RESULTS AND CONCLUSION:
    Treatment with noophen resulted in the marked decrease in the total intensity of fatigue measured with MFI-20. The decrease in fatigue intensity by 30-50% was observed in 3/4 of patients of the main group. Noophen reduced all components of fatigue syndrome, including a mental component, and improved motivation. The reduction of the mental fatigue component was combined with the improvement of cognitive functioning assessed with Schulte test. Therefore, the effect of noophen on motivation and mental fatigue component can promote cognitive training in patients with cerebrovascular insufficiency.

    KEYWORDS:
    anxiety spectrum disorders; chronic cerebrovascular insufficiency; chronic fatigue syndrome; noophen

    PMID:
    29265084
    DOI:
    10.17116/jnevro201711711131-36
     
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  2. Murph

    Murph :)

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    A couple of links to help interpret this abstract

    1. http://slatestarcodex.com/2014/08/16/an-iron-curtain-has-descended-upon-psychopharmacology/

    This piece talks about how there is a weird and extremely unhelpful lack of sharing in terms of pharmaceuticals between Russia and the west. They have drugs to cure things and we just ignore them.

    2. Noophen is this: https://en.wikipedia.org/wiki/Phenibut . It is used in a dizzying array of conditions and works as a calcium channel blocker. If you search this site for Phenibut you can see some testimonials including some describing a short positive result.
     
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  3. panckage

    panckage Senior Member

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    @Murph do you know the dosage used in the study?
     
  4. Murph

    Murph :)

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    Sorry no. And i can't seem to get the paper from sci-hub (plus it is in russian, I believe)!

    I just googled and it seems people are taking mega doses (2g+) for fun so moderate doses of 100mg are possibly safe. start out very small of course. Also a warning for its adddictive properties and the potential for withdrawal symptoms seems to be in order.

    https://www.brainprotips.com/phenibut-high/
     
  5. panckage

    panckage Senior Member

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    @Murph I take phenibut (along with kratom) and I find together they are by far the best treatment for ME. I take phenibut dose of about 1g once every 3 days (at most). I'm really curious about other dosing regimens though

    Do you know what "cerebrovascular insufficiency"
    refers to? It's hard to find a clear answer... Do they mean a stroke? Was something lost in translation? I can't make sense of it


    There are some good Russians around here. @hvac14400 any chance you can write the researcher to see if you can can a copy of the this paper for us? ;)
     
  6. debored13

    debored13 Senior Member

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    kratom used to help me but i think long term it makes things worse, because of it's histaminic and anti-androgenic effects (characteristic of any opioid). been a while since i used phenibut, which is really really effective but also physically addictive and dangerous withdrawals
     
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  7. lnester7

    lnester7 Seven

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  8. enduin

    enduin

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    I don't think that's an accurate assessment of kratom. Kratom contains a complex mix of alkaloids that include both agonists and antagonists at opioid receptors, which probably account for the fact that if used in plain leaf form and in reasonable amounts, it doesn't cause tolerance to build up. I have taken it for months at a time at the exact same dosage with no tolerance whatsoever. This can't be said of any opiate I know. I also never heard of itching as a result of large doses of plain leaf kratom (extracts are another story, but people shouldn't take extracts anyway), nausea and projectile vomit on the other end will make sure you never take too much. There are also plenty of people I know on the kratpm forums who have been taking it for years daily for pain management, and as far as I know none of them is showing the classic anti-androgenic side effects of long term opiate usage. Bottom line is: kratom ≠ opiates.

    As far as it helping, I find that kratom helps some times and not others. Unfortunately there is very little serious research on kratom, which is not going to get any better if the constant push from the FDA and DEA to ban it doesn't end. I remember reading that kratom also contains some chemicals that are NMDA antagonists, so that could be a potential mechanism for its effect on CFS, but at this point it's all speculation.

    Phenibut, on the other hand, I don't think I would be willing to take it daily for extended periods of time. GABAergic tolerance and withdrawal is just about one of the scariest things out there.
     
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  9. debored13

    debored13 Senior Member

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    i don't mean to demonize kratom. It has been found to be anti-androgenic and be an endocrine disruptor like any opioid, i believe. I've also experienced some really worsened symptoms from it lately, so while I think it's a mild drug for the average person, ppl with CFS should tread a little lighter.
     
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  10. enduin

    enduin

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    I know you mean well and I'm absolutely not taking this personally, I simply disagree with your statement. And as far as having been found to have anti-androgenic properties, it was found by WHOM? If you can post a link to the study I wouldn't mind taking a look for myself to see if the test was conducted properly. There are all sort of studies around that make a lot of claims and we know better than most that it's all about how the study was conducted that determines whether it has any credibility whatsoever (PACE anyone?).

    Even if the study has some sound scientific bases, one of the very likely issues is whether the potency of this alleged anti-androgenic effect has been measured. Usually they don't. There are a lot of studies that prove that a certain plant has a certain effect but in reality it's so weak that it's not a viable treatment option. Valerian root acts on GABA but it's no Diazepam!

    In the case of kratom, there is plenty of empirical evidence that people who use it daily for years (and sometimes at pretty high doses for pain management) don't develop gynecomastia or any other anti-androgenic symptom that is usually found in long term opiate users. So this means that either it doesn't have actual anti-androgenic properties or if it does, it's too minimal to make a difference. You can't argue with decades of use by thousands of people, not to mention the thousands of years in its native South-East Asia. That's a bigger population sample than any study I know of.

    On the other hand, I know us CFSers are not the average person, so if someone wants to be extra careful I would certainly not blame him/her. But considering that people here react badly to vitamins, minerals, even foods, not to mention drugs, I'm not sure how much more risk it poses than any other supplement we can try. Not trying to convince anyone, just pointing out some fact.

    Now back to the noophen, I really don't wanna derail the thread ;)
     
  11. Cheryl M

    Cheryl M

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    "Noophen reduced all components of fatigue syndrome, including a mental component, and improved motivation. The reduction of the mental fatigue component was combined with the improvement of cognitive functioning assessed with Schulte test."

    This completely describes my experience with pregabalin (until it stopped working - I believe tolerance developed). I was in remission for about 18 months. Baclofen does the same things for me to a lesser extent and so did phenibut/noophen and benzos, though tolerance developed to those two almost immediately and my GP wouldn't let me have any more benzos anyway. I find it ironic when people mention their addictive powers, given that I've been on at least 100mg of pregabalin daily now for the last three years with my GP's encouragement. I will have to hope the stuff isn't found to be extremely addictive now it's probably too late to come off it!

    I wondered if the remission was the result of the calcium channel blocking thing but nimodipine made me feel even worse. Apparently the GABAergic drugs increase growth hormone production by improving the quality of sleep, and also GABA potentiates other neurotransmitters... All very interesting but I can't seem to get my remission back.
     
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  12. Kenshin

    Kenshin

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    Gabapentin - I've had days of semi remission with Gabapentin.
    Increase mental energy, and some physical (But be careful because PEM will still hit you hard).
    It's no perfect panachea but has its benefits.
    Doctors say it causes drowsiness, but it does the opposite for me.
    Could this be something siimilar to stimulant calming down ADHD?

    Pregabalin - Seems pretty similar to gabapentin but smaller pills.

    Phenibut - Tried it a few times here and there, max dose around a gram, never did much, and was very chemically sour bad for the stomach.

    Kratom - A miracle when I first started it, I was walking up stairs with a look of awe on my face, no pain, light in my step, I eventually had to stop due to histamine issues and the nausia got too bad.
    Some do better on kratom than opiates, and some vice versa, it all depends on the individual.
    There has been far more research done on, and pharmeceuticals made from, opiates than kratom.
    It will be very interesting if they extract the pain killing component/s from kratom as they isolate morphine from poppies.

    I was unaware that opiates have an "anti-androgenic" effect, in laymans terms, does this mean they lower testosterone?
    Is this because the Poppy plant is estrogenic? Like Soy or Hops?

    @Cheryl M How long did Pregabalin work for you until it stopped?

    Interesting that:

    "Apparently the GABAergic drugs increase growth hormone production by improving the quality of sleep"

    Would GABAergic drugs include gabapentin and pregabalin? Seeing as they don't seem to effect Gaba, but instead work on calcium channels?

    Cheers.
     
  13. debored13

    debored13 Senior Member

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    most of the active ingredients have been extracted from kratom. the main ones are opioid agonists like mitragynine and its derivatives, although there are other alkaloids that are nmda antagonists.

    I'm on kratom as I'm typing this, but I urge caution. It certainly helps with symptoms and is maybe good to keep around if you have self-control, but it seems that there's a lot of anecdotal evidence and some research that shows that it can be endocrine dysruptive, which could make cfs worse. In my experience it will make you a bit worse when it wears off.
    Your experience with it causing histamine issues makes sense, opioids are known to do that.

    https://www.ncbi.nlm.nih.gov/pubmed/21817918
     
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  14. debored13

    debored13 Senior Member

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    yes, in laymans terms, opioids tend to lower testosterone.
     
  15. debored13

    debored13 Senior Member

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    There was a long period before I got sick that I used to fool around with opioids and use them recreationally. I never got addicted, because of being extraordinarily careful, but that's not the norm. During that time I justified their use to myself by telling myself that if you use pure opioids (e.g. not street stuff that's cut) and you don't overdose, they're virtually harmless. It's true that they don't destroy your vascular system the way speed does, and they're not quite as hard on you as alcohol, but the more I read about physiology, the more I think that these "subtle" endocrine issues and constipation that they cause is actually a really important problem.
     
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  16. debored13

    debored13 Senior Member

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    I will agree, though, that sometimes kratom really helps me get through rough spots.
     
  17. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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  18. Cheryl M

    Cheryl M

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    @Kenshin, I'm not a doctor and have no medical or healthcare training, but EMC informs me that pregabalin is a GABA analogue (whereas gabapentin, as you say, is a calcium channel modulator). Tiagabine (which I'd like to try but can't because my doctor won't prescribe it) inhibits GABA uptake. It seems to be pretty well established that slow-wave sleep promotes the production of growth hormone, so anything that improves your slow-wave sleep will help with that. Cheney also pointed out that GABA balances out excessive glutamate, right?

    I started taking pregabalin in July 2014. In August I was staring at the dirty garage door when I realised, "I could go out and WASH it!" I did, then dug the garden and ran two miles. While the remission lasted I walked up the highest and second-highest mountains in Wales on consecutive days (though I had a bit of a crash after that and realised it might have been a bit much). I did suffer terribly from irritability and hyperactivity but at least I was getting stuff done! In November 2015 I had a terrible headache and went to bed early, and the phenomenon I had begun to term "the pregabalin personality" was gone the following morning. It never came back. My health slowly deteriorated again and now I think it is probably worse than it was before the pregabalin.
     
  19. Kenshin

    Kenshin

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    Thanks for the answers guys.

    @Cheryl M, I've recently switched from gabapentin to pregabalin, and am realising that although they're similar, they have some marked differences.
    Mainly, Pregabalin feels more stimulant.
    It tends to make me multi task, or do more active things rather than passive (I find myself doing creative things at the time I would usually veg out to a movie.)

    I hope the "pregaba personality" lasts for me, even over a year like you had would be good, but I am constantly pestered by thoughts of what will happen if I stop taking it.
     
  20. debored13

    debored13 Senior Member

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    Ok, you're right that I didn't really provide enough evidence. I don't think there's been enough research on kratom. What we do know is that mitragynine is an opioid agonist (it also does other things). but it's a delta-opioid agonist, which means that while it does cause euphoria and analgesia, it may act a little different than most opioids. the delta instead of mu agonism is why it causes less respiratory depression than most opioids.

    There's a boatload of anecdotal evidence that kratom causes endocrine dysfunction, like other opioids. The loss of sex drive is well-documented. I would think that hints that it's anti-androgenic. Also, all of this anecdotal info isn't coming from people who are trying to demonize the plant. This is coming from users who enjoy it and want it to remain legal. Go on any kratom forum, these effects are well documented.

    It may be less extreme than opioids in terms of the anti-androgenic effect, but it also has serotonergic effects that may be similar in terms of endocrine dysruption. from my experience I'm guessing it's fairly histaminic too, just like any opioid.

    I'm also fairly certain it's somewhat immune suppressive.

    I"m not saying any of this to demonize the plant and I"m not trying to get in a long argument. You're right that the proof isn't all in, and all I'm saying is that I urge caution and that the anecdotal evidence suggests that it may not be totally benign. I say this of marijuana too, which has been documented to be anti-androgenic. It's true that there are no documented deaths from kratom and that it shouldn't be made illegal. I'm just pointing out that just because it doesn't kill doesn't mean it is benign.
     

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