So I saw a psychiatrist yesterday. I was in no great need, but I've been having a lot of work-related problems lately. I always cover myself with a doctor's note.

Anyway, I fancied talking to someone about my disease. I don't burden my friends with my problems, and all they say is "You'll be OK".

My neurologist certainly isn't interested. I'm essentially a research subject to him.

I'm 45, male, and I've never in my life spoken to anyone about my problems.

So, I gave this psychiatrist such a tale of misery and woe. You can imagine what I said, I don't need to repeat it to you lot.

I hadn't taken any 4-AP that day, and I was stumbling everywhere. That added more colour, more backup.

In the end, what could he say?

I'll tell you what he said, "Would you like an antidepressant?"

Why not? Paxil, Paroxetine.

I took it this morning, then again at lunch. Calm ain't the word for how I feel. Everything is good with the world.

Yes, I know. These SSRI's have some real horror stories attached to them. So do Benzos, I've been on those for years.

I'll get to the point now. I have no leg spasms.

I've just been Googling about and I read that SSRI's are a good choice for neuropathic pain. I'll post links later.

No spasms, and, I don't have the tired, achey legs. Something going on here.

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That's amazing they work like that. Are you still getting the same benefits?


Everything has it's price. God knows what the knock-on effects will be.

A lot of different things can bring on the spasms. Stress, tension, all that. Maybe, on the SSRI's, I just don't care.

I'll give it a few more weeks, see how I feel. Spasms came late last night, but manageable/ignorable.

Legs not nearly so tired though.

I'm positive there's plenty more candidate drugs out there.

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I hope it keeps working for you


What kind of exercise do you do?


I do a lot of cycling and Yoga, and meditation.

Exercise is the best antidepressant (they say). There is something in that, all those endorphins.

Depression is not such a problem for me, feel a bit down from time to time, but which of us doesn't?

I have wife, child, sick mother, job, responsibilities. Feeling sorry for myself is a luxury I cannot afford.

SSRI's are great. I know there are a lot of people rail against them, but they have a stimulant effect for me, and they really ease up my muscle spasms, and to a certain extent my spasticity. It is a lot easier to walk if I am totally relaxed.

How about yourself JasonHarnum?


only swimming. Forgive me if I missed it but, can you walk ok, or do you need the assistance of a cane, walker, etc? Cycling would be super cool, but I have to settle on watching the Tour de France. :)

You have a lot on your plate! I don't even have a cat to look after!


I can only walk with the aid of 4-AP. That stuff really is magical.

Cycling is different, just pushing down my legs. That's no problem at all.

Jason, how about yourself?

Reply ? is this something your doctor scripted for you?


That's it, though the Wikipedia page makes it look like a pure poison. I take a lot of 4-AP.


Can I ask what 4-AP is and where you get it from?


Just revisiting this old thread.


Pure magic.


Thanks for re-visiting this thread monkeybus

I must say that I now do daily 4 5-mg capsules of 4-AP together with 4 5mg of baclofen with no dizziness. In addition, I will add 5mg baclofen during the day as needed, which is maybe twice, and then at bedtime, I will rotate between 10mg baclofen or more likely 2mg of Tizanidine.

I agree with you that the 4-AP is magic. Without it, say when I go off my schedule, the spasms and pain return. As 4-AP is instant release, when I take the next dose, I feel almost instant relief.

This is not to say that I walk like my old self. I still have some balance issues and speed has not returned. Carrying my gym gear is a burden on my legs but, on the other hand, I can get a sense of balance from the weight of it - does this make sense? The pack serves as a sort of counterbalance.

I get spasms at night and in my sleep, even though I take baclofen or Tizanidine. I take it a day at a time. Sometimes when it gets late and I'm out and about, I feel I can't get home well. Other times, it's as if it were much earlier in the evening and there is less of a concern getting home.


Yes julie_ , 4-AP, always in my pocket. If my foot starts to drag, I take a capsule.

One time, I forgot to take with me. What a nightmare, no crutches, just me staggering from wall to wall. Never again.

Like you say, it comes on quick, literally within minutes. Empty stomach is best.

I've been taking 4-AP and 4-AP-3-MeOH at the same time.

They both have different effects. 4-AP is great for foot drop, and it increases my walking speed. I have to walk fast, or not at all.

4-AP-3-MeOH is good for low speed balance, very good.

4-AP is so widely used in the MS community. Seizures are so rare. Any of us with spasticity should at least consider it. When it works, it really works.

Good for walking, constipation, sensory-touchy-feely, spasms.

What a drug, best of luck getting it. What I like about them is they are not some crass "Internet Pharmacy", no pictures of good-looking "doctors" in white lab coats, no over inflated prices, no panoply of medications. Just a slim range of stuff that would help people with our type of disease.

I was talking to the man who runs it the other day via email, he told me they are about to start supplying 3,4-Diaminopyridine. Similar to 4-AP, but it doesn't cross the blood-brain barrier, just goes to your extremities. I'll try it.

It is true what you say about carrying a heavy weight, whether me a backpack, a bag slung across my shoulder or leg weights, I can walk better. Anchors me to the ground.

I find that an offset weight works best, one side of my body heavier than the other.

For the night spasms, I'll again recommend Gabapentin. Stops mine stone-dead. Lovely.


How about the antidepressants? Are they still working? Side effects?

I tried Gabapentin and did not like it during the day. I stopped taking it but yes I've heard that it really should only be taken at night.

Does it make you groggy in the morning when you wake?


I got off the antidepressants after two months. I quite enjoyed them. Like how they flatten my moods. But they aren't good for the long term.

Good for the spasms, and pain. If my neuropathic pain ramped up, I'd seriously investigate all of those antidepressants. They can stimulate as well. Though, what is the long term effects of years of use? Likely not good.

Take a low dose of Gabapentin at night won't affect you in the morning. I'm up at 6am, have to get my son off to school.

Zero pain at the moment. I ran out of Gabapentin the other week, tried Baclofen and Valium at bedtime, I was twitching about like a fish out of water.

No immediate plans to give up Gabapentin.


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