I have coined the term. M.A.C.R.O.
An acronym for MAlignant Central Reward system Overactivity
I wrote this out awhile back for a website and I will offer it as personal opinion rather than science as I literally renting a Uhaul truck and moving tomorrow. So I am not going to want to go back and forth yet on the science. So anyone wanting to do that. I dont have time at the moment.
Malignant Central Reward System Overactivity
MaCRO
“I suffer from MaCRO”
What is MaCRO, it’s malignant central reward system overactivity, it differs from addiction in that it responds to baclofen and other GABAb medications.
if someone gets in your face and says “OH or NO youre an alcoholic”
Your first response should be “Only stupid people know alcoholics” ---in your head
A better response would be “No, alcoholics are untreatable”
It’s often standard medical naming of diseases to classify them as to if they do or don’t respond to certain medications, a more widely known example is that of MRSA, methoxycillin resistant staph aureus or “ insert example of medication receptive naming”. MRSA is simply a common bacteria that has grown resistant to a very powerful antibiotic. So they may find a cure for alcoholism, but they haven’t found one yet, it certainly isn’t AA as cognitive or talk therapy alone does not treat MaCRO and that fits about 90% of people who attend AA and relapse into the chronic and progressive reward center disease which leads to early death and manifested in multiple physiological impairments-(think of new descriptive word). If AA works for an individual, then they do not have MaCRO.
People who do not respond to baclofen medication have BReMaCRO.
Baclofen-resistant Malignant Central Reward System Overactivity and the prognosis for this small minority is quite grim. MaCRO and BReMaCRO can be differentiated by PET scan. MaCRO patients can have a pre-post “cue” petscan compared to pre-post “cue” scan after baclofen administration compared to see if the reward center activity is affected and to what degree of diminishment. A true BReMaCRO patient will not show any reduction in reward center activity compared with their baseline (w/o baclofen) brain imaging.
Diminishment of reward center activity is the differentiating factor between the two forms of MaCRO.
Diminishment that is low but perceivable is a patient that is responsive to baclofen but needs a much higher dose than the mean patient. No diminishment means that even ultra-high doses of baclofen will not affect a perceivable change in brain imaging.
The reward system of the brain is tied to the many “drives” of organisms. It underlyingly guides all behaviors, as such, it works to guide decision making of all creatures, animals and humans alike. It is borne out of the innate desire for the organism to thrive, succeed and be the fittest of them all and thereby pass along the organisms genetic material to future generations of the particular species. Drives that guide one to seek out food, safety, water, oxygen, a sexual mate to procreate to pass along genetic material. Its part of the basic building blocks of life.
But what if that drive system goes haywire? That is what happens with MaCRO, a system meant to make a human thrive, succeed and be fit, does the exact opposite because it has become poisoned by outside toxins as tofor, it is a fatal, incurable disease as the person does progress in the more virulent form to seek out the toxin until their life is extinguished
So in summary, baclofen is like every single other medication, in which some respond strongly, some weakly and some none at all.
The Bre-Macro patients are a small minority.
Also, in terms of anxiety, there is different ways this can play out. From a personal perspective. I drank for a number of failings of achievements (I strive to be a high-achiever). Only to fail and that brought about drinking to self-medicate a perceived failure.
So this stuff is can be as varied as there are snowflakes as to what causes a person to drink and what can treat it.
In my own personal case, I became an alcoholic to lessen the failures. I was hospitalized several times for psychiatric illness and suicide attempts related to what I thought was alcohol related issues. Thats how I found Mywayout all that long time ago. There was scant postings on baclofen before I told my story and then zen others did their logs.
So what my point is, is that sometimes its not alcohol at all thats causing people to drink and the MACRO theory I proposed above.
Just maybe it's something else causing the problem and they do not respond to baclofen like others. Instead of seeing a psychiatrist, maybe a neurologist.
Here's why I say there are people who may respond, slightly respond or not respond at alll.
It depends on what is really going on. What is the diagnosis?
You cant just label everyone who drinks too much as an alcoholic and then treat them with baclofen and expect 100% success.
There are going to be people who were diagnosed say with "schizoaffective disorder" and they self-medicate with alcohol. Giving an undiagnosed person baclofen might not help as much as a person who is just an alcoholic.
Not everyone has the same brain chemistry at work.
Take for me, I am not going to post up studies I have them, I just dont have time, so I am not going to go there yet. So this is just personal experience.
I drank mainly b/c of these random failings that caused such distortions in my life. I just wanted to turn my brain off.
I was hospitalized, multiple times in one year. This is a few months AFTER I quit drinking. I thought it was antabuse related psychosis. I put myself on it as an insurance policy while I took a leave of absence.
What followed next was complete psychotic episodes, in that year of hell I was put on every antipsychotic drug. And I always responded. In fact, Id often find myself admitted directly to the psych ward, only to come to coherence within hours.
Then, I was a sane person, in an insane environment with people talking to me as if I as mentally ill "would you like a coloring book?"
"WHAT? No I dont want a fucking coloring book, I want out of here"
This is my point at least, not every one that drinks, drinks b/c they have the biochemistry and the process going on that baclofen affects.
So to finish the story, I was given a diagnosis after 15 or so week long and a month long psychiatric hospitalization of schizo-affective disorder. And it was near impossible to treat. I mean they had nothing left to reat me. I'd become confused, psychotic, I got tasered as well while in an airport.
I had a reason to drink at that point, but I still didnt, even though quitting drinking is what sparked this year of recurrent hospitalizations. I walked away from the hospital I worked asking what year it was just before this so everyone was concerned.
So then, years ago, I was diagnosed as schizoaffective disorder to try and explain what was going on.
I then and went and saw another psychiatrist as an outpatient. (never went to the psych hospital again after 15-20 that year). He said, there really isnt such a thing as schizoaffective disorder in his opinion.
He thought that it was the same as bipoloar with psychotic features.
He treated me with Lamictal. Issues stopped, I was right as rain and I was able to go back to working in a normal state in my professsion.
Years later, having discontinued the lamictal. I started to have musical hallucinations, a hallmark of schizoaffective disorder. I knew the science behind it.
I knew that is exactly what I ha feared and I was going to have a relapse and I resigned b/c I feared it would affect patient care.
So I was schizo, i had drank as they often did to selfmedicate, thats why I had drank, its part of the schizo profile. Lived with the thought that it would come back and it did was more than distressing.
This is my point everyone, sometimes one may look lke a duck and quack like a duck, is not a duck. And they may not respond to a medication, just like I never responded to any antipsychotics except for becoming normal on my own but never stabilized successfully.
Until I was treated with lamictal, which, is also an anti-seizure medication.
Since which time I have been diagnosed with partial seizures, where it is not necessarily easy to see. Luckily I was apologizing to someone for not being able to do my job who used to teach medical school, this after resigning a few weeks earlier saying I had schizoaffective disorder and cant see patients as I am having hallucinations.
"You are having seizures!, I told you you werent schizoaffective, Ive worked with you for five years, you are seizing right in front me right now" and "the musical hallucinations, thats classic temporal lobe seizure, and you are having jacksonian movements as the seizure marches around the brain affecting different parts of your motor skills"
And so here's the problem with all of this stuff, you have to have a diagnsosis. I self-medicated with alcohol due to this underlying seizure clusters I had been having,which is treated in an acute situation with xanax ( as I mentioned before, benzos are alcohol in a pill, but alcohol can be both pro and neg towards causing a seizure).
In my case quitting alcohol left the seizue disorder unmedicated and so while as before I was drinking a few beers a night. Now I had nothing to stop this and the post-ictal states that are left from a seizure which are often mistaken for psychoses.
So then I respond to a bipolar drug for bipolar with psychotic features. To be treated and the diagnosis secured. I can work professionally again after a year in hell of recurrent hospitalizations where Id be normal in psych unit.
Then to stop lamictal as its very expensive at the time and concurrently, strangely, start selfmedicating again with alcohol. And no psychotic illness. A functioning alcoholic suppressing partial seizures that are quite painful.
Then I quit alcohol successfully with baclofen which was designed and hoped to be an epilepsy drug, only to find out that it was just mildly effective but great at treating spasticity. I was able to get by with a weak anti-epiletpic drug after being diagnosed with schizoaffective disorder b/c I respo ded to lamictal which the only other treatment approved for its use is this partial seizure disorder. Which I am now confirmed to have.
So 20 years of a wrong diagnosis, in which I drank, ended up in the ICU with near complete suicide. Leaves of absense, embarassment in which I drank to cope with that.
Then when I stop drinking before baclofen I spend a year in and out of a psych ward.
Only to come to find out, you have to have the right diagnosis before you can treat a patient successfully. Perhaps the people who don't respond, may not have what baclofen treats. Or in my case, treats mildly and in the previous wrong diagnossis, treats extremely well only to get a misdiagnosis.
I am saying is that not every person drinks because of my theory of M.A.C.R.O. as listed above, they may have pet scan imaging that looks like it, but who knows why some respond and a small minority dont. It could be metabolism, resistance or that they are trying to treat a completely different issue with baclofen.
I posted about adding xanax into the mix on top of baclofen and my issues I was having went away. Well xanax is great for acute seizures as was observed in my case of myoclonic seizures and speech pauses.
Only after having it in front of someone who kept telling me I was misdiagnosed after working with me for 5 years and then finally having it diagnosed on the spot. "Your having seizures"
He left me with the thought of you might need to have to go to counseling to deal with the misdiagnoses all your life. He was right, a whole weekend putting it into place, why this happened and why I drank like a fish to deal with it. etc.. etc...
Baclofen works on what, 1/2 half of the GABA system where as xanax and alcohol work on the whole system
Lamotrigine or lamictal works in the same realm
As is the case for antiepileptic drugs that act on voltage-dependent sodium channels, lamotrigine inhibited the release of glutamate and aspartate evoked by the sodium-channel activator veratrine and was less effective in the inhibition of acetylcholine or GABA release.
I could go on, but there are many reasons why people drink alcohol and I do believe that anxiety and the reward system of the brain is the vast majority of why they do. And why the vast majority of people respond to baclofen
But, having said that, I may not have the same underlying mechanism that baclofen helped, it weakly prevented partial seizures. So as before when I quit drinking I ended up in a psych ward, when I quit drinking with baclofen, the anxiety and the uncomfortable partial seizures were diminished and I didnt self medicate with alcohol.
So best rule of thumb, get the correct diagnosis first before treating it
In the whole grand scheme of things, like epidemiologists who are doctors who study the population in large groups, whose more likely to die vs live with this or that.
In their view, treating a large population of alcoholics with baclofen. You'll save many more than without and side effects will also be negated as for the positive life saving, life changing effects. So on a whole, its a good thing.
But then there are going to be that dont respond or respond for a completely different reason, like me, weeks ago, I was PMing with Tiptronic thinking I overdosed with baclofen as I kept taking more and more to stop the myoclonic seizures I was having. And I was dumbfounded as to why I was having myoclonic seizures that baclofen treats, only to have an objective observer later tell me it was partial seizures, weakly treated with baclofen GABAb
By the way as far as anxiety, if your reward center of the brain wants to motivate you to do something, it induces anxiety. Thats how MACRO works to get its job done.
An acronym for MAlignant Central Reward system Overactivity
I wrote this out awhile back for a website and I will offer it as personal opinion rather than science as I literally renting a Uhaul truck and moving tomorrow. So I am not going to want to go back and forth yet on the science. So anyone wanting to do that. I dont have time at the moment.
Malignant Central Reward System Overactivity
MaCRO
“I suffer from MaCRO”
What is MaCRO, it’s malignant central reward system overactivity, it differs from addiction in that it responds to baclofen and other GABAb medications.
if someone gets in your face and says “OH or NO youre an alcoholic”
Your first response should be “Only stupid people know alcoholics” ---in your head
A better response would be “No, alcoholics are untreatable”
It’s often standard medical naming of diseases to classify them as to if they do or don’t respond to certain medications, a more widely known example is that of MRSA, methoxycillin resistant staph aureus or “ insert example of medication receptive naming”. MRSA is simply a common bacteria that has grown resistant to a very powerful antibiotic. So they may find a cure for alcoholism, but they haven’t found one yet, it certainly isn’t AA as cognitive or talk therapy alone does not treat MaCRO and that fits about 90% of people who attend AA and relapse into the chronic and progressive reward center disease which leads to early death and manifested in multiple physiological impairments-(think of new descriptive word). If AA works for an individual, then they do not have MaCRO.
People who do not respond to baclofen medication have BReMaCRO.
Baclofen-resistant Malignant Central Reward System Overactivity and the prognosis for this small minority is quite grim. MaCRO and BReMaCRO can be differentiated by PET scan. MaCRO patients can have a pre-post “cue” petscan compared to pre-post “cue” scan after baclofen administration compared to see if the reward center activity is affected and to what degree of diminishment. A true BReMaCRO patient will not show any reduction in reward center activity compared with their baseline (w/o baclofen) brain imaging.
Diminishment of reward center activity is the differentiating factor between the two forms of MaCRO.
Diminishment that is low but perceivable is a patient that is responsive to baclofen but needs a much higher dose than the mean patient. No diminishment means that even ultra-high doses of baclofen will not affect a perceivable change in brain imaging.
The reward system of the brain is tied to the many “drives” of organisms. It underlyingly guides all behaviors, as such, it works to guide decision making of all creatures, animals and humans alike. It is borne out of the innate desire for the organism to thrive, succeed and be the fittest of them all and thereby pass along the organisms genetic material to future generations of the particular species. Drives that guide one to seek out food, safety, water, oxygen, a sexual mate to procreate to pass along genetic material. Its part of the basic building blocks of life.
But what if that drive system goes haywire? That is what happens with MaCRO, a system meant to make a human thrive, succeed and be fit, does the exact opposite because it has become poisoned by outside toxins as tofor, it is a fatal, incurable disease as the person does progress in the more virulent form to seek out the toxin until their life is extinguished
So in summary, baclofen is like every single other medication, in which some respond strongly, some weakly and some none at all.
The Bre-Macro patients are a small minority.
Also, in terms of anxiety, there is different ways this can play out. From a personal perspective. I drank for a number of failings of achievements (I strive to be a high-achiever). Only to fail and that brought about drinking to self-medicate a perceived failure.
So this stuff is can be as varied as there are snowflakes as to what causes a person to drink and what can treat it.
In my own personal case, I became an alcoholic to lessen the failures. I was hospitalized several times for psychiatric illness and suicide attempts related to what I thought was alcohol related issues. Thats how I found Mywayout all that long time ago. There was scant postings on baclofen before I told my story and then zen others did their logs.
So what my point is, is that sometimes its not alcohol at all thats causing people to drink and the MACRO theory I proposed above.
Just maybe it's something else causing the problem and they do not respond to baclofen like others. Instead of seeing a psychiatrist, maybe a neurologist.
Here's why I say there are people who may respond, slightly respond or not respond at alll.
It depends on what is really going on. What is the diagnosis?
You cant just label everyone who drinks too much as an alcoholic and then treat them with baclofen and expect 100% success.
There are going to be people who were diagnosed say with "schizoaffective disorder" and they self-medicate with alcohol. Giving an undiagnosed person baclofen might not help as much as a person who is just an alcoholic.
Not everyone has the same brain chemistry at work.
Take for me, I am not going to post up studies I have them, I just dont have time, so I am not going to go there yet. So this is just personal experience.
I drank mainly b/c of these random failings that caused such distortions in my life. I just wanted to turn my brain off.
I was hospitalized, multiple times in one year. This is a few months AFTER I quit drinking. I thought it was antabuse related psychosis. I put myself on it as an insurance policy while I took a leave of absence.
What followed next was complete psychotic episodes, in that year of hell I was put on every antipsychotic drug. And I always responded. In fact, Id often find myself admitted directly to the psych ward, only to come to coherence within hours.
Then, I was a sane person, in an insane environment with people talking to me as if I as mentally ill "would you like a coloring book?"
"WHAT? No I dont want a fucking coloring book, I want out of here"
This is my point at least, not every one that drinks, drinks b/c they have the biochemistry and the process going on that baclofen affects.
So to finish the story, I was given a diagnosis after 15 or so week long and a month long psychiatric hospitalization of schizo-affective disorder. And it was near impossible to treat. I mean they had nothing left to reat me. I'd become confused, psychotic, I got tasered as well while in an airport.
I had a reason to drink at that point, but I still didnt, even though quitting drinking is what sparked this year of recurrent hospitalizations. I walked away from the hospital I worked asking what year it was just before this so everyone was concerned.
So then, years ago, I was diagnosed as schizoaffective disorder to try and explain what was going on.
I then and went and saw another psychiatrist as an outpatient. (never went to the psych hospital again after 15-20 that year). He said, there really isnt such a thing as schizoaffective disorder in his opinion.
He thought that it was the same as bipoloar with psychotic features.
He treated me with Lamictal. Issues stopped, I was right as rain and I was able to go back to working in a normal state in my professsion.
Years later, having discontinued the lamictal. I started to have musical hallucinations, a hallmark of schizoaffective disorder. I knew the science behind it.
I knew that is exactly what I ha feared and I was going to have a relapse and I resigned b/c I feared it would affect patient care.
So I was schizo, i had drank as they often did to selfmedicate, thats why I had drank, its part of the schizo profile. Lived with the thought that it would come back and it did was more than distressing.
This is my point everyone, sometimes one may look lke a duck and quack like a duck, is not a duck. And they may not respond to a medication, just like I never responded to any antipsychotics except for becoming normal on my own but never stabilized successfully.
Until I was treated with lamictal, which, is also an anti-seizure medication.
Since which time I have been diagnosed with partial seizures, where it is not necessarily easy to see. Luckily I was apologizing to someone for not being able to do my job who used to teach medical school, this after resigning a few weeks earlier saying I had schizoaffective disorder and cant see patients as I am having hallucinations.
"You are having seizures!, I told you you werent schizoaffective, Ive worked with you for five years, you are seizing right in front me right now" and "the musical hallucinations, thats classic temporal lobe seizure, and you are having jacksonian movements as the seizure marches around the brain affecting different parts of your motor skills"
And so here's the problem with all of this stuff, you have to have a diagnsosis. I self-medicated with alcohol due to this underlying seizure clusters I had been having,which is treated in an acute situation with xanax ( as I mentioned before, benzos are alcohol in a pill, but alcohol can be both pro and neg towards causing a seizure).
In my case quitting alcohol left the seizue disorder unmedicated and so while as before I was drinking a few beers a night. Now I had nothing to stop this and the post-ictal states that are left from a seizure which are often mistaken for psychoses.
So then I respond to a bipolar drug for bipolar with psychotic features. To be treated and the diagnosis secured. I can work professionally again after a year in hell of recurrent hospitalizations where Id be normal in psych unit.
Then to stop lamictal as its very expensive at the time and concurrently, strangely, start selfmedicating again with alcohol. And no psychotic illness. A functioning alcoholic suppressing partial seizures that are quite painful.
Then I quit alcohol successfully with baclofen which was designed and hoped to be an epilepsy drug, only to find out that it was just mildly effective but great at treating spasticity. I was able to get by with a weak anti-epiletpic drug after being diagnosed with schizoaffective disorder b/c I respo ded to lamictal which the only other treatment approved for its use is this partial seizure disorder. Which I am now confirmed to have.
So 20 years of a wrong diagnosis, in which I drank, ended up in the ICU with near complete suicide. Leaves of absense, embarassment in which I drank to cope with that.
Then when I stop drinking before baclofen I spend a year in and out of a psych ward.
Only to come to find out, you have to have the right diagnosis before you can treat a patient successfully. Perhaps the people who don't respond, may not have what baclofen treats. Or in my case, treats mildly and in the previous wrong diagnossis, treats extremely well only to get a misdiagnosis.
I am saying is that not every person drinks because of my theory of M.A.C.R.O. as listed above, they may have pet scan imaging that looks like it, but who knows why some respond and a small minority dont. It could be metabolism, resistance or that they are trying to treat a completely different issue with baclofen.
I posted about adding xanax into the mix on top of baclofen and my issues I was having went away. Well xanax is great for acute seizures as was observed in my case of myoclonic seizures and speech pauses.
Only after having it in front of someone who kept telling me I was misdiagnosed after working with me for 5 years and then finally having it diagnosed on the spot. "Your having seizures"
He left me with the thought of you might need to have to go to counseling to deal with the misdiagnoses all your life. He was right, a whole weekend putting it into place, why this happened and why I drank like a fish to deal with it. etc.. etc...
Baclofen works on what, 1/2 half of the GABA system where as xanax and alcohol work on the whole system
Lamotrigine or lamictal works in the same realm
As is the case for antiepileptic drugs that act on voltage-dependent sodium channels, lamotrigine inhibited the release of glutamate and aspartate evoked by the sodium-channel activator veratrine and was less effective in the inhibition of acetylcholine or GABA release.
I could go on, but there are many reasons why people drink alcohol and I do believe that anxiety and the reward system of the brain is the vast majority of why they do. And why the vast majority of people respond to baclofen
But, having said that, I may not have the same underlying mechanism that baclofen helped, it weakly prevented partial seizures. So as before when I quit drinking I ended up in a psych ward, when I quit drinking with baclofen, the anxiety and the uncomfortable partial seizures were diminished and I didnt self medicate with alcohol.
So best rule of thumb, get the correct diagnosis first before treating it
In the whole grand scheme of things, like epidemiologists who are doctors who study the population in large groups, whose more likely to die vs live with this or that.
In their view, treating a large population of alcoholics with baclofen. You'll save many more than without and side effects will also be negated as for the positive life saving, life changing effects. So on a whole, its a good thing.
But then there are going to be that dont respond or respond for a completely different reason, like me, weeks ago, I was PMing with Tiptronic thinking I overdosed with baclofen as I kept taking more and more to stop the myoclonic seizures I was having. And I was dumbfounded as to why I was having myoclonic seizures that baclofen treats, only to have an objective observer later tell me it was partial seizures, weakly treated with baclofen GABAb
By the way as far as anxiety, if your reward center of the brain wants to motivate you to do something, it induces anxiety. Thats how MACRO works to get its job done.
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