Caving and anti-nauseating

Days three and four: Without a doubt Combivir is causing ongoing nausea, headaches, and muscle aches. They were so bad today that I couldn't nap- I already have some problems with muscle aches in my back, and they have just been exaggerated by side effects. I also have been pretty tired but this could be as a result of either traveling or meds; it's uncertain which. Due to ongoing nausea and a general sensation of blah, I decided to start taking the anti-nausea meds, which I initially was uncertain about taking. Here's what I'm on:

Ondansetron, 4mg orally dissolving tabs, taken 3 times a day in 8 mg doses.

Ondansetron is a serotonin antagonist with a chemical formula of C18H19N3O. Serotonin, most popularly known as the brain's happy happy joy joy chemical, can actually make you vomit your guts out. Here's how (short version): If your digestive system is content, certain cells in your guts, known as enterochromaffin cells, will release serotonin in response to the presence of food. Normally, this serotonin will be absorbed; however, if your guts are filled with bacteria/chemotherapied/stuffed full of anti-retroviral meds, your body will release more serotonin than the body can absorb, and this will activate certain serotonin receptors in the central nervous system, known as 5HT3 receptors, which will cause you to vomit. The anti-nausea med that I am on blocks 5HT3 receptors, meaning that the excess serotonin produced in my body is never detected by my brain. Conclusion: I don't get nauseated and don't throw up, at least for a few hours after taking these meds!
Here's what it looks like:

It's interesting taking the same type of medication that a person undergoing chemotherapy might take, as several members of my family have undergone chemotherapy; it's a strange way to relate to someone (hey- we took the same meds! Wow!), but I am glad for any ability to have more compassion for those around me, even if it is bonding over the funny taste or (in)effectiveness of a particular medicine. This particular med also has several uses outside of nausea relief, which I personally to find pretty interesting and quite unexpected, as these tiny white pills seemed innocuous enough.

Here are some additional (occasionally off-label and controversial) uses of ondansetron:

1)Treatment for alcoholics. Ondansetron has been shown to significantly reduce alcohol cravings, esp. by alcoholics.

Ondansetron: All-American.
2)Bulimia treatment. Ondansetron use reduces urges in young women to binge. Here's a short study about it: Study here!

3)Relief of tardive dyskinesia. Tardive dyskinesia, notoriously hard to treat, results in uncontrolled repetitive movements of the human body, similar to a twitch. Tardive dykinesia is usually induced by long term (or high dose) antipsychotic drug use. After 4 weeks of use, patients that participated in the study received a significant reduction in symptoms of tardive dykinesia.

4)Relief of schizophrenia symptoms. Ondansetron acts on 5-HT3 receptors, which are the same receptors that are involved in development of cognitive impairment associated with schizophrenia and schizophrenia itself. Thus ondansetron may relieve some of the symptoms associated with schizophrenia and the cognitive impairment affiliated with it.

(P.S. Even though I myself am not a paranoid schizophrenic, my handle all through junior high and high school in all chat rooms/icq/irc/Palace/virtual interaction was “Paranoid Schizophrenic Duck Girl.” I went by P.S.D.G. for short. The name came from a comic book featuring Daffy Duck in a therapy session. I cut this comic out of a newspaper and carried it around for years- I only lost it when moving around a lot during college. I still hope to come across it in my stuff one day.)

5)Relief of opiate withdrawal symptoms. Once again, ondansetron acts on 5-HT3 receptors which are associated with the withdrawal symptoms of opiates, although ondansetron itself does not reduce cravings. However, it is the only drug out there right now that can potentially treat withdrawal symptoms that does not itself pose a risk of addiction. For example, a heroin addict treated with methadone may just become addicted to methadone. Let's be honest here- I have dealt with friends that have skipped the other opiate addictions and became addicted to methadone directly. But ondansetron? Not addictive at all because it does not get you high- it just takes away the vomiting.

And all that is just for starters! Turns out this drug has been targeted in many rudimentary studies, and much of the potential use for ondansetron has yet to be fully fleshed out. The future is bright!