Anyone currently trying 4-Ap?

[Smilingface]

Since my greatest disability is walking I decided to give 4-Ap or aminopyridine a try for some symptomatic relief. It was prescribed for me at the dose of 5mg TID. Has anyone had any luck with it? How long did it take to notice a change? I just swallowed the first pill today so I know I have to be patient.

[CureOrBust]

I have been using it for a while; say a year now.

I get 10mg compounded in a slow release capsule. I take one tablet in the morning (8am), and that's it normally. I think I noticed it on the very first day I ever took it.

I noticed also that if I took it close to bed time, it affected my sleep. I have no other negative effects from it, that I have noticed. If I need it, I take a second dose (10mg) around 2 pm.

I once accidentally took the second dose too close to the first (I think I forgot I just took the first), and all I noticed was a bit of extra tingling in my extremities. But it did worry me. There is also some evidence that it hiders remylination. I try and skip weekends (ie not at work) because of this

I cant imagine life without it, and consider it a bit of a saviour. Ms symptoms don't completely go, but they are definitely reduced.

[gwa]

I have been using it for a while; say a year now.


I cant imagine life without it, and consider it a bit of a saviour. Ms symptoms don't completely go, but they are definitely reduced.

Which symptoms are being reduced?

gwa

[CureOrBust]

Mainly ataxia. But also my balance is slightly improved.

[Smilingface]

I'm excited! Either this is a good placebo effect or....My spasticity upon wakening is better and after my Y excercise, the walk down the long hallway was a little easier. The total per day for me thus far is 10mg. I think I might skip it for the weekend because it's Mon-Fri during the work week when I need it the most.

[k6ristin]

I take 4-AP whenever I remember to, or expect to walk alot. I take 20 mg. I will occasionally repeat the dose after @ 6 hours. I started on 10mg and noticed no difference. I noticed alittle better coordination at 20mg.

I did not hear that it could hinder re-myelination. Do you have any information on that?

My greatest MS symptom is difficulty walking. I think 4-AP helps a little bit. It has unknown drug interactions, I think it gets "voided" out if I take xanax, but this is my observance, not based on any literature! My doctor told me not to take it with any kind of stimulant, like provigil and cold medicine, that will lower your seizure threshold.

[Smilingface]

I actually heard some forum talk about 4-AP perhaps hindering re-myelination but I wasn't worried until I came across this the other day:

6: Glia. 2004 Nov 1;48(2):156-65.

K+ channel blockade impairs remyelination in the cuprizone model.

Bacia A, Wollmann R, Soliven B.

Department of Neurology and Committee on Neurobiology, Brain Research Institute,
University of Chicago, Chicago, Illinois 60637, USA.

The adult CNS has the capacity to remyelinate following metabolic, toxic and
autoimmune demyelinating insults. In cuprizone-induced demyelination, spontaneous
remyelination occurs after the cessation of cuprizone diet. We used the cuprizone
model to investigate the role of glial K(+) channels in oligodendroglial (OLG)
regeneration and remyelination in vivo. We found that treatment with
4-aminopyridine (4-AP), a broad-spectrum K(+) channel antagonist, results in: (1)
decreased number of oligodendroglial progenitors (OP) and OLGs; (2) diminished
astrogliosis; and (3) decreased remyelination in the corpus callosum based on the
immunoreactivity to myelin basic protein (MBP), Rip monoclonal antibody, and by
electron microscopy. Our findings support the concept that glial K(+) channels
play an important role during OLG regeneration and remyelination, a crucial
factor to be considered during the development of therapeutic strategies to
facilitate recovery in demyelinating diseases and spinal cord injury.

Publication Types:
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

PMID: 15378653 [PubMed - indexed for MEDLINE]