Posted by zeugma on February 15, 2003, at 7:05:04
In reply to TCAs » missinglynxx, zeugma, posted by not exactly on February 14, 2003, at 23:39:55
> Your posts about nortriptyline have been informative and inspiring. In fact, your positive experiences (along with similar reports from other psycho-babblers) enabled me to overcome my fears & prejudices about TCAs.
>
> I tried amitriptyline once, and found the sedation, thought-clouding, and other side effects so severe that I felt like I'd been poisoned. So I concluded that the entire TCA category was not for me. Web research had bolstered that negative opinion - many sites (such as biopsychiatry.com, which seems to have otherwise informed and enlightened views) refer to TCAs as "dumb drugs" which are best avoided.
>
> Last month, I considered trying Strattera, but when I found out that my insurance would not cover the Rx, I started searching for other norepinephrine-enhancing meds. When I learned that desipramine was almost as NE-specific as Strattera (and WAY cheaper), I decided to give it a try. My experience so far (exactly 2 weeks) has been encouraging. Side effects have been minimal and are now virtually unnoticable. My mood, motivation, and overall meaningful connection to life have improved. The improvement has not been dramatic, in fact it's been surprisingly subtle. But each day things are a bit better than the day before, and there's no sign that I've leveled off yet. I know that delayed onset and gradual improvement are traditional for antidepressants, but this has never been the case for me before. In the past, every other AD I've tried (and there have been a bunch) "did its thing" (for better or worse) within the first few days.
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> Anyway, I'm now wondering about how desipramine & nortriptyline compare. Have either of you tried desipramine? My understanding is that nortriptyline is slightly more serotonergic, antimuscarinic, and sedating compared to desipramine. If desipramine turns out to be an incomplete solution, do you think nortriptyline would be worth a try?
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> I'm also intrigued by the idea of augmenting a TCA with Buspar. I may try this next once I see where the desipramine plateaus out.
>
> - Bob
>i'm very happy that you've had some success with desipramine. No, I've never tried it, but it seems similar to nortriptyline- as you said, nortriptyline is a little more serotenergic and sedating (it's the sedating that's important for me). I remember that site at biopsychiatry.com- they called TCA's "cheap, nasty and best avoided." Well, as I had posted around here recently, the last day I missed work because of chronic nausea was the day I started taking nortriptyline. So I had my own ideas on what was "nasty." I think over there they're a little too concerned with how a drug looks on paper and with how "clean" it is ( a prejudice shared in my opinion by much of the psychiatric community).
I also found nortriptyline to have a subtle effect. Aside from the relief from GI pain, which WAS pretty dramatic, I found myself feeling a little less awful in the morning... made sleep a little more restful or something. I guess I have classic melancholic depression, and TCA"s *ARE* the preferred treatment for that. Also about that slow response curve.. I can't say whether it's the conjunction with the Buspar or not, but I have been consistently going to sleep before midnight for about a month now- I am someone who suffered from insomnia since early childhood, so I am VERY happy about that. Are your symptoms at all similar? A lot of the problem with other AD's, aside from the ones I was allergic to, was that they seemed to worsen these 'melancholic' symptoms.
I was also told to try Strattera by my pdoc before it came out. But I would try desipramine first, because it seems like I would have the same problem with Strattera that I did with Prozac and Cylert- worsened sleep and appetite problems. Not to mention TCA's are way cheaper. I'm already spending a fortune on generic buspirone. Being the skeptic that I am, I was wondering this morning if I was experiencing the placebo effect from the Buspar. It's a pretty convincing one, though, so it's money well spent.
z
poster:zeugma
thread:137341
URL: http://www.dr-bob.org/babble/20030214/msgs/200658.html