Posted by chemist on August 17, 2004, at 17:52:26
In reply to Questions about long term TCA (esp desipramine), posted by Racer on August 15, 2004, at 15:22:37
hello racer, chemist here...i have recently become more familiar with the TCA class, and am far from being a fount of knowledge on this one (one might argue i am ignorant of everything, as an aside). i note that there are mixed reviews in this thread, and wanted to enlist the words of the posters who appear to be frequent commentators and/or long-term users about these meds. it is my personal experience with the MAOI parnate that it was/is an excellent anti-depressant, in the truest sense of the definition. the orthostatic hypotension was fleeting for me, and did not preclude my daily 50 km bicycle ride or trip to the gymnasium: i give it high marks, and it was (in concert with a low-dose benzo such as klonopin and later valium) exceptional at the 30 mg/day dose level (divided). my understanding of the TCAs is that - as King Vultan notes in a thread below - desipramine and protryptyline are the most ``activating'' ones, and i have read that nortriptyline exhibits a lower incidence of orthostatic hypotension than the 2 mentioned afore, although some baseline and semi-frequent blood testing are recommended, as for desipramine. in any event, i hope that folks more in the know than i can comment and get you straightened out on the quick....all the best, chemist
> This is mostly academic, but I'm still curious, so thought I'd ask now, while it's still on my mind.
>
> With all the talk of SSRI "poop out", it struck me that I'd never heard of TCAs losing their effectiveness. And then it occurred to me that I didn't know anything about long term effects of TCAs. Has anyone here taken any of the TCAs for long periods? If so, what were your experiences? Did it continue to be effective?
>
> Specific to desimpramine, let's here those stories about its effect on your weight: did anyone gain weight? If so, how much? And, if so, have other A/Ds also caused you to gain weight, and was it more or less than on the desimpramine? Did desipramine cause you to feel sedated, apathetic, or emotionally numb? And did the effects on your mood change over time? What side effects did you experience on it?
>
> Extra credit questions: for anyone who's taken a TCA, or MAOI for that matter, who has experienced problems with hypotension, did you try Florinef? If so, how was it? And, if not, did the hypotension resolve itself at all once you'd gotten through the adjustment period, or did it continue to be a problem? (And, how much of a problem was it?)
>
> Basically, I'm looking for information that will help me both adjust to the idea of being medicated for life in the first place, and also to help in choosing the best medications for that long term treatment. If TCAs have a better long term track record than the newer drugs, and the hypotension can be mitigated or will resolve once I've adjusted to the medication, *and* they don't cause you to suddenly grow new limbs or something after several years, then that's the route I'm likely to explore -- once I get out of Dr EyeCandy's Treats Shoppe and into a private psychiatrist's office where there will be better resources for minimizing the adverse effects and treating both hypotension and weight gain.
>
> Thanks, everyone!
poster:chemist
thread:377967
URL: http://www.dr-bob.org/babble/20040817/msgs/378847.html