Posted by TriedEveryMedication on April 23, 2016, at 13:27:16
In reply to Re: Are there any other NRIs besides TCAs/strattera?, posted by SLS on April 23, 2016, at 13:08:30
> > My ADD responds really well to NRIs. Well, specifically desipramine and strattera.
> >
> > Problem with them (other than being on that anticholinergic list) is wicked insomnia. On them, I wake up at about 2am and can't get back to sleep until 5am.
>
> Perhaps you should simply treat the insomnia aggressively. There have been times when I responded well to an MAOI, with or without desipramine, in which I experienced total insomnia for days and days. The best choice was to then treat the insomnia as if it were a disorder on its own. The first time, I ended up using a combination of Halcion and Ativan. I slept satisfactorily, and ended feeling well for an extended period of time. I had no qualms about taking BZDs for the long-term. I still don't. At some point, you might be able to remove the sleeping medication and remain free of insomnia.
>
> What have you tried for sleep so far?
>
> > I've been digging around. MAZINDOL has some NRI action but it is prescribed for obesity.
>
> Mazindol is a failed investigational antidepressant that later was found to be helpful in obesity. I believe its main target was brown adipose tissue. There, it would increase energy production in the form of heat to regulate body temperature and burn excess white adipose tissue (fat). I don't know. Maybe it would help you, but I wouldn't invest too much optimism in it.
>
> I am guessing that you have already investigated guanfacine?
>
>
> - ScottThings thus far I've tried to counteract desipramine insomnia either didn't work or wrecked the substantial attentional improvements I've gotten from desip. It feels like such a delicate balance.
I've tried:
-remeron: fixed the insomnia, negated the desipramine
-Z drugs: did not fix the insomnia, still wrecked the desipramine effect
-ativan: same as the z drugs
-benadryl: didn't touch the insomniaI did try guanfacine several years ago. I went so far as to have an extended release version of guanfacine compounded before intuniv was released. It didn't do anything for me, but maybe I wasn't on it long enough. I used to have the bad habit of trying something for a couple weeks and if I don't see any effect at all, I drop it. Maybe because I'm used to things like desipramine working in 24-48 hours for my focus or paxil working within hours for anxiety. I know that's all wrong as 6-weeks is usually the amount of time for things to work for whatever reason.
poster:TriedEveryMedication
thread:1088358
URL: http://www.dr-bob.org/babble/20160331/msgs/1088408.html