Posted by KaraS on April 15, 2005, at 13:46:00
In reply to Re: Melatonin etc. » KaraS, posted by Sarah T. on April 14, 2005, at 19:43:59
> Hi Kara,
>
> Thanks for your reply. I've been wondering whether you have noticed an improvement in your depressive symptoms while on doxepin? I understand that your improved sleep could, in and of itself, ameliorate your depression, but if it's possible to separate out the effects of that, do you think that low dose of doxepin is helping in other ways, besides sleep?
I'm only taking 25 mg. but it has definitely had an antidepressant effect - even at that low dosage. I am not completely anhedonic anymore. I can enjoy a tv show, a movie and even music again.
> I was interested to hear about your response to nortriptyline. Did you ever take imipramine? If so, how did that compare with nortriptyline, for you? For me, the TCA's, which I haven't taken in years, were significantly better for mood improvement than anything that's come out in the past 10-15 years (ssri's, Wellbutrin, Strattera, etc., etc), but I had severe cardiovascular effects on the TCA's. I would wake up with resting heart rates of >100 bpm. Before I even got out of bed, my heart rate was often around 105-106. That is absolutely unacceptable. I also had some other side effects that I couldn't live with, such as speech blockage, memory impairment and urinary retention (I was able to cope with the urinary retention with Bethanechol). Those symptoms weren't too bad on desipramine, but on anything like imipramine or amitriptyline, they were severe. I also had some other physical symptoms that weren't as serious, but I was bothered by them. These included edema (especially facial edema), constipation, and excessive sweating and thirst. Oddly enough, the WORST side effects I ever experienced were from maprotiline, which, like so many "newer generation" drugs, turned out to be worse than those from the previous "generation."I've never taken imipramine but I've taken desipramine and it gave me tachycardia. Since imipramine metabolizes to desipramine I'm pretty certain I wouldn't be able to tolerate it. The only reason I haven't increased the doxepin (which is obviously helping) is because of the side effects. I no longer worry about the cardio effects however, since I'm no longer getting palpitations and my EKG (ECG?) was fine.
> Thanks for asking about my sleep. Well, lately, once I finally go to sleep, my sleep has been ok. It's that darn phase shift that I struggle with. I do think that when I'm able to exercise earlier in the day, I tend to go to bed a tiny bit earier that night. I remember reading that vigorous exercise can suppress melatonin for about 12-13 hours, so perhaps that's what's happening with me.Sorry to hear you're still struggling with insomnia. I'm still trying to deal with the delayed sleep phase as well. The doxepin helps me sleep but I still don't want to go to bed at night until later and later each day. Vigorous exercise is good for so many things if you have the time and can make yourself do it.
> By the way, I did end up trying melatonin. On the first night, I took 1 mg, which was much too much. A couple of nights later, I tried 0.3 mg. That was a bit better, but even that small amount caused some worsening of my depression. It felt more like an exacerbation of the physical symptoms of my depression, but those physical symptoms can, in turn, color (or discolor) everything else for the rest of day, so I've abadoned that project for now.Definitely sounds like melatonin isn't for you. It was worth the try though.
> I always enjoy reading your posts.
Thanks. Same here.
Kara
poster:KaraS
thread:478017
URL: http://www.dr-bob.org/babble/alter/20050414/msgs/484708.html