Psycho-Babble Medication Thread 50312

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more about doxepin? st.james.john L or anyone

Posted by Julia on December 10, 2000, at 4:45:54

I've just found a posting you did about doxepin earlier this year.I am going through my first major epidode of depression,though looking back I can see evidence of a fairly mild depression getting worse.I have had a lot of trouble with anxiety/agitation as well.celexa for 2 weeks made me more agiated,reboxetine for 4 weeks did nothing,I've now been on doxepin for 4 1/2 weeks initially 150mg, now at a dose of 200mg.I'm also on mellaril 50-75mg to help with the agitation and lorazepam 2mg per day.How long do I give the doxepin-I am really struggling at present with low mood,and the anxiety is reduced but has not completely gone.I have had a bit of cognitive therapy which I will continue with,but do I worry about the fact that the doxepin doesn't work yet,or only marginally.My pdoc suggests lithium if there's no improvement soon,but would adding effexor be a good move? Can the lorazepam be making me feel more depressed?I am feeling pretty hopeless about it all,and the fact that I have chronic fatigue and can't get out of the house makes it more difficult for me to distract myself.I would really value some ideas.

 

Re: more about doxepin? st.james.john L or anyone

Posted by missinglynx on December 10, 2000, at 4:54:14

In reply to more about doxepin? st.james.john L or anyone, posted by Julia on December 10, 2000, at 4:45:54

> I've just found a posting you did about doxepin earlier this year.I am going through my first major epidode of depression,though looking back I can see evidence of a fairly mild depression getting worse.I have had a lot of trouble with anxiety/agitation as well.celexa for 2 weeks made me more agiated,reboxetine for 4 weeks did nothing,I've now been on doxepin for 4 1/2 weeks initially 150mg, now at a dose of 200mg.I'm also on mellaril 50-75mg to help with the agitation and lorazepam 2mg per day.How long do I give the doxepin-I am really struggling at present with low mood,and the anxiety is reduced but has not completely gone.I have had a bit of cognitive therapy which I will continue with,but do I worry about the fact that the doxepin doesn't work yet,or only marginally.My pdoc suggests lithium if there's no improvement soon,but would adding effexor be a good move? Can the lorazepam be making me feel more depressed?I am feeling pretty hopeless about it all,and the fact that I have chronic fatigue and can't get out of the house makes it more difficult for me to distract myself.I would really value some ideas.

Sorry To hear about the Chronic Fatigue. You sound like a brain, and a tough person, to deal with that syndrome that has no treatment and little research to find a cure(its always money isn't it). maybe adding some Cod Liver Oil to "up" your EPA and lipid blood levels might be a good trial Read Ellies post above.... Each tsp contains 550-500 mg of EPA and DHA. You might want to look it up via the Internet. Great for Joints also. Mixed into Juice or Pop it tastes fine. plus its for your health so who cares about taste. Try SAM-e at 400 mg per day. Now thats another "forgotten" treatment. Im sure its Mixable with drugs...ITs safer than Aspirin,why not try these out?

 

Re: more about doxepin? st.james.john L or anyone » Julia

Posted by Sunnely on December 10, 2000, at 21:56:04

In reply to more about doxepin? st.james.john L or anyone, posted by Julia on December 10, 2000, at 4:45:54

> I've just found a posting you did about doxepin earlier this year.I am going through my first major epidode of depression,though looking back I can see evidence of a fairly mild depression getting worse.I have had a lot of trouble with anxiety/agitation as well.celexa for 2 weeks made me more agiated,reboxetine for 4 weeks did nothing,I've now been on doxepin for 4 1/2 weeks initially 150mg, now at a dose of 200mg.I'm also on mellaril 50-75mg to help with the agitation and lorazepam 2mg per day.

******************

Hi Julia,

My main concern with the combination of doxepin (Sinequan) and thioridazine (Mellaril) is the increased risk of a silent but potentially serious heart rhythm irregularity ("prolonged QTc") and even sudden death. If you are to remain on these meds for an extended time, it is best to have your electrocardiogram (ECG) checked periodically, especially if you have other concurrent health risk factors.

 

Re: more about doxepin? st.james.john L or anyone

Posted by Julia on December 11, 2000, at 2:04:31

In reply to Re: more about doxepin? st.james.john L or anyone » Julia, posted by Sunnely on December 10, 2000, at 21:56:04


>
> ******************
>
> Hi Julia,
>
> My main concern with the combination of doxepin (Sinequan) and thioridazine (Mellaril) is the increased risk of a silent but potentially serious heart rhythm irregularity ("prolonged QTc") and even sudden death. If you are to remain on these meds for an extended time, it is best to have your electrocardiogram (ECG) checked periodically, especially if you have other concurrent health risk factors.

Sunnely-thanks for your advice:I did have an ecg done when I started the combination and all the intervals were within normal limits.What I really want to know is how long it is worth sticking with the doxepin to see if it will work

 

Re: more about doxepin? st.james.john L or anyone

Posted by stjames on December 13, 2000, at 1:13:56

In reply to more about doxepin? st.james.john L or anyone, posted by Julia on December 10, 2000, at 4:45:54

AD's take 6-8 weeks for the antidepressant effect
to start so it is normal at 4 weeks to feel like nothing
is happining. The TCA's are still our most effective AD's
for signifivcant depression so you should give doxipin it's
full course, at least 8 weeks. Since you did not mention
bad side effects you seem to be tolerating doxipin well.
It's always worth sticking with a med that causes few side effects.

Mellaril is OK short term, it also has AD effect. Long term you
should move to a newer AP. The side effect profile, both minor
and major, is better is something like Zyprexa.

James


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