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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by jms600 on May 2, 2004, at 16:12:21
Hello,
Can anyone recommend another antidepressant i.e. a Tricyclic or related drug etc, which is as effective as the SSRIs, but doesn't make you so apathetic and lethargic?? I've been on most SSRIs and all they seem to do to me is make me apathetic and lethargic. I just want to lie down and do nothing all day. Even Prozac makes me lethargic.
I don't know what else to try. I was thinking of a Tricyclic but I really don't want the nasty anticholinergic side effects. I don't want to try any MAOIs due to the diet restrictions.
Anyone else found SSRIs to cause apathy and lethargy? What did you switch to?
Thanks!
Posted by Keith Talent on May 3, 2004, at 5:24:33
In reply to SSRI substitute, posted by jms600 on May 2, 2004, at 16:12:21
This would have to be close to the number one problem reported on this board. Next week, I'm going on dextroamphetamine in an attempt to reverse what you describe (taking sertraline 200 mg a day). Don't know if there is a holy grail in this area.
Posted by King Vultan on May 3, 2004, at 8:09:13
In reply to SSRI substitute, posted by jms600 on May 2, 2004, at 16:12:21
> Hello,
>
> Can anyone recommend another antidepressant i.e. a Tricyclic or related drug etc, which is as effective as the SSRIs, but doesn't make you so apathetic and lethargic?? I've been on most SSRIs and all they seem to do to me is make me apathetic and lethargic. I just want to lie down and do nothing all day. Even Prozac makes me lethargic.
>
> I don't know what else to try. I was thinking of a Tricyclic but I really don't want the nasty anticholinergic side effects. I don't want to try any MAOIs due to the diet restrictions.
>
> Anyone else found SSRIs to cause apathy and lethargy? What did you switch to?
>
> Thanks!
>
>
>
>I had the same problem on SSRIs and Effexor and tried three different tricyclics last year: nortriptyline, desipramine, and Vivactil (protriptyline). Of those, I had by far the best luck with desipramine. It was an activating and relatively effective antidepressant completely without the apathy I suffered on SSRIs. It has weak anticholinergic effects--similar in absolute terms to those of Paxil--but because it is a strong blocker of norepinephrine reuptake, you may expect to experience "pseudo" anticholinergic effects such as constipation, dry mouth, and urinary hesitation. I found these somewhat bothersome but tolerable.
Of the other two I tried, nortriptyline had a weaker antidepressant effect on me and was much too sedating. Vivactil was quite stimulating and was probably more effective than desipramine overall but had true anticholinergic effects that were significantly worse than those of desipramine. Because of the erectile and prostate issues I suffered while on it, I am unable to recommend it to anyone who is not female.
Todd
Posted by Sad Panda on May 4, 2004, at 14:03:12
In reply to SSRI substitute, posted by jms600 on May 2, 2004, at 16:12:21
> Hello,
>
> Can anyone recommend another antidepressant i.e. a Tricyclic or related drug etc, which is as effective as the SSRIs, but doesn't make you so apathetic and lethargic?? I've been on most SSRIs and all they seem to do to me is make me apathetic and lethargic. I just want to lie down and do nothing all day. Even Prozac makes me lethargic.
>
> I don't know what else to try. I was thinking of a Tricyclic but I really don't want the nasty anticholinergic side effects. I don't want to try any MAOIs due to the diet restrictions.
>
> Anyone else found SSRIs to cause apathy and lethargy? What did you switch to?
>
> Thanks!
>
>I would take the SSRI you like the most & then try Desipramine, Wellbutrin or amphetamine with it.
Cheers,
Panda.
Posted by harryp on May 4, 2004, at 15:09:51
In reply to SSRI substitute, posted by jms600 on May 2, 2004, at 16:12:21
There's some good advice here. You implied that the SSRI's were working for you, so my feeling is that you should just try adding a stimulant. Adding a tricyclic would make more sense if you were still depressed.
You might want to try phasing out the SSRI in favor of a serotonergic TCA like protriptyline. Desipramine probably has the best SE profile of the TCA's, but it has no effect on serotonin, and the fact that the SSRI's work for you suggests that you should stick with an AD that has some serotonergic effect. Keep in mind that some people have hellish SE's on the SSRI's and no problem on the TCA's--published SE profiles are just averages, and you might experience few problems with a TCA.
This is the end of the thread.
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