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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by nephron on May 11, 2004, at 17:26:42
After pushing and pushing his psychiatrist, my friend managed to convince him to take him off the lithium and valproate, and try out some tricyclics.
However, the only tricyclic the psych was willing to try was dothiepin *sigh* after all the bad reviews I've heard... Still, it's an actual *chance* for things to get better. He was about as happy as I've seen him in 6 months or so last night- although I think that may have more to do with getting incredibly confused after taking the first dose- looked like everything was rather amusing to him.
Oh well, here's hoping to a good outcome- or at least some lifting of the depression.
Thanks for all your help!
Posted by finelinebob on May 11, 2004, at 21:18:55
In reply to Friend- started tricyclics, posted by nephron on May 11, 2004, at 17:26:42
nephron! it's good to hear from you again and to see that some progress has been made, at least in getting your friend's pdoc to consider other possibilities.
Sad Panda --
On that "First TCA to try" thread you sounded like you knew a lot more than the average bear about TCA differences. Just curious -- do you know any reason why the pdoc might pick dothiepin? nephron wrote this about the friend's dx in a different thread: "He was diagnosed bipolar a year or so ago, but that diagnosis has been changed to dysthymia with episodes of major depression."cheers,
flb
Posted by Sad Panda on May 12, 2004, at 8:53:58
In reply to Re: Friend- started tricyclics -- HEY PANDA!!, posted by finelinebob on May 11, 2004, at 21:18:55
> On that "First TCA to try" thread you sounded like you knew a lot more than the average bear about TCA differences. Just curious -- do you know any reason why the pdoc might pick dothiepin?
>
>Hi FLB,
My guess is he is in the UK or possibly Australia. Dothiepin was Britan's most popular TCA & I am guessing that it's because of politics or marketing. Amitriptyline was the USA's prefered TCA probably for the same reason. Clomipramine is the best TCA overall, but it's a French invention & we wouldn't want to attribute anything good to the French now would we? :) Imipramine, the original TCA & Clomipramine were both French discoveries as was Chlorpromazine, the original AP. Clomipramine was found to treat OCD by the French in about 1966, but was rejected by English speaking countries because it was said to be a 'me too' drug. We didn't get it here in Australia until 1983, isn't it marvelous how politics is more important that mental health. :/
Cheers,
Panda.
Posted by finelinebob on May 12, 2004, at 9:43:42
In reply to Re: Friend- started tricyclics -- HEY PANDA!!, posted by Sad Panda on May 12, 2004, at 8:53:58
> > ...do you know any reason why the pdoc might pick dothiepin?
> My guess is he is in the UK or possibly Australia. Dothiepin was Britan's most popular TCA & I am guessing that it's because of politics or marketing.We have a winner, folks. nephron and her friend are in Australia. Panda, for guessing correctly you win ... a free subscription to Babble!
> Clomipramine is the best TCA overall, but it's a French invention & we wouldn't want to attribute anything good to the French now would we? :)Well, considering the high regard they hold for the genius of Jerry Lewis, clomipramine might be a little ***too*** effective.
> isn't it marvelous how politics is more important that mental health. :/Oil and water. It isn't water's fault that oil doesn't play well with others....
HEY NEPHRON!
"Having patience" and "keeping an open mind" are two virtues difficult to keep in your friend's situation, but giving dothiepin a fair trial would probably be a Good Thing (tm) overall, given his pdoc's hesitance to try something new in the first place and the possiblity that it might actually work (imagine that!). If it doesn't, tho, it was mentioned on a different thread that nortriptyline and desipramine are good TCAs to start with. Ammunition for a month from now or so. It might be helpful for your friend to keep a meds journal right now, recording how much he's taking, how he's feeling and noting any changes. He can use that to document his progress or lack thereof and, should a change be needed, he's got data for his pdoc to evaluate.
Posted by Sad Panda on May 12, 2004, at 10:31:38
In reply to DING DING DING DING DING » Sad Panda, posted by finelinebob on May 12, 2004, at 9:43:42
> > > ...do you know any reason why the pdoc might pick dothiepin?
> > My guess is he is in the UK or possibly Australia. Dothiepin was Britan's most popular TCA & I am guessing that it's because of politics or marketing.
>
> We have a winner, folks. nephron and her friend are in Australia. Panda, for guessing correctly you win ... a free subscription to Babble!
>
>
> > Clomipramine is the best TCA overall, but it's a French invention & we wouldn't want to attribute anything good to the French now would we? :)
>
> Well, considering the high regard they hold for the genius of Jerry Lewis, clomipramine might be a little ***too*** effective.
>
>
> > isn't it marvelous how politics is more important that mental health. :/
>
> Oil and water. It isn't water's fault that oil doesn't play well with others....
>
>
> HEY NEPHRON!
> "Having patience" and "keeping an open mind" are two virtues difficult to keep in your friend's situation, but giving dothiepin a fair trial would probably be a Good Thing (tm) overall, given his pdoc's hesitance to try something new in the first place and the possiblity that it might actually work (imagine that!). If it doesn't, tho, it was mentioned on a different thread that nortriptyline and desipramine are good TCAs to start with. Ammunition for a month from now or so. It might be helpful for your friend to keep a meds journal right now, recording how much he's taking, how he's feeling and noting any changes. He can use that to document his progress or lack thereof and, should a change be needed, he's got data for his pdoc to evaluate.
>
>Here is the list of subsidised drugs we get here: http://www1.health.gov.au/pbs/scripts/dispther.cfm?lvl3id=240426&sched=GA&lvl3name=Antidepressants&lvl2name=Psychoanaleptics&lvl1name=Nervous%20system
I'd probably try Imipramine due to it's lower side effects or Clomipramine due to it's efficacy.
> Well, considering the high regard they hold for the genius of Jerry Lewis
>Have you heard Wierd Al's Genius in France song? :)
Cheers,
Panda.
Posted by chemist on May 12, 2004, at 12:41:44
In reply to DING DING DING DING DING » Sad Panda, posted by finelinebob on May 12, 2004, at 9:43:42
no, no, you don't have to give this one to the french: clomipramine was born out of a collaboration between researchers at Temple University (Philadelphia, PA) and Smith, Kline, and French, which was established by John Smith in Philadelphia, PA in the US in 1830. Kline was also from Philadelphia, and French entered the picture when Smith, Kline, and Co. acquired French, Richards, and Co. in 1891. The rest of history involves involvement many mergers/acquisitions in England with Burroughs, Glaxo, and Wellcome being major players. sorry, but thank Paul Craig, Bruce Lester, Andrew Saggiomo, Carl Kaiser, and Charles Zirkle for this one....and i will continue to thank Air France for their timely schedules, courteous service, and tight security....all the best, chemist
> > > ...do you know any reason why the pdoc might pick dothiepin?
> > My guess is he is in the UK or possibly Australia. Dothiepin was Britan's most popular TCA & I am guessing that it's because of politics or marketing.
>
> We have a winner, folks. nephron and her friend are in Australia. Panda, for guessing correctly you win ... a free subscription to Babble!
>
>
> > Clomipramine is the best TCA overall, but it's a French invention & we wouldn't want to attribute anything good to the French now would we? :)
>
> Well, considering the high regard they hold for the genius of Jerry Lewis, clomipramine might be a little ***too*** effective.
>
>
> > isn't it marvelous how politics is more important that mental health. :/
>
> Oil and water. It isn't water's fault that oil doesn't play well with others....
>
>
> HEY NEPHRON!
> "Having patience" and "keeping an open mind" are two virtues difficult to keep in your friend's situation, but giving dothiepin a fair trial would probably be a Good Thing (tm) overall, given his pdoc's hesitance to try something new in the first place and the possiblity that it might actually work (imagine that!). If it doesn't, tho, it was mentioned on a different thread that nortriptyline and desipramine are good TCAs to start with. Ammunition for a month from now or so. It might be helpful for your friend to keep a meds journal right now, recording how much he's taking, how he's feeling and noting any changes. He can use that to document his progress or lack thereof and, should a change be needed, he's got data for his pdoc to evaluate.
Posted by Sad Panda on May 12, 2004, at 13:24:14
In reply to Re: DING DING DING DING DING » finelinebob, posted by chemist on May 12, 2004, at 12:41:44
> no, no, you don't have to give this one to the french: clomipramine was born out of a collaboration between researchers at Temple University (Philadelphia, PA) and Smith, Kline, and French, which was established by John Smith in Philadelphia, PA in the US in 1830. Kline was also from Philadelphia, and French entered the picture when Smith, Kline, and Co. acquired French, Richards, and Co. in 1891. The rest of history involves involvement many mergers/acquisitions in England with Burroughs, Glaxo, and Wellcome being major players. sorry, but thank Paul Craig, Bruce Lester, Andrew Saggiomo, Carl Kaiser, and Charles Zirkle for this one....and i will continue to thank Air France for their timely schedules, courteous service, and tight security....all the best, chemist
>
>Are you sure clomipramine didn't come from Ciba-Geigy?
Cheers,
Panda.
Posted by chemist on May 12, 2004, at 13:32:02
In reply to Re: DING DING DING DING DING » chemist, posted by Sad Panda on May 12, 2004, at 13:24:14
> > no, no, you don't have to give this one to the french: clomipramine was born out of a collaboration between researchers at Temple University (Philadelphia, PA) and Smith, Kline, and French, which was established by John Smith in Philadelphia, PA in the US in 1830. Kline was also from Philadelphia, and French entered the picture when Smith, Kline, and Co. acquired French, Richards, and Co. in 1891. The rest of history involves involvement many mergers/acquisitions in England with Burroughs, Glaxo, and Wellcome being major players. sorry, but thank Paul Craig, Bruce Lester, Andrew Saggiomo, Carl Kaiser, and Charles Zirkle for this one....and i will continue to thank Air France for their timely schedules, courteous service, and tight security....all the best, chemist
> >
> >
>
> Are you sure clomipramine didn't come from Ciba-Geigy?
>
> Cheers,
> Panda.
>
geigy patented it in switzerland in 1963 and in the us in 1969. the original synthesis is in the craig et al. paper and was a collaboration between smith, kline, and french laboratories and temple university researchers in philadelphia, pennsylvania, usa. all the best, chemist
Posted by Sad Panda on May 12, 2004, at 13:44:24
In reply to Re: DING DING DING DING DING » Sad Panda, posted by chemist on May 12, 2004, at 13:32:02
> > > no, no, you don't have to give this one to the french: clomipramine was born out of a collaboration between researchers at Temple University (Philadelphia, PA) and Smith, Kline, and French, which was established by John Smith in Philadelphia, PA in the US in 1830. Kline was also from Philadelphia, and French entered the picture when Smith, Kline, and Co. acquired French, Richards, and Co. in 1891. The rest of history involves involvement many mergers/acquisitions in England with Burroughs, Glaxo, and Wellcome being major players. sorry, but thank Paul Craig, Bruce Lester, Andrew Saggiomo, Carl Kaiser, and Charles Zirkle for this one....and i will continue to thank Air France for their timely schedules, courteous service, and tight security....all the best, chemist
> > >
> > >
> >
> > Are you sure clomipramine didn't come from Ciba-Geigy?
> >
> > Cheers,
> > Panda.
> >
> geigy patented it in switzerland in 1963 and in the us in 1969. the original synthesis is in the craig et al. paper and was a collaboration between smith, kline, and french laboratories and temple university researchers in philadelphia, pennsylvania, usa. all the best, chemist
>Thats bizarre, how long before it hit the market in the USA?
Cheers,
Panda.
Posted by chemist on May 12, 2004, at 14:19:01
In reply to Re: DING DING DING DING DING » chemist, posted by Sad Panda on May 12, 2004, at 13:44:24
> > > > no, no, you don't have to give this one to the french: clomipramine was born out of a collaboration between researchers at Temple University (Philadelphia, PA) and Smith, Kline, and French, which was established by John Smith in Philadelphia, PA in the US in 1830. Kline was also from Philadelphia, and French entered the picture when Smith, Kline, and Co. acquired French, Richards, and Co. in 1891. The rest of history involves involvement many mergers/acquisitions in England with Burroughs, Glaxo, and Wellcome being major players. sorry, but thank Paul Craig, Bruce Lester, Andrew Saggiomo, Carl Kaiser, and Charles Zirkle for this one....and i will continue to thank Air France for their timely schedules, courteous service, and tight security....all the best, chemist
> > > >
> > > >
> > >
> > > Are you sure clomipramine didn't come from Ciba-Geigy?
> > >
> > > Cheers,
> > > Panda.
> > >
> > geigy patented it in switzerland in 1963 and in the us in 1969. the original synthesis is in the craig et al. paper and was a collaboration between smith, kline, and french laboratories and temple university researchers in philadelphia, pennsylvania, usa. all the best, chemist
> >
>
> Thats bizarre, how long before it hit the market in the USA?
>
> Cheers,
> Panda.
>can't say....the earliest generic application i found was 1989, and this is in agreement with the 20-year patent expiring after filing in 1969 in the u.s....could be any time in-between, or maybe it was not approved until 1989, which i doubt, so my best guess is mid- to late-1970s, and recall that the patent was to Geigy, NOT Ciba-Geigy, which was the result of the merger of Ciba and Geigy in 1970. of course the patent gets transferred, but as to who marketed it in the u.s., and under what name, i haven't the faintest...i know sandoz was involved in the mid-1970s, but to what extent, i do not know (until all of the above came under Novartis in 1995 or 1996, if i recall, mayber 1994?)....i am almost sure it was sold as Anafranil, but can't seem to find anything earlier than 1989 (Tyco)...perhaps some better-informed arm-chair historians than i can assist???? all the best, chemist
>
>
Posted by finelinebob on May 12, 2004, at 15:47:47
In reply to DING DING DING DING DING » Sad Panda, posted by finelinebob on May 12, 2004, at 9:43:42
Just to make sure this is clear, Sad Panda gets the free subscription to Babble for correctly identifying the location of nephron.
Whether or not clonipramine started in France, Weird Al has it nailed.
nephron -- in case you missed this a few DINGs back, there was actually some info in there for you from me and Panda, respectively:
> HEY NEPHRON!
> "Having patience" and "keeping an open mind" are two virtues difficult to keep in your friend's situation, but giving dothiepin a fair trial would probably be a Good Thing (tm) overall, given his pdoc's hesitance to try something new in the first place and the possiblity that it might actually work (imagine that!). If it doesn't, tho, it was mentioned on a different thread that nortriptyline and desipramine are good TCAs to start with. Ammunition for a month from now or so. It might be helpful for your friend to keep a meds journal right now, recording how much he's taking, how he's feeling and noting any changes. He can use that to document his progress or lack thereof and, should a change be needed, he's got data for his pdoc to evaluate.---
and
---> Here is the list of subsidised drugs we get here: http://www1.health.gov.au/pbs/scripts/dispther.cfm?lvl3id=240426&sched=GA&lvl3name=Antidepressants&lvl2name=Psychoanaleptics&lvl1name=Nervous%20system
> I'd probably try Imipramine due to it's lower side effects or Clomipramine due to it's efficacy.
Good on you, again for following up for your friend =^)
flb
Posted by nephron on May 12, 2004, at 17:39:21
In reply to Re: Ding-a-lings and info for NEPHRON, posted by finelinebob on May 12, 2004, at 15:47:47
Well, he's only taken 2 doses but not so good so far- been really really sedated all day, making it really hard to go to work.
He's also got some new nasty nightmares- do you have any idea if those could be at all related?
Thanks,
Sarah
Posted by Sad Panda on May 13, 2004, at 4:46:59
In reply to Re: DING DING DING DING DING » Sad Panda, posted by chemist on May 12, 2004, at 14:19:01
> > > > > no, no, you don't have to give this one to the french: clomipramine was born out of a collaboration between researchers at Temple University (Philadelphia, PA) and Smith, Kline, and French, which was established by John Smith in Philadelphia, PA in the US in 1830. Kline was also from Philadelphia, and French entered the picture when Smith, Kline, and Co. acquired French, Richards, and Co. in 1891. The rest of history involves involvement many mergers/acquisitions in England with Burroughs, Glaxo, and Wellcome being major players. sorry, but thank Paul Craig, Bruce Lester, Andrew Saggiomo, Carl Kaiser, and Charles Zirkle for this one....and i will continue to thank Air France for their timely schedules, courteous service, and tight security....all the best, chemist
> > > > >
> > > > >
> > > >
> > > > Are you sure clomipramine didn't come from Ciba-Geigy?
> > > >
> > > > Cheers,
> > > > Panda.
> > > >
> > > geigy patented it in switzerland in 1963 and in the us in 1969. the original synthesis is in the craig et al. paper and was a collaboration between smith, kline, and french laboratories and temple university researchers in philadelphia, pennsylvania, usa. all the best, chemist
> > >
> >
> > Thats bizarre, how long before it hit the market in the USA?
> >
> > Cheers,
> > Panda.
> >
>
> can't say....the earliest generic application i found was 1989, and this is in agreement with the 20-year patent expiring after filing in 1969 in the u.s....could be any time in-between, or maybe it was not approved until 1989, which i doubt, so my best guess is mid- to late-1970s, and recall that the patent was to Geigy, NOT Ciba-Geigy, which was the result of the merger of Ciba and Geigy in 1970. of course the patent gets transferred, but as to who marketed it in the u.s., and under what name, i haven't the faintest...i know sandoz was involved in the mid-1970s, but to what extent, i do not know (until all of the above came under Novartis in 1995 or 1996, if i recall, mayber 1994?)....i am almost sure it was sold as Anafranil, but can't seem to find anything earlier than 1989 (Tyco)...perhaps some better-informed arm-chair historians than i can assist???? all the best, chemist
> >
> >
>
According to the FDA is was approved December 29 1989 as Anafranil for OCD by Ciba-Geigy. That's pretty stunning that it was brewed up in the USA, found to be a great drug by French psychiatrists & then it takes 20+ years to get used in the USA. It makes a mockery of all the tests that indicate that SSRI's are better than TCA's when the best TCA was rarely used. Here in Australia it's still not indicated for depression, only for "cataplexy associated with narcolepsy, OCD & phobic disorders in adults."Cheers,
Panda.
Posted by chemist on May 13, 2004, at 12:59:39
In reply to Re: DING DING DING DING DING » chemist, posted by Sad Panda on May 13, 2004, at 4:46:59
> > > > > > no, no, you don't have to give this one to the french: clomipramine was born out of a collaboration between researchers at Temple University (Philadelphia, PA) and Smith, Kline, and French, which was established by John Smith in Philadelphia, PA in the US in 1830. Kline was also from Philadelphia, and French entered the picture when Smith, Kline, and Co. acquired French, Richards, and Co. in 1891. The rest of history involves involvement many mergers/acquisitions in England with Burroughs, Glaxo, and Wellcome being major players. sorry, but thank Paul Craig, Bruce Lester, Andrew Saggiomo, Carl Kaiser, and Charles Zirkle for this one....and i will continue to thank Air France for their timely schedules, courteous service, and tight security....all the best, chemist
> > > > > >
> > > > > >
> > > > >
> > > > > Are you sure clomipramine didn't come from Ciba-Geigy?
> > > > >
> > > > > Cheers,
> > > > > Panda.
> > > > >
> > > > geigy patented it in switzerland in 1963 and in the us in 1969. the original synthesis is in the craig et al. paper and was a collaboration between smith, kline, and french laboratories and temple university researchers in philadelphia, pennsylvania, usa. all the best, chemist
> > > >
> > >
> > > Thats bizarre, how long before it hit the market in the USA?
> > >
> > > Cheers,
> > > Panda.
> > >
> >
> > can't say....the earliest generic application i found was 1989, and this is in agreement with the 20-year patent expiring after filing in 1969 in the u.s....could be any time in-between, or maybe it was not approved until 1989, which i doubt, so my best guess is mid- to late-1970s, and recall that the patent was to Geigy, NOT Ciba-Geigy, which was the result of the merger of Ciba and Geigy in 1970. of course the patent gets transferred, but as to who marketed it in the u.s., and under what name, i haven't the faintest...i know sandoz was involved in the mid-1970s, but to what extent, i do not know (until all of the above came under Novartis in 1995 or 1996, if i recall, mayber 1994?)....i am almost sure it was sold as Anafranil, but can't seem to find anything earlier than 1989 (Tyco)...perhaps some better-informed arm-chair historians than i can assist???? all the best, chemist
> > >
> > >
> >
>
>
> According to the FDA is was approved December 29 1989 as Anafranil for OCD by Ciba-Geigy. That's pretty stunning that it was brewed up in the USA, found to be a great drug by French psychiatrists & then it takes 20+ years to get used in the USA. It makes a mockery of all the tests that indicate that SSRI's are better than TCA's when the best TCA was rarely used. Here in Australia it's still not indicated for depression, only for "cataplexy associated with narcolepsy, OCD & phobic disorders in adults."
>
> Cheers,
> Panda.
>well, welcome to the land of red tape and the FDA...thanks for the final salvo in re: history of anafadil...all the best, chemist
This is the end of the thread.
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