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Re: Insomnia, Vivid dreams, reboxetine & efexor

Posted by Elizabeth on March 24, 1999, at 14:17:23

In reply to Re: Insomnia, Vivid dreams, reboxetine & efexor, posted by nick on March 21, 1999, at 15:11:27

> Many thanks for taking the time to help me out. I'd actually taken the plunge this week & started clonidine 0.1 mg in a patient with A/D induced sleep disturbance and a patient with PTSD (markedly intrusive symptoms, rather than avoidant)

Hey, sure! I hope it works out.

>Unfortunately, psychopharmacology is not taught in any structured way beyond a very basic level in the UK even to specialists, and I am always keen to learn new strategies.

That seems to be the way a lot of it is done here (U.S.) as well - the exchange of anecdotes! Pretty scary, I think. (Even as I sit here participating in it.)

> Lofepramine is a relatively NA specific MARI, with reduced antihistaminergic & anticholinergic potential in comparison with the older drugs. Its not very sedative.

That's too bad; I'd heard of it as a "kinder, gentler" tricyclic and thought it might offer some help here.

>I accept your point about tricyclics as adjunctive medication but that seems culturally foreign to me, as they are regarded as a 'bad thing'.

They're not used so much here anymore, either, but recently the combination of SSRI (usually Prozac) + low-dose desipramine has gotten - uh, trendy :-) - if the SSRI by itself does not help enough.




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