Posted by Chloe on June 11, 2002, at 18:13:24
In reply to Re: Trimipramine= no sleep! (Ami vs. Dox vs. Trim) » Chloe, posted by fachad on June 11, 2002, at 16:42:16
> I've taken all three, and also have researched the pharmacological differences between these three. Each one has unique properties.
>
> The three parameters that accout for the way the drugs effect you are:
>
> Histamine blockade (sedation, increased appetite)
>
> Cholenergic blockade (dry mouth, consitpation, etc.)
>
> Re-uptake of NE and 5HT.
>
> Ami is the most potent at cholenergic blockade. At the same doses, it causes much more dry mouth and constipation than Dox or Trimip. Also, there is a withdrawl symptom from "cholenergic rebound" that could explain why you felt bad subing trimip for ami.
>
> Doxepin is the most potent at Histamine blockade. At the same doses it is the most potent sedative. Trimip is very close to doxepin, slighty less H1 blockade than dox, but much more than ami.
>
> Trimp is nearly as potent as dox at H1 blockade, and should be much more sedating than ami. It is slightly more potent than dox at cholenergic blockade. The other unique things about trimp are lack of re-uptake of NE and 5HT, and very slight DA blockade
>
> Here are the numbers for the three on H1 and Ach blockade from one study I read:
>
> Drug------H1------Ach
>
> Ami-------91------5.1
> Dox------410------1.3
> Trim-----370------1.7
>
>
> So for me dox and trimp seem much stronger, but much cleaner for sleep. I would not underestimate the severity of the cholenergic rebound if switching from ami to one of the other two.
>Fachad,
that information is so helpful. But I am not sure why trimip's sedative effect did not allow me to sleep some...I had to resort to benzo's to sleep. But I do think I had the cholinergic rebound. I was sweating and peeing, etc like crazy. It was very uncomfortable. Really a withdrawal syndrome. I guess, or maybe I am just oversensitive???, that I should have stayed on the ami and added the trimip? Then gradually decrease the ami?However, Trimip is out for me. I have bad eps in my mouth, clenching, tongue wagging, it exacerbated some old td symptoms. :(
But I am really curious about doxepin. If it wouldn't be so drying. I have sores in my mouth that just won't go away. My mouth gets so dry when I sleep (so soundly!) that my gums, lips never heal up. But maybe the H1 in doxepin would also cause drying? You said the H1 causes weight gain. Did you experience this? And if you know, how strong is the NE reuptake compared to ami? I think that is the component in ami that makes me incredibly grouchy and short fused. I get nasty really fast, no warning. It's awful. That's why I had high hopes for trimip. And for those two day+ on trimip, my mood was exceptionally even with an long fuse.
Hope you don't mind all the questions. I just want to have as much info as possible before I ask my pdoc about doxepin. I only have such a short time to talk to her, I have to be totally prepared.
Thanks again, your researched info is so appreciated. Have you found the "right" dose of trimip for you yet? I know 25 is too much still, right?
Chloe
poster:Chloe
thread:108844
URL: http://www.dr-bob.org/babble/20020609/msgs/109516.html