Posted by zeugma on January 20, 2003, at 16:57:18
In reply to Re: Older drugs vs. newer drugs..., posted by coral on January 20, 2003, at 12:20:46
> Tofranil (even at max dosages) was worthless for me, and Elavil caused a sense of rage. Zoloft worked like a charm.
>
> Xanax wraps me up in cotton batting but Librium does the trick.
>
> Go figure.I had increased irritability when I started nortriptyline too. Things I didn't like but had been prepared to tolerate because I felt so 'out of it' (really bad foggy feelings) suddenly caused me to act, which in the long run was a good thing(I'm glad I left a bad work situation), but was definitely unsettling at first. I assume this is due to increased NE levels. I'm really thankful I made the changes, I consider them the first signs the med was helping me, about a week into it; but I suppose if I had existing problems with irritability they could have been worsened intolerably.
What I'm curious about is 1) how TCA's and other older compare to SSRI's in terms of 'poop-out'(I'd guess they're less liable to this, for a number of reasons, but what research has been done on this topic?) and 2) whether they treat what are really different syndromes or illnesses. For example, I have severe ADD, and TCA's are considered a second-line treatment for this condition, but not SSRI's. Or we can think about the classic distinction between 'endogeneous' or 'melancholic' depression and atypical depression. I have read many studies for example that assert that melacholics are helped more by TCA's
and atypicals by MAOI's. One criticism I have is that this promising line of research seems to have been abandoned, as SSRI's have replaced both classes of drugs in all but the most refractory cases. I'll just state my personal opinion on SSRI's just to throw it out there. They seem to be really good at relieving acute symptoms of depression in a lot of people, but don't seem to help the 'core' problems; they seem to camouflage depression more than truly relieve it. I should add that I'm talking about people with chronic depression. I know some people who took Prozac for relatively brief periods who didn't have a history of more-or-less lifelong depression, and did just fine on it.
poster:zeugma
thread:136591
URL: http://www.dr-bob.org/babble/20030119/msgs/136776.html