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Re: Strattera for depression without ADD? SLS

Posted by zeugma on July 14, 2003, at 7:52:28

In reply to Re: Strattera for depression without ADD? zeugma, posted by SLS on July 13, 2003, at 14:42:01

> > Parnate and desipramine seems like it would be a very activating combination.
> It was very activating the first time I tried it. Of course, my system was closer to being in a virginal state than it is now. At the time, I had total insomnia and needed to take Ativan and Halcion for sleep. My REM was probably 100% suppressed, as I didn't dream at all. Unfortunately, this combination does not now affect the quality nor duration of sleep, and I dream all of the time. I believe this gives evidence as to how my nervous system has been changed by repeated exposure to various drugs and why so many drugs are no longer helpful to me.

Yes, I worry about that too. At this point, though, the period I spend dreaming is significantly less than when I was severely depressed and off meds. One reason I am so happy with the nortriptyline is that I simply cannot sleep normally without it. I also was very prone to getting REM-induced headaches which were another manifestation of the 'dissociated' wake and sleeping states. Those seemed to diminish around the time I started taking Buspar, and I haven't had an episode in a number of months. Have you ever tried Buspar? There is a theoretical possibility (due to its being metabolized to an alpha-2 adrenergic antagonist) of its potentiating a noradrenergic agent. I know that I was still feeling a lot of dysphoria at the time I added the Buspar, but my mood seemed to improve almost immediately after adding it.
> > Do you find Strattera activating (specifically in comparison to a TCA?)
> When I first started Strattera, it reminded me of how I feel whenever I begin a tricyclic. It is sort of like being slightly activated and sleepy at the same time. What I find encouraging is that the Strattera had this effect on me despite my already being on imipramine 300mg. Maybe it is doing more of what I need from the tricyclics. Who knows? You can't blame a guy for hoping.

I can't! I certainly hope it does help.

> As far as combining medications is concerned, I have had less trouble with side effects when using Parnate rather than Nardil in combination with tricyclics. With Parnate, I can use imipramine, desipramine, and nortriptyline without sequalae. However, combining imipramine or nortriptyline with Nardil produces serotonin syndrome, severe hypotension, and the inability to initiate urination. I have managed to combine successfully Nardil and desipramine, although I still have trouble with hypotension and urination.
I appreciate the info about tricyclic/ MAOI combinations. I have thought a lot about MAOI's lately, after realizing that I have avoidant personality disorder along with all the other syndromes. I plan to start cognitive/behavioral therapy for this problem and for the general phobias I suffer from, since I doubt whether MAOI's are an option for me at this point. I am going to see my pdoc this morning and I am going to report a lot of improvement on the depression and ADHD fronts, but less for the fearfulness around people and social inhibition. The generalized phobia seems to be going down,however. The combination of phobia and insomnia has always precipitated a slide into severe depression in the past, which is why I am so determined to find a solution for the phobias that remain (whether through meds or therapy)






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