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Re: Zeugma - some information, please Kacy

Posted by zeugma on October 22, 2003, at 20:52:30

In reply to Re: Zeugma - some information, please, posted by Kacy on October 22, 2003, at 19:23:03

> Thanks for the information. I appreciate it.
>
You're very welcome :)

> How long did it take you to get a response to despramine? Does desipramine work on different norepinephrine sites? Is it a re-uptake inhibitor?

Desipramine and nortriptyline are reuptake inhibitors. They also have some antagonisms of alpha-1 receptors, which can lower blood pressure (hence the common hypotension on TCA's). It's hard to say how long it took me to respond to nortriptyline (I never took desipramine). It was kind of slow. On the other hand, I made gradual but steady progress over a period of months (I was truly a wreck when I started on it last year).
>
> I went up to 225 mg. Effexor without any additional benefits. The side effects of a missed dose were too scary. It causes more sexual numbness too. Never got any NE-type response at all, at least not by measuring NE by Strattera and seeing no resemblance in the two drugs. In combination with Strattera, 75 mg. of Effexor works as well as 150 mg. Effexor without Strattera. That drug is for excessive ruminating and does the job well.
I think of drugs in the same way- if a drug is deoing it's job I don't want to ditch it without a DAMN good reason for doing so (like maybe it's killing me somehow!) It doesn't make sense to ditch something that's working welll in search of perfection that will probably never materialize. If 75 mg of Effexor is stopping a problem that is HIGHLY unpleasant for you (and it sounds like it really is!) then it's a good drug for you unless it's killing you some other way (doesn't sound like it is).

I don't know why he wants to trade it for desipramine. I don't want the ruminating to come back. Could NE take care of that? Strattera by itself most certainly did not.

It's interesting that Effexor and Strattera don't resemble each other subjectively for you. Nortriptyline and Strattera have some similarity, but the Strattera is much more activating for me. It's a good morning drug. No sedation at all.

>
> Do you mean to say that Effexor could make desipramine cause cardio problems? Could that be why he wants to trade Effexor off?

Desipramine can cause cardio problems on its own if the dose is too high or if its metabolism is inhibited by another drug (not Effexor particularily though). Maybe he knows something i don't, however.
>
> Strattera has been too sedating on the 100 mg. dose, so that's one of the problems. It's great in the morning, but it backfires in the afternoon. That problem went away at 80 mg. of Strattera as did some of the benefit. It won't go away at 100, so I'm leery of 120. The sedation does seem to be lessening some after five months, but so does the positive benefit. It doesn't help much with Add/inattentive issues but it does wonders for anxiety.

That's really interesting. What do you take for the inattention? It doesn't seem to have reduced my anxiety, but has worked wonders with my inattention- the exact reverse of your experience! No wonder psychopharmacolgy is an art, not a science.
>
> Splitting doses of Stratttera leaves no effect at all. I don't get anything from 60 mg. in the morning and 40 mg. at noon. It must just not be strong enough. I get zip-nada benefit when taking it in the evening. I wake up a little early but want to go back to bed an hour or two later. Unlike anyone else posting anywhere, I am getting only seven hours of response. It's been hard to convince my psychiatrist that it doesn't work 24 hours. Surprisingly, it's half-life is the same as Effexor's and Effexor does work 24 hours a day.
>

Effecor comes in an extended release formulation unlike Strattera. Strattera's half life is puzzling. I suppose in my case I benefit from nortriptyline's long half life.


> I absolutely don't need sedation. I'm way too sedate as it is, and none of the things that are supposed to be enervating or energizing give me any physical energizing effect. Some mental effect, though.

Well, then I would think desipramine would be a better TCA than nortriptyline for you. I wonder if your pdoc can give you a convincing reason for his choice of meds? The anti-ruminating effect of Effexor sounds like a serotonergetic effect to me which is backed up by Strattera's lack of effect on that problem. Desipramine is probably no better than Strattera in that regard. Then again, it has a longer half-life.
>
> Sorry about misspelling your name.

That's only ONE of my names :)

z
>
>


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Psycho-Babble Medication | Framed

poster:zeugma thread:269769
URL: http://www.dr-bob.org/babble/20031021/msgs/272068.html