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Re: wash-out before maoi King Vultan

Posted by Sad Panda on May 23, 2004, at 1:33:07

In reply to Re: wash-out before maoi Sad Panda, posted by King Vultan on May 22, 2004, at 11:35:33

>
>
> >
> > Hi Todd,
> >
> > What sort of bad rections did you have to trazodone & nortriptyline? I am against the atypical AP for sleep for unipolar people, but they may be a good option for bipolar people needing sleep & mood stabization.
> >
> > Cheers,
> > Panda.
> >
>
> I found nortriptyline dreadfully sedating, and it also had a dual depressant/antidepressant action. I would go down in the dumps at first on a dosage increase, but then my spirits would gradually rise. Trazodone was a pure depressant for me and made me feel so depressed and out of sorts the next day after taking it that I dumped it after just a few days.
>
> I'm not sure what's going on with these drugs, but because I get such an immediate and positive response from SSRI type drugs (in as little as four hours with 25-50 mg Zoloft in a depressed and recently unmedicated state), perhaps my system is just geared more for this kind of drug than these atypical antidepressants. Nortripyline, at least, is a selective norepinephrine reuptake inhibitor, on top of the other things it does, and I'm convinced this is the only reason it had any antidepressant efficacy. Trazodone has very little direct effect on either serotonin or norepinephrine reuptake. I expect I would also react very badly to Serzone, which has a very similar pharmacology.
>
> Todd
>
>

Trazodone, Serzone & Nortriptyline are all 5-HT2A & Alpha-1 NE blockers, I'd be interested to know which receptor blockade causes you grief. A Remeron trial could be revealing, it stands out from the other sedating AD's because it doesn't block Alpha-1 NE.

Have you tried the other antihistamine for sleep like Phenergan & Polaramine? Phenergan might be bad, I think it would hit a bunch of receptors.

Cheers,
Panda.


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URL: http://www.dr-bob.org/babble/20040521/msgs/349817.html