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Re: TCA-Thorazine resemblances, and more Sad Panda

Posted by zeugma on May 29, 2004, at 8:49:24

In reply to Re: TCA-Thorazine resemblances, and more zeugma, posted by Sad Panda on May 29, 2004, at 0:31:22

The differences between desipramine & nortriptyline are similar to the differences between imipramine & amitriptyline. Imipiramine is a weak H1 & 5-HT2A blocker while amitriptyline is potent. Amitriptyline is also a milder SRI than imipramine & clomipramine & can be cautiously combined with MAOI's, although I can't imagine a benefit to this. I would think doxepin or nortriptyline would be the ideal TCA's for useage with MAOI's as both are 5-HT2A bloackers & NRI's with no real SRI activity.

Cheers,
Panda.>>>

Panda,

The idea was that AMI, IMI, or CMI combined with a stimulant would simulate an MAOI. I had wanted to switch to CMI because I had suffered a relapse of depression while on nortriptyline as my AD (there's also Strattera but that's another story) and I wanted to try CMI as lowering the dose of NOR made my sleep significantly worse, both in quantity and quality. That plan is in abeyance for now, as my pdoc put the NOR dosage back at 75 mg and plans to do another plasma level test on me after a month at that level again. The change this time is the elimination of buspirone 15 mg at night just before bed, with the goal, if that goes OK, of eliminating buspirone entirely (I now take 15 mg am). The previous goal was eliminating (his preference) or exchanging (my preference- for CMI) the NOR. As that worsened sleep, and didn't help with fatigue or depression, the NOR is going back up to where it was, and he says, depending on the plasma test, that I could go up to 100 mg.

Going back to NOR was my preference if CMI failed, as it definitely helps a LOT with sleep and I have LOTS of sleep problems (I would be fascinated I'm sure by the results of a sleep EEG, but I am short on funds and going to a sleep clinic is not an option currently). He is convinced that noradrenergic meds are the way to treat my depression, and now seems sure that serotonergetic meds would damage my sleep further. From what I've observed personally, and read about here, that is a justified assumption.


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URL: http://www.dr-bob.org/babble/20040527/msgs/351811.html