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Re: Surmontil/trimipramine for sleep, ibs yeltom

Posted by Larry Hoover on July 20, 2004, at 16:58:00

In reply to Surmontil/trimipramine for sleep, ibs King Vultan, posted by yeltom on July 20, 2004, at 16:08:26

> Surmontil/trimipramine looks interesting. Seems to work primarily on norepinephrine, like desipramine, so it would theoretically be good to augment/balance an ssri.

I'm taking it right now, with Zoloft.

> But unlike desipramine, it's sedating. Yet it has a relatively short half-life, so it might give less of a hangover than amitriptyline. And instead of inhibiting REM sleep, like most antidepressants, it appears to increase it, which might be good, especially since celexa inhibits it. Does this reasoning make sense? I wonder why it's particularly good for gastrointestinal problems? Anyone have any experience with this?

Trimipramine was found to be useful in the treatment of IBS, over twenty years ago, particularly the type not including constipation. I'm not sure why, though. Here's a blurb on the sleep effects:

Eur Arch Psychiatry Clin Neurosci. 1996;246(5):235-9.

Trimipramine: a challenge to current concepts on antidepressives.

Berger M, Gastpar M.

Klinikum, Albert-Ludwigs-Universitat, Freiburg, Germany.

Although it is chemically a classical tricyclic antidepressant agent, trimipramine shows atypical pharmacological properties. Its well-documented antidepressant action cannot be explained by noradrenaline or serotonin reuptake inhibition or by a down-regulation of beta-adrenoceptors. Furthermore, its receptor affinity profile resembles more that of clozapine, a neuroleptic drug, than that of tricyclic antidepressants. Trimipramine does not reduce, but rather increases, rapid eye movement sleep. It stimulates nocturnal prolactin secretion and inhibits nocturnal cortisol secretion and may act at the level of the hypothalamus on corticotropin-releasing hormone secretion. Trimipramine is of particular value in depressed patients with insomnia, and it has been shown to be effective in the therapy of primary insomnia. As the pharmacological profile indicates, and an open clinical study has shown, trimipramine might also be active as an antipsychotic. The drug is both a tool for increasing our understanding of depression and a potential therapy for several psychiatric disorders.

Lar

 

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poster:Larry Hoover thread:367805
URL: http://www.dr-bob.org/babble/20040719/msgs/368346.html