Posted by zeugma on August 12, 2004, at 10:27:20
In reply to Somebody! I need advice fast!, posted by Ame Sans Vie on August 12, 2004, at 10:05:21
Hi Ame,
I'm no expert (and wary of the whole 'take this 'cause it worked for me' deal) but given these symptoms:
Currently, my panic attacks, avoidant behavior, social phobia, agoraphobia, performance anxiety, somatic manifestations of anxiety, insomnia, attention deficit disorder, mild obsessive-compulsive disorder and dysthymia are in complete remission. But that still leaves me with the ever so pleasant endogenous atypical reactive depression -- anhedonia (though that's improved about 40% with the Adderall), complete lack of motivation, hypersomnia, and fatigue. Luckily, the Adderall has stopped my binge-eating.>
I would say that your pdoc's recommedations of Wellbutrin XL, desipramine, or nortriptyline are in order, but given that your panic attacks and anxiety are in remission, I would go with the TCA's as they are also antipanic agents. Both desipramine and nortriptyline can be anxiogenic but to less degree, and in descending order of anxiogenicity, than Wellbutrin. Nortriptyline would also have an anti-insomnia effect, unlike desipramine. OTOH you mention binge-eating, and nortriptyline can have mixed effects in this regard, while desipramine is more likely to lower appetite.
None of these meds is likely to induce anhedonia, or worsen ADHD symptoms.
curious to see what others say.
-z
poster:zeugma
thread:376819
URL: http://www.dr-bob.org/babble/20040811/msgs/376830.html