Posted by karaS on October 29, 2004, at 1:25:28
In reply to Re: Cymbalta and coffee? » karaS, posted by zeugma on October 28, 2004, at 18:32:11
> > >
> >
> > Hey z,
> >
> > Missed you these past few days!
>
> Same here. I've been wretchedly busy.Poor baby!
> > Re: Cymbalta, many people ARE finding it to be much cleaner than Effexor. I didn't have a good experience on Effexor until I took the XR version. Maybe it's not fair to compare the two until there's an XR version of Cymbalta.
>I read on the PI sheet that Cymbalta is enteric coated to provide timed release. Or at least I think I read that. In any case, it's the cymbalta currently available that needs to be evaluated for cleanliness, especially since we don't always have infinite time at our disposal in our evaluations of meds.
That's true and I do have the enteric coated capsules here rather than the pills.
> > I'm wondering if I shouldn't have tried a higher dose of Effexor. I tolerated it so well (as long as it was XR). Maybe I should have gone up to 300.
> I'm guessing you don't have a dr. you trust to discuss your concerns about increased blood pressure on the higher doses of Effexor. That's a shame, because it's a necessity. Your concerns about blood pressure are a real concern that any M.D. should be able to provide reliable advice about.
Actually I did run that by him many moons ago. He wasn't that concerned about the rise at that point but I was. I am such a coward. My blood pressure had gone from about 100 to 120 and I didn't want it to go over 120. Since I wasn't having much AD effect at 225 mg, I thought it wasn't worth the risk. However, if that last 75 mg. is much more noradrenergic, then I should have given it a try. It sure would have been nice to be able to have something work that you get so few side effects from. That's probably why I'm thinking about this now even though SE boosting is not the best way for me to go now. You are not a big fan of anything SSRI related, are you?
> > I'm curious why you suggested maprotiline. I used to take a small amount of it for years for sleep. I tolerated it well but I gained too much weight from it.
>
> I suggested maprotiline because it is the most NE-selective (relative to serotonin) reuptake inhibitor on the market that I'm aware of. It is also has less anticholinergic effects than desipramine, the least anticholinergic of the TCA's, according to the chart I am going by:
>
> http://www.primarypsychiatry.com/pdf/art_453.pdf
>
> (If you scroll down past the dull text you get to the useful info.) I seem to remember that you had tachycardia from desipramine and nortriptyline. That sounds like an anticholinergic s/e.
So it's the anticholinergic effects that cause the tachycardia? That would probably explain why some noradrenergics produce this effect and others don't. That always puzzled me.
I didn't see a chart on there that measured that. What am I not getting? That's a great source though, lots of information. Thanks.
> As for weight gain, that's because of MAP's potent H1 blockade, but if you are using it at doses higher than those needed for sleep, its NE reuptake inhibition might counteract the sleepiness and weight gain. At the very least, you might be less depressed. It's easier to lose weight in that condition. And a good night's sleep is not a useless commodity. >Once I adjusted to the small doses I took, 25 mg or 50 mg., I didn't have much daytime sleepiness... or did I? I'm trying to remember. Actually I think I did feel groggy in the AM. I realize now that I tend to feel that way in the morning anyway though so I don't know how much of that to attribute to the maprotiline. I also used to attribute all of my blurry morning vision to meds but recently I realized that I get that even when I don't take any medication.
I just remembered that I did try a therapeutic dosage of doxepin many, many years ago. It didn't help much. I wonder if maprotiline would be any different. I wonder if anything would be any different for that matter.
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> > Caffeine isn't an AD for me but it's sure the best drug I've ever taken for energy!
> >
> The Ritalin LA at 50 mg requires supplementation from caffeine. I can tell you that it seems much less stimulating than Provigil, and provides none of the 'jolting' effects of Strattera. It is doing something, though. Ask me in a week about it.OK, I will. Thank goodness for coffee! I've been lost without it on the Cymbalta. Hoping that the 50 Ritalin LA ends up working sufficiently for you.
I've toyed with the idea of using the Ritalin I have here for a sleeping pill. I doubt there's any harm in using it periodically (assuming it isn't contrainidicated with anything else I'm taking) but I wonder if there would be any harm in usuing it frequently. I don't need it now but when I get stressed out and can't sleep, it could come in very handy.Well, I know you're really busy and you must be very tired so I won't ask you any more questions for now.
Take care of yourself and try not to let all of the stress get to you.
K
poster:karaS
thread:406397
URL: http://www.dr-bob.org/babble/20041024/msgs/408643.html