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Re: Saw pdoc - didn't go as I had hoped - scared » Sad Panda

Posted by KaraS on November 3, 2004, at 14:52:09

In reply to Re: Saw pdoc - didn't go as I had hoped - scared » jujube, posted by Sad Panda on November 3, 2004, at 10:41:49

> > I saw the pdoc yesterday. I am currently on 40 mg of Celexa, after not having any success with Paxil (2nd time); Prozac and Effexor.
> >
> > I raised the issue of a return to Paxil, which had been really effective for me in the past. He said there was no point in trying Paxil (since I didn't respond to it the second time late last year). I should have asked about Remeron, but I couldn't stop crying for most of the appointment.
> >
> > The issue of a TCA came up, and he thought that was the way to go. He said he was going prescribe Anafranil (25 mg to start). Having been a psychiatrist for about 40 years, he has a lot of experience with all types of meds, and he felt that Anafranil would be the most effective. I told him that a chart that I have shows that nortryptline has fewer side effects and maybe that would be better and not as sedating. He didn't think so, given his experience with Anafranil. He wants me reduce my dose of Celexa to 20 mg, and add the Anafranil. Should I be concerned about serotonin syndrome with this combination.
> >
> > I am scared! I want this andhedonic depression gone, but I don't want to be plagued with side effects. I haven't had much of life for a few months now (no energy, no interest, etc.), and it's starting to take its toll on me, my family and my friends. I want to go back to enjoying life again, including all the small pleasures. But, I don't want to be tired and walking around in a fog all the time. I mean, I couldn't even tolerate 25 mg of Trazadone. Am I setting myself up for weeks of side effect misery by starting the Anafranil? Is there a possibility that it could really help my depression and anxiety?
> >
> > I don't know what to do. Anyone have any advice or words of wisdom?
> >
> > Thanks, and sorry for the desperate plea.
> >
> > Tamara
> >
> >
>
> Hi Tamara,
>
> Anafranil is one of the best antidepressants of all time & is well worth trying. Serotonin syndrome is not a worry with Anafranil because it serves as it's own antidote via 5-HT2A antagonism. Nortriptyline is great when added on to a SSRI that is working, but isn't as good as Anafranil when used as monothearpy.
>
> Cheers,
> Paul.
>


Panda,

Why do you think it is that we don't hear more or talk more about Anafranil on this board if it is such an effective AD? Also, how would you compare it to maprotiline? (I have been considering trying maprotiline but am a bit worried about weight gain.)

K


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poster:KaraS thread:411041
URL: http://www.dr-bob.org/babble/20041103/msgs/411175.html