Posted by jujube on December 10, 2004, at 11:07:23
In reply to jujube or others - TCAs, provigil-Pdoc TODAY! PLZ., posted by becksA on December 10, 2004, at 8:36:16
The TCAs are the older generation antidepressants, and most of them work on both serotonin and norepinephrine. I am a real novice at this stuff, but as I understand it, they tend to be better for adhedonic, anxious depressions than the SSRIs and even SNRIs like Effexor. The side effects can be more bothersome than those associate with the SSRIs and SNRIs, including dizziness (particularly when standing up), dry mouth, constipation, and a few others. If you have adhedonic, anxious depression, you might want to discuss Tofranil, Anafranil (which is also supposed to be excellent for OCD) and Pamelor (nortripyline)(is a bit more activating, but apparently has both antidepressant and anxiolytic properties) with your doctor. If you are prone to anxiety, you will probably want to stay away from Desipramine I think. I am currently using Anafranil, and at 50 mg, the side effects have been minimal. I will be going up to 75 mg in the next few days. The effect has been pretty good so far, even at such a low dose.
Provigil is neither a SSRI nor a SNRI. It is a type of stimulant, but has a chemical make-up different than traditional stimulants. Here is a little bit of info on Provigil:
Provigil etc. (Modafinil) is a unique wake-promoting agent that is chemically distinct from traditional stimulants. Officially an Alpha1-adrenergic agonist medication (also known as an "eugeroic" drug), Modafinil was approved in 1998 (U.S. FDA) for the treatment of excessive daytime sleepiness associated with narcolepsy. A small number of clinical trials have also suggested that Modafinil also has memory-improving and mood-brightening effects. For these reasons it is now being used to augment treatment in depression patients who have had only a partial response to antidepressant therapy. Similarly, Modafinil has also found a number of other potential uses like reducing fatigue and cognitive problems commonly found in health conditions like Multiple Sclerosis, Chronic Fatigue Syndrome etc..
Modafinil appears to be well-tolerated and to be free of side-effects like agitation, irritability, nervousness, euphoria or the potential for paranoid delusion and addiction that are common to other stimulants like amphetamines or cocaine. This may be because Modafinil targets very specific regions of the brain believed to regulate normal wakefulness, like the the neurotransmitter dopamine. As Modafinil has a fairly long half life of approximately 15 hours (the amount of time before half of the drug's peak plasma level is eliminated by the body), it can be taken once-daily - usually in the morning to avoid impacting night-time sleep.
Hope the above information is helpful. As I mentioned, I am no expert on this stuff, but have been doing some research because of my own depression in the past month or so.Good luck to you.
Tamara
> Morning,
> I read an earlier reply to one of my posts suggesting I try a TCA, or ask my pdoc about it. I have not tried one as far as I know, at least none that you mentioned. Tofrinil rings a bell, but it would have been a long time ago when I was just a kid and I didn't have the same symptoms at all. How are they different?
>
> Secondly, how is provigil different from SSRI's and SNRI's? As you may know I'm taking lamictal in hopes of helping my BP2 depression, which seems to be taking some effect, which would be nice because I think a lot of the anxiety stems from that depression.
>
> Thanks for the help.
poster:jujube
thread:427138
URL: http://www.dr-bob.org/babble/20041206/msgs/427199.html