Posted by ed_uk on May 2, 2006, at 14:44:17
In reply to Re: low-dose desipramine » ed_uk, posted by circusboy on May 2, 2006, at 7:55:29
As far as I know, atomoxetine (Strattera) was originally developed as an antidepressant but clinical trials did not demonstrate efficacy.
>Maybe going down to 10mg would've helped, but I'm skeptical. At 25mg I felt little except dry mouth, constipation, and poor sleep...none of the mitigating positive effects that made me stick with the drug for two months before giving up.
I doubt 10mg would be enough. The 10mg tablets might be useful in helping you find the minimum effective dose though, whatever that may be eg. 40mg.
The side effects which you experienced on desipramine were probably not true anticholinergic side effects. Desipramine acts mainly as a potent NE reuptake inhibitor. It's anticholinergic properties are relatively weak. Unfortunately, NE reuptake inhibition produces very similar side effects to anticholinergic drugs eg. constipation, dry mouth etc. These symptoms are sometimes called pseudo-anticholinergic side effects.
I think you might be able to overcome the side effects of desipramine with additional medication. I know it's not a particularly attractive prospect, but it may be worthwhile. You could try zolpidem (Ambien) for insomnia and MiraLax (or another laxative) for constipation. Sugar-free chewing gum is good for a dry mouth. Various sprays and pastilles are also available.
I wonder how reboxetine would work for you. Reboxetine is a NE reuptake inhibitor which is approved as an antidepressant in most countries apart from the US. If you live in the US, you might be able to import it.