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Re: SLS, r u here?

Posted by SLS on February 3, 2007, at 6:27:38

In reply to SLS, r u here?, posted by UgottaHaveHope on February 3, 2007, at 1:39:58

Hi UGHH.

> Scott, right now I am on week four of an Emsam trial. Emsam definitely gives me a little boost of extra energy,

Most people report this phenomenon, but more often than not, don't seem to glean a true antidepressant response.

> but I am not sure if that is a good thing with anxiety as my primary issue.

Interestingly, many people have seen an anxiolytic effect early in treatment with Emsam. However, I am not sure how long it persists.

> Have you taken Emsam?

Yes. But for less than a week. I thought it was producing dysphoria. However, it could very well have been the after-effects of being on Lyrica.

If so, what did you notice as the difference between Emsam and Nardil?

Unfortunately, I really can't answer that question.

If you didn't take it, what would predict is the difference? I know you know these meds, and could predict.

I think Nardil would produce a greater and more persistent anxiolytic effect for GAD and social anxiety with or without panic attacks. I also think that it is a more potent antidepressant.

> I once asked my doc about taking Imipramine. He's very aggressive with drugs, but said he didn't want to give me that one because it can cause heart problems.

Personally, I think there is too much drama associated with antidepressants these days. Imipramine used to be the gold standard of antidepressants, and cardiac function was almost never an issue.

> Are those other TCAs you mentioned safe to take?

But, yes, the two TCAs that represent the best margin of safety are nortriptyline and desipramine, and possibly trimipramine. I am aware of one case of a possible serotonin syndrome associated with the combination of Nardil + imipramine. Me. So, I am reluctant to recommend this treatment to anyone else. Nardil + nortriptyline seems to be safe so far.


> Thanks for all of your help!

No problem!

Take care.


- Scott

 

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