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Re: Anyone using Tricyclics for Depression?

Posted by circusboy on November 16, 2007, at 12:38:01

In reply to Anyone using Tricyclics for Depression?, posted by clubfitter on November 11, 2007, at 14:14:52

I tried both desipramine and nortriptyline, in separate, back-to-back trials.

Desipramine was very good in terms of mood and motivation. Just what you might expect from a good noradrenergic drug. No real cognitive SEs to speak of. I did have some symptoms that could be described as anticholinergic (constipation, crazy urges to pee along with urinary retention), but I've also read on babble that those could be caused by extra norepinephrine as much as by muscarinic acetylcholine receptor antagonism. IIRC, I felt the positive effects within 2 weeks. On the other hand, it sort of flattened my creativity and sense of humor. That was not what I expected from an antidepressant, especially after nearly a decade on and off of SSRIs. Also -- and this was the kicker -- it made my heart pound irregularly, making it nearly impossible to fall asleep. I gave it a good try, even at a low dose, but never adjusted.

So. Desipramine: good if you can tolerate it.

Then I tried nortriptyline. Slept beautifully; very little constipation and urinary retention. However, I started to feel like I had early onset dementia. I could barely do my work -- I was overwhelmed by things I used to handle easily. My doctor briefly considered prescribing me a cholinergic drug to compensate. I had to ask for an emergency vacation, which was generously granted. Took me a few weeks to feel normal again after I stopped. On the other hand, once I got up to a therapeutic dose (150mg? can't remember), my mood did improve significantly. Not nearly enough to compensate for the cognitive SEs, though.

So Nortriptyline: Terrible for me! Extra-sticky to the wrong receptors in the brain. Some people here on babble seem to really like it, though... so YMMV.

Good luck,
-cb


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