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Re: Other things I've tried

Posted by Tony P on January 24, 2008, at 11:50:23

In reply to Re: Other things I've tried, posted by linkadge on January 23, 2008, at 22:07:49

> I think that trimipramine is still pretty strongly anticholinergic, it has strong m1 antagonism and 5-ht2a antagonism.
>
> It can improve sleep achetecure apparently though.
> I thought it was pretty good, although it did have a strong hangover effect. I don't know how it works (no monoamine uptake inhibition), but it really is an antidepressant (at least thats what I found).
>
> Linkadge

Agreed. Wikipedia states "Trimipramine is the only effective drug against insomnia known so far that does not alter the normal sleep architecture. In particular, it does not suppress REM-sleep...." It's been my mainstay the last year or so. As you say the hangover is bad (the half-life may be as long as 36 hours), so I find some combination of _two_alarms, a light box &/or a pot of coffee on automatic essential if I have to be anywhere.

It _is_ an A/D and can react with others (esp. MAOI's) as I just learned last night to my cost, but it is about the mildest and safest of the TCAs that way; my pdoc said when they used to use it as an antidepressant it was so ineffective they gave people 600 mg and up, whereas I take 100-200 mg for sleep.

I've also found melatonin to be moderately effective so long as I'm not agitated.

Seroquel I think is horrible; poor quaity toss-and-turn-sleep, 50 mg doesn't last long enough but I still feel hungover the next AM. The only good thing I have to say about it is if I'm having a hypomanic episode and it looks like I'm going to stay up all night doing things, Seroquel stops me dead in my tracks.


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poster:Tony P thread:807753
URL: http://www.dr-bob.org/babble/20080124/msgs/808721.html