Posted by SLS on July 12, 2008, at 17:06:32
In reply to Re: nortriptyline))SLS any thoughts?, posted by Roslynn on July 12, 2008, at 16:09:34
Dear Roslynn,
5 years ago, I could not have imagined that any of the psychotropics would turn out to be genotoxic. Unfortunately, there are more than just a handful of studies implicating most of the tricyclics. Desipramine is one of them. It is considered to be an initiator rather than a promoter. In other words, it can cause damage to the gene to initiate a cancer cell, but does not promote its growth thereafter. I have been on and off both imipramine and desipramine for years. It is only now that I have some concern. Still, I don't have a good "feel" as to the propensity for genotoxic events to occur with these drugs at normal dosages. I guess I should look into it more. Perhaps Linkadge has some numbers to cite.
I would choose nortriptyline first. It is not on the list of genotoxic TCAs, and I believe it has a broader spectrum of activity. For me, nortriptyline produces more of an improvement in anhedonia than does desipramine.
If I were responsive to solely desipramine, I would take it. However, I would go with nortriptyline 50-100mg first. Measuring blood levels can help determine therapeutic dosages, but not always. Besides, the range is very wide. You can take too much of this drug. It has a therapeutic window. 75mg might work great, but then moving up to 100mg might cause a loss of response.
Until this genotoxic thing becomes more formalized with numbers of human events, I would have to suggest the nortriptyline first.
- Scott
> > one that may have less of these problems that is supposed to be similar to desipramine is nortriptyline, if you are needing to go back on something like desipramine. (i wish i could, but i have such a fear of it now.) SLS may have advice on this.
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> > i'll try to write more later, but my mind is very paralysed and useless right now.
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> Dear SLS do you have any thoughts on this? (Desipramine being genotoxic/carcinogenic??)
> Thank you for any help!!!
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poster:SLS
thread:839295
URL: http://www.dr-bob.org/babble/20080706/msgs/839468.html