Posted by softheprairie on December 26, 2008, at 12:04:23
In reply to Re: Ideas for inattentive-type ADD treatment? » softheprairie, posted by TriedEveryDrug on December 26, 2008, at 7:34:25
> Hi softheprairie,
>
> Thanks for your reply. I'm curious - do you take your desip at night or in the morning? I used to take it at night - it would knock me out and then I would wake up bright and ready to go. But then after the 3rd or 4th go around with it (the longest I've been on it was 3 months), it started keeping me awake at night.
When to take it is an interesting question. I've read it can go either way -- some find it activating, some sedating. I'm not quite sure how I find it; I think neutral to a little activating, although I have had some insomnia, but I don't think it's related to the desip dose. Anywho, to answer: right now I'm taking 5 pills of 50 mg at waking up and the last 50 mg pill later when I take one of my metformin pills (for type 2 diabetes) at a meal.
That's a kind of odd schedule, but I had been taking it spaced at two to three times a day, and forgot a few times the mid-day dose, which I told the pdoc, and he said I should be able to take it all once a day (length of action-wise) if I don't have the side effects of it all at once (I had been having some headaches at each dose increase to deal with, not as bad if doses spread out throughout the day, but they thankfully subsided, usually after a few days); he advised me to move by one 50-mg pill at a time towards taking all at the same time, at any hour preferred. I haven't made the move of the last pill yet; I could, but haven't been forgetting of late the 2nd dose, so am not in much of a hurry. At my next time to reauthorize the Rx, I think I'll switch to 3 pills times the 100 mg dose, to keep the dose the same and maybe save my insurance a few dollars by taking a lower # of pills per day.
>
> Also the max dose I've been on was 50 or 75mg. Did you notice any of the side-effects decreasing as you increased the dose?My headaches at each 50-mg increase got less severe at each increase.
The anxiety I think has gotten worse as I've gotten to higher doses. This is kind of complicated to me to explain -- the anxiety is mixed in with the tachycardia/rapid heartrate and heart palpitations, and they're all helped by the beta blocker which my primary care dr is in charge of, and I've wanted more of the beta blocker, to deal with the anxiety caused by the desipramine, but she sees my heartrate as now fine on the dose I'm at of beta blocker. She didn't up it at my appt. 3 months ago, but I asked again at my recent appt., I asked to be allowed it also PRN, and she only wrote the latest Rx for one dose a wk PRN, which I find stingy of her. I'm dealing with some bitterness there, esp. since I know my pdoc is fine with upping the beta blocker, but that since the primary care dr. is the one who Rxed it initially, I have to go through her for it. I was Rxed the little dose of beta blocker back when my desipramine dose was only 100 mg, I think it was, and yet now that it's 300 I still have to deal with more anxiety, but the same low dose of beta blocker. I do have PRN use of perphenazine, also, but I don't like the sedation, and have most of the contents left of my bottle of Ativan, but it was a disappointment to me relief-wise, and is sedating.
>
> One thing for me that stopped the desipramine anxiety almost instantly was effexor. My doc said it was an ok combo, esp. at lower doses, but epocrates says there is a cardiac interaction.Thanks for adding that fact about relief via Effexor.
>
> I'll ask my doc about neuroleptics.
>
> Regards.To thee as well.
poster:softheprairie
thread:870732
URL: http://www.dr-bob.org/babble/20081223/msgs/870864.html