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Re: Desipramine Questions » busub

Posted by Escapee on June 16, 2015, at 17:31:09

In reply to Desipramine Questions, posted by busub on June 12, 2015, at 15:38:17

> After a very short failed trial of Latuda (akathisia, muscle pain), I finally convinced my pdoc to do a TCA trial. He had been hesitant based on my previous experience on clomipramine (extreme sedation, constipation and sexual side effects), but relented after I sent him an email on my thoughts on nortriptyline. At the appointment though, he threw me a curve ball and prescribed desipramine instead.
>
> I took my first 25mg last night and while I have a little fatigue (much improved over the clomipramine) I feel restless today. Is this normal for TCA's? I was under the impression that this was less of an issue than with the SSRI's. If this is the TCA, how long can I expect it to last?
>
> Last question, anyone else with experience on desipramine? Any input would be appreciated.

Hi. For starters don't confuse clomipramine with the other TCAs. Despite its TCA-like chemical structure its effects are that of a very potent SSRI.
Here in UK we have lofepramine and its main metabolite it desipramine. Almost a full NRI. I see people mentioning nortriptyline but that still is a part SRI part NRI. ie, you can still get serotonin syndrome if mixed with other serotonergics. Desipramine has a negligable effect on serotonin. But going on what you say, perhapse Nortriptyline would be a better option by giving a serotonin boost to help with the anxiety/tremmors. tho it might limit you adding other serotonergics if needed.
If you get stuck, and your doctor is willing, imipramine on its own might be worth a try. An old TCA it still remains one of the strongest all-in-one ADs out there.
Just thinking out loud :)
Escapee.


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