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Re: Desiprimine augment SNRI B2chica

Posted by SLS on April 28, 2018, at 16:22:18

In reply to Desiprimine augment SNRI, posted by B2chica on April 28, 2018, at 11:38:14

Hi.

> I will be augmenting my pristiq with desiprimine,

I also recommend as possible augmenters nortriptyline and Wellbutrin.

What is the rationale for choosing desipramine rather than nortriptyline? I'm not questioning the choice. I'm just curious.

Desipramine is a particularly selective and potent norepinephrine reuptake inhibitor (NRI). It can be activating. However, it might actually sedate you during the first week. I don't think it matters when you take it once you've established regular dosing. I've always been one to take medication as multiple doses either twice or three times a day. You can take the whole dosage at night if you want. It is very important to understand that two people can react in opposite ways to the same drug. You might want to start desipramine on your day off from work as a morning dose of 25 mg to see how you react to it. If you become sedated, you can then dose another 25 mg at night. If, however, you find your morning dose stimulating, you might then take your second 25 mg by 3:00 PM to minimize sleep disturbance. The first time I started imipramine and desipramine, I felt strangely energized with a feeling of sedation at the same time. With each drug, I reached a dosage of 300 mg/day. I hope you find relief with lower dosages.

Desipramine might make your heart race with palpitations. Call your doctor if your resting rate reaches 100 beats per minute. Palpitations often disappear on their own, and are not necessarily indicative of cardiac distress. Prepare for some dry mouth and other side effects that look like those of an anticholinergic drug (pseudo-anticholinergia). These should mitigate over time.

If desipramine proves to be too harsh for you, nortriptyline might represent an alternative. The side effects are quite a bit milder. However, some people who respond to desipramine do not respond to nortriptyline and vice-versa.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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