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Re: Desiprimine augment SNRI SLS

Posted by B2chica on April 29, 2018, at 1:01:44

In reply to Re: Desiprimine augment SNRI B2chica, posted by SLS on April 28, 2018, at 16:22:18

hi Scott
so glad to hear from you. thank you for the info. i've been on Wellbutrin and it pooped out (and tried years later, no go).
We had talked about desipramine exactly because it was more norepinephrine. Since SSRI's are terrible for me (end up making depression worse and either giving me a little psychosis or down to suicidal) but Pristiq (hitting on more N) works (worked) well for me, we thought about Desipramine.
i was planning on starting it tomorrow i was thinking of taking the 25mg first thing in am and second in afternoon so were on the same page... i do like better the idea around 3pm as my depression seems to start to get worse later afternoon evening (about 4-ish on up).
important to know about the resting heart rate. My anxiety is Finally lowering to a livable level, so i'll have to be aware if its med or my anxiety.
Dry mouth is just about a daily thing anymore, so no worries there.

Good to know about nortriptyline as another option.
history-a couple years ago pdoc put me on amitriptyline, took a bit beause my episode was so bad but it worked well. only issue was after about 7 months it started giving me what i felt like were cognitive issues. slower thinking, trouble following conversations, muddy head feeling. just cog. slower in general. So he took me off. (i improved after that).
Anyway, we discussed next to try desipramine next but by then my great adderall company got bought out and stopped making so i was struggling with that. i tried a couple and ended up with Evekeo. Its ok, but not that great with my mood as the past one was.

this episode depression started around jan, but became an issue around Feb. built since then.- long story short, last month increased anxiety, depression, agitation/anger -S.ideation becoming intent all hitting peak last week. anyway, he called in rx for desipramine. hopefully it works with my brain chemistry better.

THanks for any input. and for reading.

> 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

"What is madness, but nobility of soul at odds with circumstance.
The day is on Fire, and i know the purity of pure despair."
Theodore Roethke




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