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Re: Desiprimine augment SNRI B2chica

Posted by SLS on April 29, 2018, at 10:31:40

In reply to Re: Desiprimine augment SNRI SLS, posted by B2chica on April 29, 2018, at 1:01:44

> 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).

Some psychiatrists would label your depression as being endogenous or melancholic. TCA is supposed to be particularly effective for this type. By extension, I would say that SNRI would be better for you than SSRI.

> 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.

This can happen with anticholinergic drugs, although I can't explain the latency. For instance, imipramine is called the "stupid drug". Amitriptyline is also very anticholinergic. Desipramine and nortriptyline are not really anticholinergic. If you experience brain-fog with desipramine early in treatment, I would say that it is likely to disappear.

> 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.

I hope so, too. If desipramine is right for you, it should actually reduce anxiety, not increase it. It also has the potential to treat ADHD. However, you can add an amphetamine to it if necessary. Again, you should be wary of the emergence of a worsened depression, anxiety, and suicidality. In my experience, if these things appear, giving a treatment more time will not help. This happened to me with reboxetine.

Is anhedonia a problem? For me, nortriptyline 75-100 mg/day is better for anhedonia than is desipramine 300 mg/day.

Good luck.


- 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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