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Re: Cholinergic depression/aniety breakthrough Jay2112

Posted by SLS on May 21, 2022, at 21:00:37

In reply to Cholinergic depression/aniety breakthrough, posted by Jay2112 on May 21, 2022, at 16:57:06

> After 3 months of taking the highly anti-cholinergic med amitriptyline, I have found the largest remission of my psychiatric symptoms, ever!! No other antidepressant has come close, for me. And, this seems to fit with the cholinergic theory of depression, quite well. Whenever I have tried coming off it, just once because of urinary problems, and my day was like a day in many of the days I used to have. Yes, I am aware of the risk of dementia with anti-cholinergics,but I do a lot of tests with my pdoc to screen for this. I DON'T feel hyper-aroused, have normal reactions to sh*tty things, and still get pissed off. But there is SO MUCH MORE CONTROL!! Choline just feels like the huge, wet, freezing cold blanket that can get this way in anxiety and depression.
> IMHO, etc..
> Jay

If you have never tried nortriptyline, it would be the most logical drug to choose next.

When one takes amitriptyline (a tertiary amine), much of it is metabolized into nortriptyline (a secondary amine) . If one takes amitriptyline alone, nortriptyline appears in the bloodstream, too.

The major advantage of nortriptyline when compared to amitriptyline is that it displays very little anticholinergic activity. The major disadvantage is that dosing is sometimes challenging. Nortriptyline is the most well-studied of the TCAs with respect to blood levels and therapeutic response. Nortriptyline is the only TCA that has a true therapeutic window. If 100 mg/day brings one to complete remission, it is likely that increasing the dosage to 150 mg/day will cause them to relapse as if they had discontinued the drug altogether. The therapeutic range of blood levels is between 50-150 ng/ml

- Scott

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

The only thing necessary for the triumph of evil is that good men do nothing.




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