![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by tex1 on April 17, 2002, at 10:50:41
Hi all. I've been on SSRI switching from one to another almost four, five years. In the first part of treatment (as I wrote in another post, see HOMEOSTASIS), let's say in the first two/three weeks, everything was ok, and I had no problems, but starting from one month to the end of therapy I became to get angry, better, nervous almost all the time, and to have bad mood shifts during the day. I benefited by adding a benzo, but wanted to go off of it as soon as I could because even in this case, also the benzos give with time very marked tolerance. In one word I felt "stimulated" a bit too much on SSRIs. I have mixed anxiety and depression. Now the point is : I know that tryciclic antidepressants are more sedative than SSRI even if they have more adverse effects. My pdoc wants to put me on them (clomipramine). Have you guys any experience with this old class drugs ? Do they better relief anxiety sympotms of depression ?
Thanks to all who'll answer.
Posted by Ritch on April 17, 2002, at 13:43:49
In reply to SSRI vs TRYCICLICS, posted by tex1 on April 17, 2002, at 10:50:41
> Hi all. I've been on SSRI switching from one to another almost four, five years. In the first part of treatment (as I wrote in another post, see HOMEOSTASIS), let's say in the first two/three weeks, everything was ok, and I had no problems, but starting from one month to the end of therapy I became to get angry, better, nervous almost all the time, and to have bad mood shifts during the day. I benefited by adding a benzo, but wanted to go off of it as soon as I could because even in this case, also the benzos give with time very marked tolerance. In one word I felt "stimulated" a bit too much on SSRIs. I have mixed anxiety and depression. Now the point is : I know that tryciclic antidepressants are more sedative than SSRI even if they have more adverse effects. My pdoc wants to put me on them (clomipramine). Have you guys any experience with this old class drugs ? Do they better relief anxiety sympotms of depression ?
>
> Thanks to all who'll answer.
Sounds like you are getting some med-induced dysphoric hypomania from SSRI's-I do too-I have to keep the dose insanely microcosmal or I get really *tweaky* on them. I have tried most of the TCA's. I don't know if you will like them or not. Most people don't (because of side effects). Clomipramine is the most serotonergic of the bunch and is used for OCD primarily. If you start getting the same problems with it that you got on the SSRI's you may need to add a mood stabilizer or switch to a more noradrenergic TCA (like amitriptyline or doxepin).Mitch
Posted by JohnX2 on April 18, 2002, at 2:55:03
In reply to Re: SSRI vs TRYCICLICS » tex1, posted by Ritch on April 17, 2002, at 13:43:49
> > Hi all. I've been on SSRI switching from one to another almost four, five years. In the first part of treatment (as I wrote in another post, see HOMEOSTASIS), let's say in the first two/three weeks, everything was ok, and I had no problems, but starting from one month to the end of therapy I became to get angry, better, nervous almost all the time, and to have bad mood shifts during the day. I benefited by adding a benzo, but wanted to go off of it as soon as I could because even in this case, also the benzos give with time very marked tolerance. In one word I felt "stimulated" a bit too much on SSRIs. I have mixed anxiety and depression. Now the point is : I know that tryciclic antidepressants are more sedative than SSRI even if they have more adverse effects. My pdoc wants to put me on them (clomipramine). Have you guys any experience with this old class drugs ? Do they better relief anxiety sympotms of depression ?
> >
> > Thanks to all who'll answer.
>
>
> Sounds like you are getting some med-induced dysphoric hypomania from SSRI's-I do too-I have to keep the dose insanely microcosmal or I get really *tweaky* on them. I have tried most of the TCA's. I don't know if you will like them or not. Most people don't (because of side effects). Clomipramine is the most serotonergic of the bunch and is used for OCD primarily. If you start getting the same problems with it that you got on the SSRI's you may need to add a mood stabilizer or switch to a more noradrenergic TCA (like amitriptyline or doxepin).
>
> MitchThe benzo acts as a mood stabilizer (although sort of a dirty one). It sounds like you may do well augmenting your medicine with a more classical anticonvulsant mood stabilizer as Mitch suggested (Depakote, Lamictal, etc, these help to stabilize the AD response for some people and these stabilizers doesn't usually poop out like a benzo might). Try this if the other AD classes of medicines don't go well.
Regards,
John
Posted by JohnX2 on April 18, 2002, at 3:00:57
In reply to Re: SSRI vs TRYCICLICS, posted by JohnX2 on April 18, 2002, at 2:55:03
> > > Hi all. I've been on SSRI switching from one to another almost four, five years. In the first part of treatment (as I wrote in another post, see HOMEOSTASIS), let's say in the first two/three weeks, everything was ok, and I had no problems, but starting from one month to the end of therapy I became to get angry, better, nervous almost all the time, and to have bad mood shifts during the day. I benefited by adding a benzo, but wanted to go off of it as soon as I could because even in this case, also the benzos give with time very marked tolerance. In one word I felt "stimulated" a bit too much on SSRIs. I have mixed anxiety and depression. Now the point is : I know that tryciclic antidepressants are more sedative than SSRI even if they have more adverse effects. My pdoc wants to put me on them (clomipramine). Have you guys any experience with this old class drugs ? Do they better relief anxiety sympotms of depression ?
> > >
> > > Thanks to all who'll answer.
> >
> >
> > Sounds like you are getting some med-induced dysphoric hypomania from SSRI's-I do too-I have to keep the dose insanely microcosmal or I get really *tweaky* on them. I have tried most of the TCA's. I don't know if you will like them or not. Most people don't (because of side effects). Clomipramine is the most serotonergic of the bunch and is used for OCD primarily. If you start getting the same problems with it that you got on the SSRI's you may need to add a mood stabilizer or switch to a more noradrenergic TCA (like amitriptyline or doxepin).
> >
> > Mitch
>
> The benzo acts as a mood stabilizer (although sort of a dirty one). It sounds like you may do well augmenting your medicine with a more classical anticonvulsant mood stabilizer as Mitch suggested (Depakote, Lamictal, etc, these help to stabilize the AD response for some people and these stabilizers doesn't usually poop out like a benzo might). Try this if the other AD classes of medicines don't go well.
>
> Regards,
> JohnPS. The anticonvulsant (mood stabilizer) medications help to maintain the homeostasis achieved after an antidepressant response. (Per your other thread).
John
Posted by paulb on April 18, 2002, at 15:43:33
In reply to SSRI vs TRYCICLICS, posted by tex1 on April 17, 2002, at 10:50:41
Apart from Clomipramine the SSRI's advantage over the older TCA's seems to be that they work on various anxiety disorders and are particulalrly suited for atypical depression. I think for anxious/depressives nardil is the ideal choice and if you were going to go with an older medication why not go with nardil. The TCA's are tricky because they all affect the monoamines to varying degrees. anafranil may be a more potent seroternergic than all the SSRI's, marginally. elavil and tofranil possess both seroternergic and norepinephrine effects. maprotiline, nortriptiline and desipramine are primarily NRI's. anafranil may better relieve anxiety symptoms of depression and elavil and tofranil may too because they have central blocking 5-HT properties.
paulb
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.