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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by smittay17 on December 14, 2003, at 12:51:03
i was fine on Imipramine for years it cured my OCD and Panic Disorder for 6 years. I even have mild touretttes.
i have to switch off the imipramine because it is swelling my tongue and causing sleep apnea.
so im on (right now) 100mg Imipramine, 40mg Celexa, 75mg Desipramine (my doctor wants to eventually eliminate the Imipramine)
i am feeling SO SO shaky and jittery and over nervous and scared. i can't relax. Imipramine used to make me sedated and sleepy, now i cant sleep at all or relax or even just have a quiet afternoon with my wife! im so anxious.
please somebody help me and suggest something. do i have too much serotonin or too much norepinephrine? what should i do. im only seeing a primary care physician and i can't find a good psychiatrist/neurologist north of Boston.
if you have any help PLEASE post in this thread or email me at smittay1975@hotmail.com . i know most of you have been through stuff and im just dying here... please help me get my life back :(
erik
Posted by zeugma on December 14, 2003, at 13:05:26
In reply to Help ME- whats wrong with me????, posted by smittay17 on December 14, 2003, at 12:51:03
neither celexa nor desipramine have strong sedating properties. Desipramine is much less sedating than its parent imipramine. You might want to try nortriptyline which is slightly weaker as a norepinephrine reuptake inhibitor but is more sedating than desipramine. (Also I don't think you have to taper from desipramine to nortrityline because they're very similar.)
Posted by smittay17 on December 14, 2003, at 13:11:35
In reply to Re: Help ME- whats wrong with me????, posted by zeugma on December 14, 2003, at 13:05:26
okay, but is it the Norepinephrine I need? or the Serotonin?
i dont know which to increase and which to decrease...
what are the symptoms for too much SERO?
what are the symptoms for too much NE?
based on what im on, what should i increase or decrease? my primary care physician knows nothing it seems and i can find a good psychiartrist or neurologist North of Boston? Can someobdy please help?
Posted by Dinah on December 14, 2003, at 13:34:11
In reply to Help ME- whats wrong with me????, posted by smittay17 on December 14, 2003, at 12:51:03
I get nervous, jittery, and agitated on even small doses of NE, while serotonin makes me ummm... even. The serotonin was what worked for my OCD.
Everyone's different of course. How far north of Boston are you? It might be worth driving to the city. I'm sure there are many talented psychopharmacologists there.
Posted by HappyGirl on December 14, 2003, at 14:07:15
In reply to Help ME- whats wrong with me????, posted by smittay17 on December 14, 2003, at 12:51:03
Hi:
It might be hard to say whether one of the meds. Impiramine is as effective as a newer form of anti-dep., such as Wellbutrin SR that has some similar property to the one you've been on,... from the reading. Most of newer ones have less 'side effect'/being tolerable, that in turn gives easier consumption on med.
Also, I firmly believe that it's the time for you to find a competent pdoc., because the primary doc. often dx and rx for simpler form of mental illnesses, like 'situational/transient depressive episodes/anxiety, rather classic ones that is more than one or two years'duration. Then, if more than this scenario, you certainly need to consult with psychiatrist, ideally psychopharmacologist, if you could find one.
Good Luck!!!
HappyGirl
Posted by zeugma on December 14, 2003, at 14:52:27
In reply to Help ME- whats wrong with me????, posted by smittay17 on December 14, 2003, at 12:51:03
> i was fine on Imipramine for years it cured my OCD and Panic Disorder for 6 years. I even have mild touretttes.
>
> i have to switch off the imipramine because it is swelling my tongue and causing sleep apnea.
>
> so im on (right now) 100mg Imipramine, 40mg Celexa, 75mg Desipramine (my doctor wants to eventually eliminate the Imipramine)
>
> i am feeling SO SO shaky and jittery and over nervous and scared. i can't relax. Imipramine used to make me sedated and sleepy, now i cant sleep at all or relax or even just have a quiet afternoon with my wife! im so anxious.
>
> please somebody help me and suggest something. do i have too much serotonin or too much norepinephrine? what should i do. im only seeing a primary care physician and i can't find a good psychiatrist/neurologist north of Boston.
>
> if you have any help PLEASE post in this thread or email me at smittay1975@hotmail.com . i know most of you have been through stuff and im just dying here... please help me get my life back :(
>
> erik
There are many possibilities. I was making my recommendation based on the fact that both imipramine and nortriptyline have a 'sedating component,' H1 blockade, that both celexa and desipramine lack. That's neither NE nor SER. In theory, 40 mg celexa should be adequate serotnin reuptake blockade... lexapro is more potent and you could try 10 or 20 mg of that instead.I think you had said earlier that Celexa wasn't enough by itself to remit your depression. That suggests to me that it's the dual action of imipramine that was helping you... of course it's impossible to measure the ratios in your CNS of reuptake blockade, so it's going to be guesswork on the part of your dr. (even a knowledgeable one). I would say that nortriptyline is less likely to cause jitteriness than desipramine, while still complementing the Celexa (going by your previous statement that celexa by itself didn't work).
Posted by Flipsactown on December 15, 2003, at 1:33:03
In reply to Help ME- whats wrong with me????, posted by smittay17 on December 14, 2003, at 12:51:03
Hello,
It sounds to me that you are having withdrawals from the imipramine. Maybe you are going off of it too fast. Go back to the previous dosage before you started getting the shakey jittery feeling. That is my layman's point of view.
Flipsactown
> i was fine on Imipramine for years it cured my OCD and Panic Disorder for 6 years. I even have mild touretttes.
>
> i have to switch off the imipramine because it is swelling my tongue and causing sleep apnea.
>
> so im on (right now) 100mg Imipramine, 40mg Celexa, 75mg Desipramine (my doctor wants to eventually eliminate the Imipramine)
>
> i am feeling SO SO shaky and jittery and over nervous and scared. i can't relax. Imipramine used to make me sedated and sleepy, now i cant sleep at all or relax or even just have a quiet afternoon with my wife! im so anxious.
>
> please somebody help me and suggest something. do i have too much serotonin or too much norepinephrine? what should i do. im only seeing a primary care physician and i can't find a good psychiatrist/neurologist north of Boston.
>
> if you have any help PLEASE post in this thread or email me at smittay1975@hotmail.com . i know most of you have been through stuff and im just dying here... please help me get my life back :(
>
> erik
Posted by smittay17 on December 15, 2003, at 8:15:26
In reply to Re: Help ME- whats wrong with me????, posted by zeugma on December 14, 2003, at 14:52:27
wow thanks guys and girls :)
so
1) i should find a psychopharmacologist
2) i should also look into adjusting my levels of sero/NE,but also the celexa/desipramine combo might be missing the sedating effects of the imipramine totally? the H1 blockade? what is that exactly? is that what i'm missing you guys think?
im in danvers, ma - 30 minutes north of boston... does anyone know any psychopharmacologists up here they could recommend, i really need to see someone besides my primary care physician....
thanks,
erik
Posted by smittay17 on December 15, 2003, at 8:42:18
In reply to Re: Help ME- whats wrong with me????, posted by zeugma on December 14, 2003, at 14:52:27
thanks zuegma, how do yo know so much ? :)
its really helping me and my wife... im going to see my primary at noon today, if anyone knows any drs around danvers ma- it would be great to know...>
> There are many possibilities. I was making my recommendation based on the fact that both imipramine and nortriptyline have a 'sedating component,' H1 blockade, that both celexa and desipramine lack. That's neither NE nor SER. In theory, 40 mg celexa should be adequate serotnin reuptake blockade... lexapro is more potent and you could try 10 or 20 mg of that instead.
>
> I think you had said earlier that Celexa wasn't enough by itself to remit your depression. That suggests to me that it's the dual action of imipramine that was helping you... of course it's impossible to measure the ratios in your CNS of reuptake blockade, so it's going to be guesswork on the part of your dr. (even a knowledgeable one). I would say that nortriptyline is less likely to cause jitteriness than desipramine, while still complementing the Celexa (going by your previous statement that celexa by itself didn't work).
>
>
Posted by Sebastian on December 16, 2003, at 11:42:03
In reply to Help ME- whats wrong with me????, posted by smittay17 on December 14, 2003, at 12:51:03
Try a low dose of zyprexa, 2.5 or 5 mg.
Posted by Sebastian on December 16, 2003, at 11:48:58
In reply to Re: Help ME- whats wrong with me????, posted by smittay17 on December 15, 2003, at 8:42:18
Ya man I think 5 mg zyprexa would work great for you. Stop the imaprine that you don't like and just start the zyprexa, same day. If it is too much cut down to 2.5 (you can cut the pills if you need). The initial 5 should kill the anxiety and sleeplessnes imediatly, take it 2 hours before bed.
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