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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by KaraS on January 28, 2005, at 1:58:50
I need to take something that is going to control my anxiety and panic attacks. TCAs do a good job of that for me even in small dosages. I'd also like to try 5-10 mg. selegiline with DLPA (otherwise it's back on to Effexor).
Can I safely combine either of these TCAs in a low dose with the selegiline + DLPA? I know that some people here have combined trimipramine with Parnate so I'm thinking that it's probably a safe combination, no?
Posted by zeugma on January 28, 2005, at 14:28:15
In reply to Low dose doxepin or trimipramine w/ selegiline?, posted by KaraS on January 28, 2005, at 1:58:50
Hi kara.
I've come across a report of serotonin syndrome with nortriptyline and low-dose (5-10 mg) selegiline, so I would be cautious. of course the report didn't say what the dosage of nortriptyline was. What sort of benefit are you getting from selegiline? Are you sure it's not the selegiline and DLPA that are giving you tachycardia, and not the maprotiline?
trimipramine is pretty anticholinergic, so I would expect tachycardia as a possible side effect, especially in conjunction with selegiline.-z
Posted by zeugma on January 28, 2005, at 15:06:23
In reply to Re: Low dose doxepin or trimipramine w/ selegiline? » KaraS, posted by zeugma on January 28, 2005, at 14:28:15
oh, I'm sorry, I see you're not on selegiline right now- I'm either going thru 'dumb-drug euphoria' because I raised my nortriptyline dose, or I can't stay awake long enough to read a whole post because I'm not on any stim other than tons of caffeine :) Now, if I could be awake enough to enjoy the euphoria of total stupidity, I'd be set!
-z
Posted by KaraS on January 29, 2005, at 2:29:47
In reply to Re: Low dose doxepin or trimipramine w/ selegiline?, posted by zeugma on January 28, 2005, at 15:06:23
> oh, I'm sorry, I see you're not on selegiline right now- I'm either going thru 'dumb-drug euphoria' because I raised my nortriptyline dose, or I can't stay awake long enough to read a whole post because I'm not on any stim other than tons of caffeine :) Now, if I could be awake enough to enjoy the euphoria of total stupidity, I'd be set!
>
> -z
No problem. Does trimipramine metabolize to imipramine? If so, it will definitely give me tachycardia. I'll be trying low-dose doxepin again soon for sleep. I also took that for many years. I wonder if that will give me problems now too. So it's probably a moot point whether or not I can take either of them with selegiline. Back to the drawing board.
Posted by zeugma on January 29, 2005, at 10:37:03
In reply to Re: Low dose doxepin or trimipramine w/ selegiline? » zeugma, posted by KaraS on January 29, 2005, at 2:29:47
trimipramine is not metabolized to imipramine. But it might induce tachycardia because it is antimuscarinic. It's similar to doxepin, except it has virtually no effect on NE or 5-HT, and resembles an atypical antipsychotic in some ways, including D2 receptor antagonism.
-z
Posted by KaraS on January 29, 2005, at 16:07:57
In reply to Re: Low dose doxepin or trimipramine w/ selegiline? » KaraS, posted by zeugma on January 29, 2005, at 10:37:03
> trimipramine is not metabolized to imipramine. But it might induce tachycardia because it is antimuscarinic. It's similar to doxepin, except it has virtually no effect on NE or 5-HT, and resembles an atypical antipsychotic in some ways, including D2 receptor antagonism.
>
> -z
Thanks. I'll soon see if I can tolerate the doxepin still. If not, I probably couldn't take trimipramine either (at least not without a beta blocker).One last question, trimipramine's D2 receptor antagonism would be a good thing for me, wouldn't it? (esp. if I'm taking an SSRI?)
Posted by zeugma on January 29, 2005, at 17:04:52
In reply to Re: Low dose doxepin or trimipramine w/ selegiline? » zeugma, posted by KaraS on January 29, 2005, at 16:07:57
One last question, trimipramine's D2 receptor antagonism would be a good thing for me, wouldn't it? (esp. if I'm taking an SSRI?)
Well, if your theory of super-sensitive D2 autoreceptors is true, then yes, it would be a good thing. Trimipramine is a curious drug. its known pharmacological profile resembles that of clozapine, the prototype of the atypical antipsychotics, and yet it seems to be better as an antidepressant than an antipsychotic.
-z
Posted by KaraS on January 29, 2005, at 19:23:53
In reply to Re: Low dose doxepin or trimipramine w/ selegiline? » KaraS, posted by zeugma on January 29, 2005, at 17:04:52
This is the end of the thread.
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