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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by orbital on November 28, 2011, at 12:46:23
Hi all :-)
I'm wondering if anybody has experience with TCAs, specifically I'd like to know if they cause the infamous SSRIs/SNRIs emotional blunting (at least that's my experience, I eventually get the "blashs" on all of them).
The list of meds I'm taking right now is so long I can barely remember it. Some of them: Effexor, Zoloft, Provigil, Abilify, amisulpiride (low dose) and others, along with benzos and supplements. I feel okay and energetic, but certainly not happy -nor sad for that matter.
I'm wondering if I should ask my doc to wash out for a week, then try a TCA (imipramine). I've never been on a TCA, and only Elavil and imipramine are available where I live due to lack of sales.
Any thoughts? As usual thanks in advance.
Posted by Phillipa on November 28, 2011, at 12:55:10
In reply to TCAs and emotional blunting, posted by orbital on November 28, 2011, at 12:46:23
If you feel okay don't mess with it is my advise. I would love to feel good. Have you tried doing more, excercise just to boost mood a bit? Phillipa
Posted by orbital on November 28, 2011, at 14:18:40
In reply to Re: TCAs and emotional blunting » orbital, posted by Phillipa on November 28, 2011, at 12:55:10
Thanks for the advice Phillipa(how are you doing?)
I don't feel "good", I feel non-depressed in an almost robotic way. I take fistfulls of meds, rinse, repeat.
You're right, however, I certainly don't want to mess up.
Brisk walks do perk me up, at least for a while.
> If you feel okay don't mess with it is my advise. I would love to feel good. Have you tried doing more, excercise just to boost mood a bit? Phillipa
Posted by Christ_empowered on November 28, 2011, at 18:38:37
In reply to Re: TCAs and emotional blunting » Phillipa, posted by orbital on November 28, 2011, at 14:18:40
I tried Tofranil-PM, the once-nightly Tofranil. It made me feel both flattened out and petulant.
Posted by gman22 on November 28, 2011, at 19:54:06
In reply to Re: TCAs and emotional blunting, posted by Christ_empowered on November 28, 2011, at 18:38:37
By my own experience (and a lot of anecdotal evidence) the TCA's are much less likely to cause emotional blunting than SSRI's. Imipramine is a good TCA to start with as it is very safe and proven for about 50 years. It is still in widespread use today.
Posted by bleauberry on December 1, 2011, at 15:09:31
In reply to TCAs and emotional blunting, posted by orbital on November 28, 2011, at 12:46:23
What I experienced was that TCAs were less likely to cause blunting but it could still happen most especially if the dose was too high. The TCAs mostly have a fairly strong norepinephrine component to them that the ssris/snris don't have, so that helps. I think the blunting is primarily caused by increasing serotonin without increasing norepinephrine at the same time. But if norepinephrne gets too high, blunting can kick in again. My theory is it is related to the normal operation of the feedback loops. So anyway, TCAs are less likely to cause blunting but the dose is important. So you would have to experiment to find out what is too low and what is too high.
This is the end of the thread.
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