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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 Phil on January 25, 2000, at 11:29:04
I had to drop Effexor because of itching. The last few nights, Desip seems to be heading in the same direction. Could this be because both affect noradrenaline?
Beginning to wonder if I should have ordered that Reboxetine, too.
Also, probably the best AD I have ever been on was Amitriptyline but I don't want to go back because of side effects. May have to though. ANYONE HAVE ANY SUGGESTIONS?Thanks,
Phil again
Posted by quilter on January 26, 2000, at 0:32:14
In reply to Effexor itching-Now Desipramine, posted by Phil on January 25, 2000, at 11:29:04
> I had to drop Effexor because of itching. The last few nights, Desip seems to be heading in the same direction. Could this be because both affect noradrenaline?
> Beginning to wonder if I should have ordered that Reboxetine, too.
> Also, probably the best AD I have ever been on was Amitriptyline but I don't want to go back because of side effects. May have to though. ANYONE HAVE ANY SUGGESTIONS?
>
> Thanks,
> Phil againIf there is no rash causing the itching, it may be due to extremely dry skin. I had this problem when celexa was added to the other meds I was taking. It improved a lot with regular use of some heavy duty moisturizing cream.
Posted by Scott L. Schofield on January 26, 2000, at 11:07:48
In reply to Re: Effexor itching-Now Desipramine, posted by quilter on January 26, 2000, at 0:32:14
> > I had to drop Effexor because of itching. The last few nights, Desip seems to be heading in the same direction. Could this be because both affect noradrenaline?
Yes. Although, as mentioned before, it could be due to many other reasons as well.
I can't say that the itching will go away for you, but it did for me. It did take a month or more, though. If you experience itching after taking showers or bubble-baths, you can help minimize it by "patting" yourself dry rather than wiping the towel across the skin. I think very hot showers may be more apt to instigate the itching.
I know that it is more than just a minor nuisance. The itching can be pretty intense. Also, I found that if I scratched one area, that seems to trigger a new itch somewhere else. It would sometimes take 30 - 60 minutes to stop. Eventually, I was forced to wake-up for work an hour earlier so as to allow enough of a buffer for itch-time.
I'm curious. Where did you find information regarding the possibility that this itching might be precipitated by the drugs' noradrenergic effects?
- Scott
Posted by Scott L. Schofield on January 27, 2000, at 9:54:02
In reply to Effexor itching-Now Desipramine, posted by Phil on January 25, 2000, at 11:29:04
> Also, probably the best AD I have ever been on was Amitriptyline but I don't want to go back because of side effects. May have to though. ANYONE HAVE ANY SUGGESTIONS?
Maybe you're a tricyclic person.There are quite a few to choose from besides amitriptyline (Elavil). I hated amitriptyline because of the heavy-duty sedation it caused me. I'm not sure how many people experience this to the same degree, but sedation is one of the more prominent effects that this drug is known for. In fact, doctors often make use of it to help treat insomnia. Other side-effects include those that are considered to be anticholinergic and/or norandrenergic: dry mouth, constipation, sweating, disturbances of vision, rapid pulse, and palpitations. Weight-gain is also common. However, it is the effects of tricyclics (and some other antidepressant drugs) on cardiac function that is important to screen for and follow-up on. Personally, I have not come across anyone for whom this has occurred.
Imipramine (Tofranil) is another tricyclic that is very similar to amitriptyline, but is considered to be less sedating. I have tried it several times and have found this to be true, although there was just a bit early on. Both amitriptyline and imipramine have "children" drugs named nortriptyline (Pamelor) and desipramine (Norpramin) respectively. They tend to have milder side-effects and are often just as effective as the parent drugs.
My guess is that a good place to start would be with nortriptyline. Since you have had such a good response to amitriptyline, using its active metabolite (child drug) will hopefully work as well. Nortriptyline has been the best studied of the tricyclics with respect to drug blood-levels and response patterns. My doctor likes this drug and usually targets 75 mg/day as being within the effective range. You *can* take too much nortriptyline and lose the antidepressant response, even though there may be no difference in side-effects.
There are more tricyclic antidepressants as well, but I think the ones mentioned above are the most frequently used. It might also be worth considering Ludiomil, Effexor, or reboxetine (not currently sold in the U.S.) based upon the possibility that you respond well to norepinephrine reuptake inhibitors.
- Scott
Posted by Kev on January 27, 2000, at 21:40:27
In reply to Effexor itching-Now Desipramine, posted by Phil on January 25, 2000, at 11:29:04
> I had to drop Effexor because of itching. The last few nights, Desip seems to be heading in the same direction. Could this be because both affect noradrenaline?
***That is a very interesting hypothesis. Ironically, I experienced the itching AFTER I stopped taking it- connection??
-Kev
This is the end of the thread.
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