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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Squiggles on January 19, 2004, at 8:35:29
(not my case)
I regret to report that after some
months of a very optimistic trial
with Remeron, this AD at the therapeutic
average dose sputtered out. I have
no idea why this happened - possibly it
permitted a withdrawal effect of the
imipramine, and allowed the depression
to resurface. Possibly, the dose was not
high enough.It was a great disappointment as Remeron
had fewer side effects (except for great
appetite) and was an anxiolytic and
hypnotic at the same time (with clonazepam
later adjuncted). Unfortunately, severe
depression returned after about
2 and a half months. Imipramine had to be
reintroduced.It was the best alternative of about 16-20
drugs tried, including SSRIs and an MAOI.
The condition is severe, endogenous depression.
Conclusion:It seems that imipramine is
a stronger antidepressant than
Remeron. Imipramine also seems
to produce more anxiety than Remeron
(otherwise the anxiety is part of the
depression condition). Anxiety can
be handled easily in both ADs with the
addition of clonazepam.Squiggles
Posted by SLS on January 19, 2004, at 9:31:56
In reply to Imipramine again, posted by Squiggles on January 19, 2004, at 8:35:29
Hi Squiggles.
What does it mean: "not my case"?
I'm sorry that Remeron did not work for you. Have you thought about continuing with the Remeron and adding stuff to it? Effexor? I combined imipramine 300mg, Effexor 300mg, and Remeron 60mg without any adverse events.
- Scott
Posted by Squiggles on January 19, 2004, at 9:46:07
In reply to Re: Imipramine again, posted by SLS on January 19, 2004, at 9:31:56
> Hi Squiggles.
>
> What does it mean: "not my case"?
>
> I'm sorry that Remeron did not work for you. Have you thought about continuing with the Remeron and adding stuff to it? Effexor? I combined imipramine 300mg, Effexor 300mg, and Remeron 60mg without any adverse events.
>
>
> - Scott
>
>
>
Hi Scott,I speak on behalf of a close friend. I know
the case very well. I agree with your suggestion
about adding something to Remeron, but unfortunately,
my friend and possibly her doctor, are pooped out
with experimenting.Thanks for your suggestion, i will pass it on, in
case the imipramine becomes a pain again -- which
is the reason for all the other experiments. What
we are hoping for now is that the clonazepam will
eliminate the insomnia and the anxiety -- so far
it looks promising, and possibly that should have
been done first. Instead, talk therapy was suggested,'
which is great for light depression, but very heavy
"treatment resistant" depression seems to do better
with drugs.Squiggles
Posted by Francesco on January 19, 2004, at 10:17:13
In reply to Re: Imipramine again, posted by SLS on January 19, 2004, at 9:31:56
> I'm sorry that Remeron did not work for you. Have you thought about continuing with the Remeron and adding stuff to it? Effexor? I combined imipramine 300mg, Effexor 300mg, and Remeron 60mg without any adverse events.What do you mean by 'any advese events' ? Do you mean also that you have no side-effects ? I didn't know that one could take all that Imipramine ! I can feel also the effect of just 10 mg ! (anyway, my problem is not depression, but adhd-like syntoms)
Posted by mattdds on January 19, 2004, at 12:05:58
In reply to Imipramine again, posted by Squiggles on January 19, 2004, at 8:35:29
Hello,
I had the same experience with imipramine. It was just too anxiogenic to continue with the trial. My social anxiety is normally well controlled with Klonopin and lots of CBT, but when I started taking imipramine, I would get all sweaty and nervous when talking to people. It creates a *lot* of anxiety, at least in my situation.
Of course, as you mentioned, if it works, the side effects can be controlled with clonazepam or another similar minor tranquilizer, probably at a high dose - Klonopin felt like a sugar pill when I was on imipramine.
I understand that imipramine *does* have the best track record for severe "endogenous" type depression. Not very useful for anxiety though, IMO.
Why not imipramine + clonazepam (high dose) + sleep med like Ambien?
Best,
Matt
Posted by Squiggles on January 19, 2004, at 12:29:55
In reply to Re: Imipramine again, posted by mattdds on January 19, 2004, at 12:05:58
> Hello,
>
> I had the same experience with imipramine. It was just too anxiogenic to continue with the trial. My social anxiety is normally well controlled with Klonopin and lots of CBT, but when I started taking imipramine, I would get all sweaty and nervous when talking to people. It creates a *lot* of anxiety, at least in my situation.
>
> Of course, as you mentioned, if it works, the side effects can be controlled with clonazepam or another similar minor tranquilizer, probably at a high dose - Klonopin felt like a sugar pill when I was on imipramine.
>
> I understand that imipramine *does* have the best track record for severe "endogenous" type depression. Not very useful for anxiety though, IMO.
>
> Why not imipramine + clonazepam (high dose) + sleep med like Ambien?
>
> Best,
>
> MattThanks Matt;
Ambien also -- hmm - thanks for the suggestion;
I guess just raising the Klonopin would not
be enough? So far (about 2 weeks) the situation
is much better than Imipramine without clonazepam.Many of the ADs seem to provoke anxiety --
there could many reasons for this - life
of the drug, drug itself, dose, in cases
where it is not the depression itself.
I think the cognitive therapy might be good
once the "organic" problems are taken care
of.Squiggles
Posted by SLS on January 19, 2004, at 12:55:45
In reply to Re: Imipramine again » SLS, posted by Francesco on January 19, 2004, at 10:17:13
> > I'm sorry that Remeron did not work for you. Have you thought about continuing with the Remeron and adding stuff to it? Effexor? I combined imipramine 300mg, Effexor 300mg, and Remeron 60mg without any adverse events.
> What do you mean by 'any advese events' ? Do you mean also that you have no side-effects ? I didn't know that one could take all that Imipramine ! I can feel also the effect of just 10 mg ! (anyway, my problem is not depression, but adhd-like syntoms)I had no serious side-effects or drug interactions. I was also taking Lamictal and Abilify. I experienced the same side effects as if one were taking each separately. Imipramine is used at dosages between 200-300mg for severe depression. It helps me a little when I combine it with Lamictal, but it takes a full 300mg.
- Scott
Posted by Sad Panda on January 20, 2004, at 1:29:01
In reply to Imipramine again, posted by Squiggles on January 19, 2004, at 8:35:29
> (not my case)
>
> I regret to report that after some
> months of a very optimistic trial
> with Remeron, this AD at the therapeutic
> average dose sputtered out. I have
> no idea why this happened - possibly it
> permitted a withdrawal effect of the
> imipramine, and allowed the depression
> to resurface. Possibly, the dose was not
> high enough.
>
> It was a great disappointment as Remeron
> had fewer side effects (except for great
> appetite) and was an anxiolytic and
> hypnotic at the same time (with clonazepam
> later adjuncted). Unfortunately, severe
> depression returned after about
> 2 and a half months. Imipramine had to be
> reintroduced.
>
> It was the best alternative of about 16-20
> drugs tried, including SSRIs and an MAOI.
> The condition is severe, endogenous depression.
>
>
> Conclusion:
>
> It seems that imipramine is
> a stronger antidepressant than
> Remeron. Imipramine also seems
> to produce more anxiety than Remeron
> (otherwise the anxiety is part of the
> depression condition). Anxiety can
> be handled easily in both ADs with the
> addition of clonazepam.
>
> SquigglesWhat were the problems you had with SSRI's? Did you try adding Remeron to one of them? Have you tried Clomipramine? Sorry for all the questions & no answers :)
Cheers,
Panda.
Posted by Sad Panda on January 20, 2004, at 2:22:25
In reply to Re: Imipramine again, posted by SLS on January 19, 2004, at 9:31:56
> I combined imipramine 300mg, Effexor 300mg, and Remeron 60mg without any adverse events.
>
>
> - Scott
>Ever tried Clomiparmine Scott?
Cheers,
Panda.
Posted by Squiggles on January 20, 2004, at 6:53:49
In reply to Re: Imipramine again » Squiggles, posted by Sad Panda on January 20, 2004, at 1:29:01
Problems with SSRIs were
- intense anxiety
- insomnia
- ineffective treatment of depression
Yes, clomipramine was tried - not as
good imipramine;Adjuncts were never really tried by
doctor, except Effexor WITH Imipramine -
which was little different from Imipramine.Best adjunct so far has been addition
of clonazepam to anxiety provoking effects
of Imipramine [assumed].Squiggles
Posted by Sad Panda on January 21, 2004, at 12:20:21
In reply to Re: Imipramine again » Sad Panda, posted by Squiggles on January 20, 2004, at 6:53:49
> Problems with SSRIs were
> - intense anxiety
> - insomnia
> - ineffective treatment of depression
>
>
> Yes, clomipramine was tried - not as
> good imipramine;
>
> Adjuncts were never really tried by
> doctor, except Effexor WITH Imipramine -
> which was little different from Imipramine.
>
> Best adjunct so far has been addition
> of clonazepam to anxiety provoking effects
> of Imipramine [assumed].
>
> SquigglesWhat happened when you tried Desipramine? :)
Cheers,
Panda.
Posted by Squiggles on January 21, 2004, at 13:44:41
In reply to Re: Imipramine again » Squiggles, posted by Sad Panda on January 21, 2004, at 12:20:21
> What happened when you tried Desipramine? :)
>
> Cheers,
> Panda.
Panda, it was the same as imipramine only
3x as expensive - that's the reply i got.Squiggles
This is the end of the thread.
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