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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 tendency on April 15, 2005, at 17:01:59
if i decide to try a TCA for my anxiety which is a good first line one to try? what side effects might i expect?
will it be helpful for depression and some ocd tendencies i have?
could it trigger hypomania?
thanks.
Posted by Maxime on April 15, 2005, at 17:34:54
In reply to need help picking TCA, posted by tendency on April 15, 2005, at 17:01:59
Amitryptaline (sp?) Don't take this wrong way, but we once had a dog who when she got older became very anxious. The vet prescribed Ami! It is highly sedating, but some people get used to it after a while. I took to help me sleep (weird to your dog's antidepressant medication to help you sleep!). Funny I took the same dosage as her and it would knock me out. It didn't knock her out. I was later presribed it myself.
Maxime
> if i decide to try a TCA for my anxiety which is a good first line one to try? what side effects might i expect?
>
> will it be helpful for depression and some ocd tendencies i have?
>
> could it trigger hypomania?
>
> thanks.
Posted by banga on April 15, 2005, at 17:44:41
In reply to Re: need help picking TCA » tendency, posted by Maxime on April 15, 2005, at 17:34:54
Of the TCAs, clomipramine is the one that has strong anti-OCD properties. Others can help as well..in terms of triggering hypomania, I am not quite sure...my guess is, if SSRIs don't trigger hypomania for you, then clomipramine could be fine.
It is generally described as acting mostly on serotonin, but it in fact also affects norepinephrine powerfully as well.
Side effects can be grogginess, spaciness, orthostatic hypotension (becoming dizzy when you stand up, esp. if you had low blood pressure to begin with), and weight gain for some people.
Some people are hit by side effects quite badly, however some people (like me with my odd chemistry) have little to no side effects.For me this medication helped immensely with negative ruminations and preoccupations.
There are other TCAs that could help, but this is the main OCD one people think of.
Posted by linkadge on April 15, 2005, at 18:37:26
In reply to Re: need help picking TCA, posted by banga on April 15, 2005, at 17:44:41
Clomipramine is helpful for depression OCD and anxiety.
The drowsyness will go away, but you will be somewhat dummer in the morning. This clears up
by about noon. You won't feel dumb in the evening.Amitryptaline might be better for insomnia, and depression, but perhpas less effective for OCD symptoms.
Doxapine would be good for sleep/depression, but less effective for OCD.
There are others but with different profiles/uses, but not much application for OCD.
Linkadge
Posted by Phillipa on April 15, 2005, at 19:34:38
In reply to Re: need help picking TCA, posted by linkadge on April 15, 2005, at 18:37:26
What's the best one for chronic low grade depression and anxiety? I was once given one to try and it caused me to cry and walk around the block all night. Fondly, Phillipa
Posted by banga on April 16, 2005, at 7:55:25
In reply to Re: need help picking TCA, posted by Phillipa on April 15, 2005, at 19:34:38
I'd still venture to guess clomipramine, since it has the more potent antianxiety property. Supposedly Nortryptiline too could help, as it too blocks the 5ht2a receptor....
Are you considering changing your medication?
Posted by theo on April 16, 2005, at 12:21:31
In reply to Re: need help picking TCA, posted by Phillipa on April 15, 2005, at 19:34:38
> What's the best one for chronic low grade depression and anxiety? I was once given one to try and it caused me to cry and walk around the block all night. Fondly, Phillipa
Which one caused this?
Posted by Phillipa on April 16, 2005, at 14:43:56
In reply to Re: need help picking TCA » Phillipa, posted by theo on April 16, 2005, at 12:21:31
Theo, I wish I could remember the name. I was only 23 at the time. I remember being told it was an upper-downer. That was a long time ago.
Bangs, No, I'm not thinking of changing meds. I'm just trying to educate myself because of the bad experience I had in the past. Just picked my pharmacist's brain, and he said they now have some sort of pharmacist PA, who can Rx medications but then the chart has to be reviewed by a pdoc. He said they are constantly calling pdocs questioning doseages of meds and combos they have Rx'd. He said they don't have the foggiest. He said pharmacists go to school to learn abaout meds, and a doctor goes to learn anatomy,etc. He even agreed the pharmacitical companies give out huge incentives to use their drugs. He looked Lunesta up just for curiousity, and said it comes in l,2,3mg tablets. They're not enteric coated, and the cost of a lmg tab was $3.37. He was shocked. He agreed to stick with tried and true drugs like valium. He also said Roche doesn't have a generic of their own. Greenstone is the generic version of xanax that is manufactured by the manufacturers of xanax, so it's the real deal. Fondly, Phillipa
This is the end of the thread.
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