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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk on July 27, 2005, at 17:32:47
In reply to Re: I don't hate amitriptyline (Elavil) anymore......., posted by Tom Twilight on July 27, 2005, at 9:54:30
Hi Tom!
>I felt fine the next day.
I thought you would do :-) I was just concerned about the risk of SS.
Did it help you sleep?
Kind regards
~Ed
Posted by ed_uk on August 7, 2005, at 16:24:07
In reply to I don't hate amitriptyline (Elavil) anymore......., posted by ed_uk on July 26, 2005, at 15:38:46
Hi!
I'm still taking a low dose of amitriptyline at night. It's surprisingly ok, I haven't really had any side effects. I take 10-30mg.
~Ed
Posted by ed_uk on August 7, 2005, at 16:42:19
In reply to Amitriptyline is ok, posted by ed_uk on August 7, 2005, at 16:24:07
How did you find it?
~Ed
Posted by KaraS on August 7, 2005, at 18:06:04
In reply to Amitriptyline is ok, posted by ed_uk on August 7, 2005, at 16:24:07
> Hi!
>
> I'm still taking a low dose of amitriptyline at night. It's surprisingly ok, I haven't really had any side effects. I take 10-30mg.
>
> ~Ed
It's supposed to be more sedating than doxepin, isn't it?K
Posted by ed_uk on August 8, 2005, at 14:06:37
In reply to Re: Amitriptyline is ok » ed_uk, posted by KaraS on August 7, 2005, at 18:06:04
Hi K,
>It's supposed to be more sedating than doxepin, isn't it?
Not really, it's variable which TCA people find to be the most sedating.
Ed xx
Posted by darkhorse on August 11, 2005, at 8:50:07
In reply to Has anyone tried amitriptyline for depression?, posted by ed_uk on August 7, 2005, at 16:42:19
> How did you find it?
>
> ~EdHI ED!
Yes I tried it 25 mg + 50 mg of imipramine : it oimmediatly improved my sleep and anxiety. Hmmmm,this was a very good combination .
After trying so many TCA's I believe the golden rule is to go very slowly 10 -25- 50 -75 mg in 2-3 weeks,because in this way the body get accustomed to the drug and things like sedation and dry mouth ..etc start to fade totally.That is why people can take up to 200mg with no big side effects.The only lasting side effect is an increase in appetite and weight gain.All the best,
Dark Horse.
Posted by darkhorse on August 11, 2005, at 8:53:03
In reply to Re: Amitriptyline is ok » KaraS, posted by ed_uk on August 8, 2005, at 14:06:37
> Hi K,
>
> >It's supposed to be more sedating than doxepin, isn't it?
>
> Not really, it's variable which TCA people find to be the most sedating.
>
> Ed xxIn my experience Mirtazapine,Trazodone and Doxepin are more sedating.
Mianserin,Nefazodone and Amiriptyline come 2nd.
All the best!
Dark Horse.
Posted by ed_uk on August 11, 2005, at 14:27:47
In reply to Re: Has anyone tried amitriptyline for depression? » ed_uk, posted by darkhorse on August 11, 2005, at 8:50:07
Hi DH!
>I believe the golden rule is to go very slowly 10 -25- 50 -75 mg in 2-3 weeks
I agree absolutely!
~Ed (Edward)
Posted by KaraS on August 11, 2005, at 17:57:31
In reply to Re: Amitriptyline is ok » KaraS, posted by ed_uk on August 8, 2005, at 14:06:37
Sad Panda used to use 100 mg. of amitriptyline along with Effexor. It worked very well for him.
k
Posted by ed_uk on August 12, 2005, at 1:17:24
In reply to Re: Amitriptyline is ok » ed_uk, posted by KaraS on August 11, 2005, at 17:57:31
Hi K!
Have you ever tried amitriptyline?
~Ed x
Posted by Jedi on August 13, 2005, at 2:51:36
In reply to Re: I don't hate amitriptyline (Elavil) anymore......., posted by Tom Twilight on July 27, 2005, at 9:54:30
> Could/would you take 10mg amitriptyline (with 10mg Parnate) for sleep? You reckon Zolpidem would be better? Any other suggestions?
> > Declan
>
> Hey Declan
>
> I'm not Ed, but I'm on 30mgs of Marplan, last night I took 20mgs of Amitryptaline for sleep
> I felt fine the next day
>
> I imagine that the major risk from this combination is serotonin syndrome, but at low doses I don't imagine this would be a problem
> Still its early days
>Hi,
Though officially contraindicated the MAOI/tricyclic combination has been well studied. I have used phenelzine with nortriptyline (the active metabolite of amitriptyline) with no problem. The usual method is to add the MAOI to an established dosage of tricyclic or start the two simultaneously. Some people have been able to go the other way, but it is more risky. At the small dosage your describing, I don’t know.
JediHere is an abstract of a long-term combination study:
J Affect Disord. 1995 Jun 8;34(3):187-92.
A 3-year follow-up of a group of treatment-resistant depressed patients with a MAOI/tricyclic combination.Berlanga C, Ortega-Soto HA.
Division of Clinical Research, Mexican Institute of Psychiatry, Mexico, DF.Treatment-resistant depression is a clinical complication that not infrequently affects a certain number of patients. Within the treatment strategies proposed for this condition, the association of a MAO inhibitor (MAOI) with a tricyclic antidepressant has gained reputation both for its unusual efficacy, as for its potential toxicity. However, when cautions are taken, it may be safely administered. Most reports on this combination have been carried in nonresistant patients and, when resistant patients are included, only the acute phase of the treatment is reported. In this study, a group of well-defined resistant patients received an open trial with the association of isocarboxazide and amitryptiline (n = 25). Those who responded were followed during the next 3 years (n = 12) and every 6 months an attempt was made to discontinue the MAOI and continue only with amitryptiline. At the end of the study, 4 patients maintained response with single medication, 6 still required both drugs and 2 relapsed. No clinical differences were apparent between the outcome groups, except that those who maintained their response only with the 2 combined drugs had more previous depressive episodes than the others. The isocarboxazide/amitryptiline combination may be a good treatment option for at least some forms of resistant depression. The safety of this treatment modality is confirmed, even when given for long periods of time. The study also suggest that there are no clinical characteristics in resistant depression that may predict the treatment outcome but, perhaps in some patients, a combined treatment is required to obtain a broader biochemical effect that could convert them from nonresponders to responders.
PMID: 7560546 [PubMed - indexed for MEDLINE]
Posted by darkhorse on August 13, 2005, at 3:57:50
In reply to MAOI combined with tricyclic, posted by Jedi on August 13, 2005, at 2:51:36
I tried Amitriptyline 25mg with Tranylcypromine 60mg with no ill effects.
Not all TCA's are containdicated with MAOIs;the more serotonergics are more dangerous, so apart from Clomipramine,Imipramine,all SSRIs,Venlafaxine,Duloxetine(and maybe Milnacipran),any other Antidepressant would not cause a problem(e.g all other TCAs,Maprotiline,Reboxetine,Trazodone,Mirtazapine..etc)
Posted by KaraS on August 13, 2005, at 15:09:15
In reply to Re: Amitriptyline is ok » KaraS, posted by ed_uk on August 12, 2005, at 1:17:24
> Hi K!
>
> Have you ever tried amitriptyline?
>
> ~Ed xOnly once. The first doctor I went to for anxiety/depression gave me a 75 mg. sample of amitriptyline to take. I was out for a couple of days. I know it was way too big a starting dose but still I've never gone near it again!
K
xx
Posted by ed_uk on August 13, 2005, at 18:15:58
In reply to Re: Amitriptyline is ok » ed_uk, posted by KaraS on August 13, 2005, at 15:09:15
Arghhhhhhh! Start at 10mg if you want to try it - I'd expect you'd like it.
~Ed
Posted by KaraS on August 13, 2005, at 19:06:24
In reply to Re: Amitriptyline is ok » KaraS, posted by ed_uk on August 13, 2005, at 18:15:58
> Arghhhhhhh! Start at 10mg if you want to try it - I'd expect you'd like it.
>
> ~Ed
Probably but what's the advantage over doxepin? They're very similar, aren't they?L
Posted by Jedi on August 13, 2005, at 19:09:27
In reply to Re: MAOI combined with tricyclic » Jedi, posted by darkhorse on August 13, 2005, at 3:57:50
> I tried Amitriptyline 25mg with Tranylcypromine 60mg with no ill effects.
>
> Not all TCA's are containdicated with MAOIs;the more serotonergics are more dangerous, so apart from Clomipramine,Imipramine,all SSRIs,Venlafaxine,Duloxetine(and maybe Milnacipran),any other Antidepressant would not cause a problem(e.g all other TCAs,Maprotiline,Reboxetine,Trazodone,Mirtazapine..etc)Hi,
Obviously the US prescribing information provided by Pfizer for phenelzine is overly conservative. What this does is make it very difficult for people to know what is really dangerous and what is not. I have eaten many of the foods and taken many of the medications that are warned about in the prescribing information for phenelzine and tranylcypromine. However, I will not advise another person to do the same. I do my own research and take my own chances. I have been burned in the past listening to advice from pharmacists and MDs. Once a supermarket pharmacist told me a cough syrup I asked them about would be fine with phenelzine as long as it didn’t contain dextromethorphan. That should have been my clue right there that she didn’t know what she was talking about. I had misplaced my reading glasses or I could have seen the microscopic print, 30mg pseudoephedrine hydrochloride. That was a $1000 mistake: a mild hypertensive crisis, a trip to the ER, and a CT scan later. It could have been much worse. If she didn’t know the answer for sure, that’s what those computer terminals are for.The best source for actual MAOI food restrictions I’ve found:
http:/www.dr-bob.org/babble/20010814/msgs/75408.html
This list was compiled by Elizabeth; “the guru of treatment resistant depression”. In my experience with MAOIs, I’ve found it to be very accurate. Does anyone know what Elizabeth is doing now? She was a wealth of knowledge in the earlier days of babble.
JediPrescribing information for phenelzine:
http://www.pfizer.com/pfizer/download/uspi_nardil.pdf… “CONTRAINDICATIONS
NARDIL should not be used in patients who are hypersensitive to the drug or its
ingredients, with pheochromocytoma, congestive heart failure, a history of liver disease,
or abnormal liver function tests.
The potentiation of sympathomimetic substances and related compounds by MAO
inhibitors may result in hypertensive crises (see WARNINGS). Therefore, patients being
treated with NARDIL should not take sympathomimetic drugs (including amphetamines,
cocaine, methylphenidate, dopamine, epinephrine, and norepinephrine) or related
compounds (including methyldopa, L-dopa, L-tryptophan, L-tyrosine, and
phenylalanine). Hypertensive crises during NARDIL therapy may also be caused by the
ingestion of foods with a high concentration of tyramine or dopamine. Therefore, patients
being treated with NARDIL should avoid high protein food that has undergone protein
breakdown by aging, fermentation, pickling, smoking, or bacterial contamination.
Patients should also avoid cheeses (especially aged varieties), pickled herring, beer, wine,
liver, yeast extract (including brewer’s yeast in large quantities), dry sausage (including
Genoa salami, hard salami, pepperoni, and Lebanon bologna), pods of broad beans (fava
beans), and yogurt. Excessive amounts of caffeine and chocolate may also cause
hypertensive reactions.NARDIL should not be used in combination with dextromethorphan or with CNS
depressants such as alcohol and certain narcotics. Excitation, seizures, delirium,
hyperpyrexia, circulatory collapse, coma, and death have been reported in patients
receiving MAOI therapy who have been given a single dose of meperidine. NARDIL
should not be administered together with or in rapid succession to other MAO inhibitors
because HYPERTENSIVE CRISES and convulsive seizures, fever, marked sweating,
excitation, delirium, tremor, coma, and circulatory collapse may occur. ...
Posted by Jedi on August 13, 2005, at 19:19:17
In reply to Nardil - US Prescribing Information from Pfizer, posted by Jedi on August 13, 2005, at 19:09:27
The link to Elizabeth's "MAOI Short List" of food restrictions didn't convert for me. Copy and paste to your address line and it will take you there.
Jedi
Posted by ed_uk on August 14, 2005, at 9:20:27
In reply to Re: Amitriptyline is ok » ed_uk, posted by KaraS on August 13, 2005, at 19:06:24
Hi K,
>Probably but what's the advantage over doxepin?
I've always believed that amitriptyline was probably more effective. It's a much more potent serotonin and NE reuptake inhibitor than doxepin. It's a better established AD. It's probably more likely to cause tachycardia though........ but not much as desipramine.
Ed xx
Posted by ed_uk on August 14, 2005, at 9:22:43
In reply to Nardil - US Prescribing Information from Pfizer, posted by Jedi on August 13, 2005, at 19:09:27
Hi,
>This list was compiled by Elizabeth; “the guru of treatment resistant depression”.
Wasn't she just!
>Does anyone know what Elizabeth is doing now?
I tried to find out but I couldn't, no one seems to know for sure.
Kind regards
~ed
Posted by darkhorse on August 14, 2005, at 12:05:42
In reply to Re: Amitriptyline is ok » KaraS, posted by ed_uk on August 14, 2005, at 9:20:27
Hi ED :
> I've always believed that amitriptyline was probably more effective. It's a much more potent serotonin and NE reuptake inhibitor than doxepin. It's a better established AD. It's probably more likely to cause tachycardia though........ but not much as desipramine.Me too. In my opinion Doxepin is a powerful anti-histamine medican, with very mild 5ht/ne uptake as a bonus!
However I agree that Amit. is a potent NE/5ht,5ht2 antagonist,and anti- histaminic as a bonus!
Yes, desipramine gave me the 2nd worst tachycardia ever (after the pro-aggression/depressive Sibutramine).
Posted by KaraS on August 14, 2005, at 15:50:06
In reply to Re: Amitriptyline is ok » KaraS, posted by ed_uk on August 14, 2005, at 9:20:27
> Hi K,
>
> >Probably but what's the advantage over doxepin?
>
> I've always believed that amitriptyline was probably more effective. It's a much more potent serotonin and NE reuptake inhibitor than doxepin. It's a better established AD. It's probably more likely to cause tachycardia though........ but not much as desipramine.
>
> Ed xx
Thanks. Maybe someday I'll try it again. Right now, since it is more likely to cause tachycardia, then I think I'll stay away from it. I don't want to be combining it with the Dex.K xx
Posted by KaraS on August 14, 2005, at 15:54:34
In reply to Re: Amitriptyline is ok » ed_uk, posted by darkhorse on August 14, 2005, at 12:05:42
> Hi ED :
>
> > I've always believed that amitriptyline was probably more effective. It's a much more potent serotonin and NE reuptake inhibitor than doxepin. It's a better established AD. It's probably more likely to cause tachycardia though........ but not much as desipramine.
>
> Me too. In my opinion Doxepin is a powerful anti-histamine medican, with very mild 5ht/ne uptake as a bonus!
> However I agree that Amit. is a potent NE/5ht,5ht2 antagonist,and anti- histaminic as a bonus!
> Yes, desipramine gave me the 2nd worst tachycardia ever (after the pro-aggression/depressive Sibutramine).
>
Yes, doxepin's anti-histamine effect has been great for me for a number of reasons.I'm surprised that you're calling sibutramine "pro agression/depressive". I know of two people who have mentioned recently that they really want to try it as an AD (one of them being SLS).
k
Posted by KaraS on August 14, 2005, at 17:45:33
In reply to Re: Amitriptyline is ok, posted by KaraS on August 14, 2005, at 15:54:34
Posted by Phillipa on August 14, 2005, at 18:28:48
In reply to Re: Amitriptyline is ok, posted by KaraS on August 14, 2005, at 15:54:34
Hi Kara, Just wondering if you'd heard from Scott SLS. Last time I saw a post he wasn't doing well at all with his trileptal. Fondly, Phillipa
Posted by KaraS on August 14, 2005, at 18:36:32
In reply to Re: Amitriptyline is ok » KaraS, posted by Phillipa on August 14, 2005, at 18:28:48
> Hi Kara, Just wondering if you'd heard from Scott SLS. Last time I saw a post he wasn't doing well at all with his trileptal. Fondly, Phillipa
Hi,He posted a couple times recently further down on the board. You may have seen his posts already by the time you read this.
K
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