Psycho-Babble Medication Thread 836230

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Imipramine/Lexapro - have anything in common?

Posted by brooke484 on June 24, 2008, at 13:34:08

I've been on a lot of meds since 1993. These two drugs are the only two that worked (in 1993 and in 2002) but when I tried them again (and again and again) I had too many side effects and could not take them. I was on 600 mgs of Imipramine at one point and even that didn't work.

So, does anyone know what these two have in common, if anything? I haven't been able to find a medication that works in 6 years.

Thanks so much,

brooke

 

Re: Imipramine/Lexapro - have anything in common? brooke484

Posted by SLS on June 24, 2008, at 13:59:18

In reply to Imipramine/Lexapro - have anything in common?, posted by brooke484 on June 24, 2008, at 13:34:08

Hi Brooke.

Antidepressants do so many different things, both known and unknown, that it is difficult to give a comprehensive answer to your question. However, one commonality between both drugs is that they inhibit the reuptake of serotonin (5-HT).

Hopefully, Linkadge or one of the equally knowledgeable posters here will respond to your question, as I am not confident in my ability to list all the effects that these drugs have on receptors.

It can't be emphasized enough that the net effect of two "similar" drugs can be very different biologically. The localization of the brain circuitry being manipulated can be quite different. It gets real complicated from here. Much of the difference between similar drugs lies in the ratios of effect on various receptors, whether direct or indirect.

My guess is that you will probably need a combination of drugs with different mechanisms of action. For example, I had some success combining nortriptyline with Effexor (TCA + SNRI). Hopefully, you won't need to take 5 different drugs for depression as I do.

Current Treatment:

Nardil 90mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
Deplin 7.50mg


Thanks for telling your story. You are not the first person who has had trouble returning to a previously effective treatment.


- Scott


> I've been on a lot of meds since 1993. These two drugs are the only two that worked (in 1993 and in 2002) but when I tried them again (and again and again) I had too many side effects and could not take them. I was on 600 mgs of Imipramine at one point and even that didn't work.
>
> So, does anyone know what these two have in common, if anything? I haven't been able to find a medication that works in 6 years.
>
> Thanks so much,
>
> brooke

 

Re: Imipramine/Lexapro - have anything in common?

Posted by brooke484 on June 24, 2008, at 22:01:44

In reply to Re: Imipramine/Lexapro - have anything in common? brooke484, posted by SLS on June 24, 2008, at 13:59:18

Thanks for your reply. I guess I am asking a pretty complicated question.

I would take 10 different medications if I knew it would help. No one should feel this bad.

Thanks again,

brooke

 

Re: Imipramine/Lexapro - have anything in common? brooke484

Posted by Phillipa on June 25, 2008, at 0:52:19

In reply to Re: Imipramine/Lexapro - have anything in common?, posted by brooke484 on June 24, 2008, at 22:01:44

Brooke I'm sorry you feel so bad. Love Phillipa

 

Re: Imipramine/Lexapro - Phillipa

Posted by brooke484 on June 25, 2008, at 22:12:09

In reply to Re: Imipramine/Lexapro - have anything in common? brooke484, posted by Phillipa on June 25, 2008, at 0:52:19

Thanks Phillipa. Tomorrow will be 3 weeks on EMSAM but it hasn't done anything yet. I'm trying to be patient.

brooke

 

Re: Imipramine/Lexapro - have anything in common? brooke484

Posted by Marty on June 26, 2008, at 13:59:22

In reply to Imipramine/Lexapro - have anything in common?, posted by brooke484 on June 24, 2008, at 13:34:08


The only thing I see is that they are both very strong Serotonin Reuptake Inhibitor compared to much of the other AD of the SSRI and Tricyclic familly. In fact, Escitalopram (Lexapro) is the most selective (and so stronger) SSRI: escitalopram has the highest affinity for the human serotonin transporter (SERT) which is the thing AD needs to inhibite in order to reduce the reuptake of serotonine. Also Imipramine is said to have a strong SERT affinity.

Apart from that they have more differences than anything else. Escitalopram is the AD which 'plays' with the less stuff apart the SERT which make it the AD with (usually) less Side effects. While Imipramine 'plays' with about everything : norepinephrine, serotonin, dopamine, epinephrine, opiates, enkephalinase, histamine, muscarine, and acetylcholine. That makes it the LESS selective and Escitalopram the MOST selective.

I wonder how you would feel on a very small dose of Imipramine with a medium dose (or strong) of Escitalopram.... that could be very good for you I suspect.

/\/\arty

 

Thanks Marty! nm

Posted by brooke484 on June 27, 2008, at 13:18:39

In reply to Re: Imipramine/Lexapro - have anything in common? brooke484, posted by Marty on June 26, 2008, at 13:59:22

.


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