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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by KarenRB53 on October 14, 2008, at 8:24:50
I've read all the posts in "the best tricyclic for depression" and learned a lot and I even responded asking about depression. Thought I'd get some info by opening new post about tricyclics for depression. I have Major Depression (Atypical). I have used Prozac for over 10yrs but its stopped working for me. Tried augmenting with Wellbutrin but that caused more agitation. My pdoc wants me to try Imipramine. I'd appreciate any information.
Karen
Posted by azalea on October 14, 2008, at 9:50:50
In reply to Best Tricyclic for Depression, posted by KarenRB53 on October 14, 2008, at 8:24:50
What dose of Prozac are you taking? There are many strategies for dealing with Prozac poop-out. One is increasing the dose. You could also try augmenting with a Lamictal or Lithium.
Switching to imipramine is an option, but you might ask your doctor about trying SSRI augmenting agents before switching to a TCA.
> I've read all the posts in "the best tricyclic for depression" and learned a lot and I even responded asking about depression. Thought I'd get some info by opening new post about tricyclics for depression. I have Major Depression (Atypical). I have used Prozac for over 10yrs but its stopped working for me. Tried augmenting with Wellbutrin but that caused more agitation. My pdoc wants me to try Imipramine. I'd appreciate any information.
>
> Karen
Posted by KarenRB53 on October 14, 2008, at 10:13:20
In reply to SSRI augmentation » KarenRB53, posted by azalea on October 14, 2008, at 9:50:50
> What dose of Prozac are you taking? There are many strategies for dealing with Prozac poop-out. One is increasing the dose. You could also try augmenting with a Lamictal or Lithium.
>
> Switching to imipramine is an option, but you might ask your doctor about trying SSRI augmenting agents before switching to a TCA.
>
> > I've read all the posts in "the best tricyclic for depression" and learned a lot and I even responded asking about depression. Thought I'd get some info by opening new post about tricyclics for depression. I have Major Depression (Atypical). I have used Prozac for over 10yrs but its stopped working for me. Tried augmenting with Wellbutrin but that caused more agitation. My pdoc wants me to try Imipramine. I'd appreciate any information.
> >
> > Karen
>
>Hi: I just tapered off Prozac completely so am on nothing right now. Its been 5 wks. I did try augmenting with Wellbutrin, Buspar and Lamictal. The Wellbutrin and Lamictal both caused more agitation and the Buspar did nothing. I appreciate your responding.
Karen
Posted by bulldog2 on October 14, 2008, at 10:26:48
In reply to Best Tricyclic for Depression, posted by KarenRB53 on October 14, 2008, at 8:24:50
> I've read all the posts in "the best tricyclic for depression" and learned a lot and I even responded asking about depression. Thought I'd get some info by opening new post about tricyclics for depression. I have Major Depression (Atypical). I have used Prozac for over 10yrs but its stopped working for me. Tried augmenting with Wellbutrin but that caused more agitation. My pdoc wants me to try Imipramine. I'd appreciate any information.
>
> KarenImipramine used to be called the gold standard for depression. With the advent of ssris the tcas went more into disuse as the tcas generally have more side effects. If you google the archives there are some very good results using this med and it probably is more effective against major depression than the ssris. Of the tcas,Imipramine has a fairly balanced reuptake of both serotonin and norepinephrine.
Posted by KarenRB53 on October 14, 2008, at 10:44:23
In reply to Re: Best Tricyclic for Depression, posted by bulldog2 on October 14, 2008, at 10:26:48
> > I've read all the posts in "the best tricyclic for depression" and learned a lot and I even responded asking about depression. Thought I'd get some info by opening new post about tricyclics for depression. I have Major Depression (Atypical). I have used Prozac for over 10yrs but its stopped working for me. Tried augmenting with Wellbutrin but that caused more agitation. My pdoc wants me to try Imipramine. I'd appreciate any information.
> >
> > Karen
>
> Imipramine used to be called the gold standard for depression. With the advent of ssris the tcas went more into disuse as the tcas generally have more side effects. If you google the archives there are some very good results using this med and it probably is more effective against major depression than the ssris. Of the tcas,Imipramine has a fairly balanced reuptake of both serotonin and norepinephrine.
Thanks so much. I think I'm going to give it a try at the lowest dosage to start. The script is for 25mg however I'm going to google and see if its okay to cut in half for a few days.Karen
Posted by Phillipa on October 14, 2008, at 10:50:21
In reply to Re: Best Tricyclic for Depression, posted by KarenRB53 on October 14, 2008, at 10:44:23
Karen good luck been following your posts. Phillipa
Posted by KarenRB53 on October 14, 2008, at 11:11:25
In reply to Re: Best Tricyclic for Depression, posted by Phillipa on October 14, 2008, at 10:50:21
> Karen good luck been following your posts. Phillipa
Thanks, I appreciate your concern.
Karen
Posted by greywolf on October 14, 2008, at 23:38:06
In reply to Re: Best Tricyclic for Depression, posted by KarenRB53 on October 14, 2008, at 11:11:25
Have you tried Remeron? Imipramine did nothing for me. I'm on Remeron now at a low starting dose, and it seems cleaner than imipramine--though it is as sedating as all heck and makes me ravenous.
Greywolf
Posted by KarenRB53 on October 15, 2008, at 8:08:23
In reply to Re: Best Tricyclic for Depression, posted by bulldog2 on October 14, 2008, at 10:26:48
Also, was wondering what dosage do people usually start out at and when to increase plus do most take it in the morning or evening?
Karen
Posted by KarenRB53 on October 15, 2008, at 8:10:17
In reply to Re: Best Tricyclic for Depression » KarenRB53, posted by greywolf on October 14, 2008, at 23:38:06
> Have you tried Remeron? Imipramine did nothing for me. I'm on Remeron now at a low starting dose, and it seems cleaner than imipramine--though it is as sedating as all heck and makes me ravenous.
>
> GreywolfNo, I've not tried Remeron. I've read a lot about it causing weight gain and I'm still trying to lose weight I gained from Prozac. I know TCA's are bad for weight gain too.
Karen
Posted by azalea on October 15, 2008, at 10:51:00
In reply to Re: Best Tricyclic for Depression, posted by KarenRB53 on October 15, 2008, at 8:08:23
Karen,
For imipramine, the starting dosage is usually 25mg taken at night with increases in 25mg increments every 3-4 days as tolerated. Some pdocs may recommend a slower or faster titration, so be sure to ask your pdoc. Maximum is 300mg/day. Typical effective dose for depression is 150-300mg. I hope imipramine works well for you. Let us know.
> Also, was wondering what dosage do people usually start out at and when to increase plus do most take it in the morning or evening?
>
> Karen
Posted by KarenRB53 on October 15, 2008, at 14:06:55
In reply to imipramine dosing » KarenRB53, posted by azalea on October 15, 2008, at 10:51:00
> Karen,
>
> For imipramine, the starting dosage is usually 25mg taken at night with increases in 25mg increments every 3-4 days as tolerated. Some pdocs may recommend a slower or faster titration, so be sure to ask your pdoc. Maximum is 300mg/day. Typical effective dose for depression is 150-300mg. I hope imipramine works well for you. Let us know.
>
> > Also, was wondering what dosage do people usually start out at and when to increase plus do most take it in the morning or evening?
> >
> > Karen
>
>Thanks very much for the information. I will post how things work out.
Karen
Posted by bulldog2 on October 15, 2008, at 15:29:06
In reply to Re: imipramine dosing, posted by KarenRB53 on October 15, 2008, at 14:06:55
> > Karen,
> >
> > For imipramine, the starting dosage is usually 25mg taken at night with increases in 25mg increments every 3-4 days as tolerated. Some pdocs may recommend a slower or faster titration, so be sure to ask your pdoc. Maximum is 300mg/day. Typical effective dose for depression is 150-300mg. I hope imipramine works well for you. Let us know.
> >
> > > Also, was wondering what dosage do people usually start out at and when to increase plus do most take it in the morning or evening?
> > >
> > > Karen
> >
> >
>
> Thanks very much for the information. I will post how things work out.
>
> KarenI think appetite and weight gain would be a bigger issue on remeron than imipramine. I found the fatigue on remeron unbareable and appetite increase off the wall.
Posted by Jay_Bravest_Face on October 15, 2008, at 22:56:58
In reply to Best Tricyclic for Depression, posted by KarenRB53 on October 14, 2008, at 8:24:50
I am just starting imipramine with my Prozac too. I'll let you know how I make out as well. Best wishes....
Jay
Posted by KarenRB53 on October 16, 2008, at 7:53:00
In reply to Re: Best Tricyclic for Depression » KarenRB53, posted by Jay_Bravest_Face on October 15, 2008, at 22:56:58
> I am just starting imipramine with my Prozac too. I'll let you know how I make out as well. Best wishes....
>
> Jay
I've come right off Prozac and just started Imipramine by itself. Did you add Imipramine to Prozac because it stopped working as well for you? How much Prozac and Imipramine are you using?Karen
Posted by Jay_Bravest_Face on October 16, 2008, at 16:30:10
In reply to Re: Best Tricyclic for Depression, posted by KarenRB53 on October 16, 2008, at 7:53:00
> > I am just starting imipramine with my Prozac too. I'll let you know how I make out as well. Best wishes....
> >
> > Jay
>
>
> I've come right off Prozac and just started Imipramine by itself. Did you add Imipramine to Prozac because it stopped working as well for you? How much Prozac and Imipramine are you using?
>
> KarenI am using quite a high dose of both. (BTW, the max on Imipramine is 300mg's.) 150mg of Imipramine, and 80mg's of Prozac. These meds are right for me, and I can tolerate them, so my doc and I 'pushed the envelope' a bit. I am also on clonazepam, risperdal, and topomax. All seems very good so far. No "high" or "low". How are you doing? It is best to start out at a lower dose. as I have seen you do. Let me know how you make out!
Jay :)
Posted by KarenRB53 on October 16, 2008, at 18:00:49
In reply to Re: Best Tricyclic for Depression » KarenRB53, posted by Jay_Bravest_Face on October 16, 2008, at 16:30:10
> > > I am just starting imipramine with my Prozac too. I'll let you know how I make out as well. Best wishes....
> > >
> > > Jay
> >
> >
> > I've come right off Prozac and just started Imipramine by itself. Did you add Imipramine to Prozac because it stopped working as well for you? How much Prozac and Imipramine are you using?
> >
> > Karen
>
> I am using quite a high dose of both. (BTW, the max on Imipramine is 300mg's.) 150mg of Imipramine, and 80mg's of Prozac. These meds are right for me, and I can tolerate them, so my doc and I 'pushed the envelope' a bit. I am also on clonazepam, risperdal, and topomax. All seems very good so far. No "high" or "low". How are you doing? It is best to start out at a lower dose. as I have seen you do. Let me know how you make out!
>
> Jay :)
>
>Hi Jay: I'm up to 25mg imipramine for last 3 nights but its affecting my sleep (wake up several times during night) and it seems to be making me more agitated. How long have you been using the combination? Prozac was wonderful for me and when I first started taking it about 10yrs ago it was almost "miraculous". Kind of dramatic but seemed true at the time. I felt happy to be alive probably for the first time in my life. But then it just slowly stopped working for me and for the last year it just seemed I was getting the side effects without the benefits. I hope it continues to work for you.
Karen
Posted by bulldog2 on October 17, 2008, at 15:14:23
In reply to Re: Best Tricyclic for Depression, posted by KarenRB53 on October 16, 2008, at 18:00:49
> > > > I am just starting imipramine with my Prozac too. I'll let you know how I make out as well. Best wishes....
> > > >
> > > > Jay
> > >
> > >
> > > I've come right off Prozac and just started Imipramine by itself. Did you add Imipramine to Prozac because it stopped working as well for you? How much Prozac and Imipramine are you using?
> > >
> > > Karen
> >
> > I am using quite a high dose of both. (BTW, the max on Imipramine is 300mg's.) 150mg of Imipramine, and 80mg's of Prozac. These meds are right for me, and I can tolerate them, so my doc and I 'pushed the envelope' a bit. I am also on clonazepam, risperdal, and topomax. All seems very good so far. No "high" or "low". How are you doing? It is best to start out at a lower dose. as I have seen you do. Let me know how you make out!
> >
> > Jay :)
> >
> >
>
> Hi Jay: I'm up to 25mg imipramine for last 3 nights but its affecting my sleep (wake up several times during night) and it seems to be making me more agitated. How long have you been using the combination? Prozac was wonderful for me and when I first started taking it about 10yrs ago it was almost "miraculous". Kind of dramatic but seemed true at the time. I felt happy to be alive probably for the first time in my life. But then it just slowly stopped working for me and for the last year it just seemed I was getting the side effects without the benefits. I hope it continues to work for you.
>
> KarenAmitriptyline is better for anxiety and sleeping.
Posted by KarenRB53 on October 17, 2008, at 19:31:52
In reply to Re: Best Tricyclic for Depression, posted by bulldog2 on October 17, 2008, at 15:14:23
I don't like the way the Imipramine is making me feel at all so far. I'm not crying but I feel like I could put my fist through a window or something. Very agitated. No matter what anybody says or does it irritates me. I'm not normally like this at all. And I've only been on it about a week. Yikes.
Karen
Posted by francineus on October 17, 2008, at 22:51:32
In reply to Re: Best Tricyclic for Depression, posted by KarenRB53 on October 17, 2008, at 19:31:52
I'm sort of in the same boat. Was on Prozac for years and then it pooped out and then all antidepressants made me agitated. Some suspect that using ssri's for so long can cause what presents more of a form of bipolar (3) disorder. For this you might consider doing a mood stabilizer with the ssri. It's lousy though and I hear you. we're just guinea pigs until someone figures out how to treat depression. It's all guesswork now.
Right now I'm on Wellbutrin and it's okay but I take
klonopin as needed. Another thing you might consider.
Good luck. You're not alone
Posted by KarenRB53 on October 18, 2008, at 8:54:44
In reply to Re: Best Tricyclic for Depression, posted by francineus on October 17, 2008, at 22:51:32
> I'm sort of in the same boat. Was on Prozac for years and then it pooped out and then all antidepressants made me agitated. Some suspect that using ssri's for so long can cause what presents more of a form of bipolar (3) disorder. For this you might consider doing a mood stabilizer with the ssri. It's lousy though and I hear you. we're just guinea pigs until someone figures out how to treat depression. It's all guesswork now.
> Right now I'm on Wellbutrin and it's okay but I take
> klonopin as needed. Another thing you might consider.
> Good luck. You're not aloneThanks for the support. Does the Wellbutrin help well for the depression? Have you been on it for long and what dose did you start at and what are you taking now? Hope you don't mind the questions but I'm calling my pdoc on Monday and want to be prepared. Not only am I agitate by the Imipramine but this morning I woke up with hives on my face. I put cream on and it actually felt like it was burning. I didn't know you could be allergic to imipramine. Thats the only time I get hives, when I'm allergic to something.
Karen
Posted by Tomatheus on October 18, 2008, at 16:45:22
In reply to Re: Best Tricyclic for Depression, posted by KarenRB53 on October 17, 2008, at 19:31:52
Karen,
I had strong irritability on clomipramine, another tricyclic. I only ended up staying on the medication for a day (which is probably shorter than I should have stayed on it, but I couldn't stand the way that I was feeling on it).
Tomatheus
> I don't like the way the Imipramine is making me feel at all so far. I'm not crying but I feel like I could put my fist through a window or something. Very agitated. No matter what anybody says or does it irritates me. I'm not normally like this at all. And I've only been on it about a week. Yikes.
>
> Karen
Posted by KarenRB53 on October 18, 2008, at 16:48:20
In reply to Re: Best Tricyclic for Depression » KarenRB53, posted by Tomatheus on October 18, 2008, at 16:45:22
> Karen,
>
> I had strong irritability on clomipramine, another tricyclic. I only ended up staying on the medication for a day (which is probably shorter than I should have stayed on it, but I couldn't stand the way that I was feeling on it).
>
> Tomatheus
>
> > I don't like the way the Imipramine is making me feel at all so far. I'm not crying but I feel like I could put my fist through a window or something. Very agitated. No matter what anybody says or does it irritates me. I'm not normally like this at all. And I've only been on it about a week. Yikes.
> >
> > Karen
>
>Thanks for responding. Its good to know that someone else has been affected the same way.
Karen
Posted by Phillipa on October 18, 2008, at 19:04:09
In reply to Re: Best Tricyclic for Depression, posted by KarenRB53 on October 18, 2008, at 16:48:20
Karen and hives would be considered I think an allergic reaction and advise probably to stop the med. Phillipa
Posted by KarenRB53 on October 18, 2008, at 21:24:21
In reply to Re: Best Tricyclic for Depression, posted by Phillipa on October 18, 2008, at 19:04:09
> Karen and hives would be considered I think an allergic reaction and advise probably to stop the med. Phillipa
Hi Phillipa: Yes, I stopped the imipramine. I definitely believe I have had an allergic reaction. I'll be calling my doctor on Monday. Thanks for your concern.
Karen
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