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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Economist on March 30, 2010, at 13:09:00
I am done with the SSRIs and SNRIs. I'm on EMSAM right now with no effect. So I'd like to suggest something to my doctor next time. I'm suffering from anhedonia and lack of interest in everything around me.
Posted by hopefullynow on March 30, 2010, at 14:26:32
In reply to Is anyone here taking a tricyclic that works?, posted by Economist on March 30, 2010, at 13:09:00
Hy, I am on a combination of Anafranil(TCA) 25 mg and Maprotiline (TCA-NRI) at 75 mg.As an addon i take 1000 mg of Glucophage to stop the ravenous hunger from the meds-by the way, it works wonderful!.Anafranil worked long time ago, and always pull me from the deepest episodes of depression and anhedonia.Being an anhedonic it's not a fiable option on the long run without an NRI, i suggest you nortryptiline, maprotiline is dirtier and harder to tolerate.The addition of a NRI gives me calm and energy - but strage, only combined with Anafranil.Anafranil....I can't compare with any ssri, snri or any ad, it really works, even better than amitryptiline.I could feel a sense of joy that no other AD ever gave me and i suppose that this different sense of well being is not given by the fact that it targets serotonin, i feel it's about a combination of serotonin and opoid systems involved in its action.
As an add on i take risperdone 0.75 mg at bedtime and 2 mg clonazepam, anafranil could be very energetic, so i am sure i can sleep ok.Now, I try to augument the SRI+NRI with a tiny amount of buspirone(5 mg)for enhancing the AD's response.SO, REALLY, THERE IS HOPE AFTER SSRI...the ol' good tca's do wonders...sometimes.I'm in remission after 10 years of hundred of combinations, you name them.I don't have a phobia of drugs so i tried everything on this planet, except stimulants, MAOI, pot or other street drugs.
This combo allows me to tweak doses independently and to change the ratio of SE/NE/DA/GABA after how it feels.
So my regimen is:
anafranil 25 mg
maprotiline 75
buspirone 5-10 mg
risperdone 0.75
clonazepam 2mg
Glucophage (metformin)1000-1250 mg sperad all over the day in 3-4.
All drugs except Glucophage are taken at night to avoid sedation and cravings.I woke up refreshed, after 7-8 hours of sleep, and i feel better and better!!!I hope this post will help, all the best economist!
> I am done with the SSRIs and SNRIs. I'm on EMSAM right now with no effect. So I'd like to suggest something to my doctor next time. I'm suffering from anhedonia and lack of interest in everything around me.
Posted by Phillipa on March 30, 2010, at 16:02:28
In reply to Is anyone here taking a tricyclic that works?, posted by Economist on March 30, 2010, at 13:09:00
What dose of EMSAM you on? Thought the EMSAM targeted all the neurotransmitters? Phillipa
Posted by gman22 on March 30, 2010, at 17:05:35
In reply to Is anyone here taking a tricyclic that works?, posted by Economist on March 30, 2010, at 13:09:00
Imipramine saved my life. my doctor was an old school guy who always used it, even after ssri's and ssnri's came out. the side effects were pronounced but if you really have severe depression they are a welcome relief compared to the disease. he treated thousands of patients from around 1965 until his death last year. he had seen imipramine have dramatic effects in therapeutic dosages with patients far too sick to use a computer. he was also a huge fan of Nardil and Parnate, and wasn't afraid to try new combos.
now i'm on nortriptyline and sertraline, a combo that works very well, and nearly no side effects.
Posted by linkadge on March 30, 2010, at 18:16:46
In reply to Re: Is anyone here taking a tricyclic that works?, posted by gman22 on March 30, 2010, at 17:05:35
I have been prescribed amitriptyline. Generally, yes, it does work and I would consider it superior to SSRI's in most regards.
Unfortunately, I feel its a med that I am not willing to take consistently. It makes me feel out of it and a little yukky (metabolically).
I think that TCA's can be superior to break an initial severe and deep depression. Whether you can take them consistenly for long term maintainance or to prevent relapse, is another story.
I'm a bad patient though. No sooner do I get feeling emotinally better than I throw in the towel and say "I feel this med is not healthy to take long term".
I want a medication that is safe for the body and the mind. I know I want a lot, but I won't really be satisfied until that happens.
Linkadge
Posted by bulldog2 on March 31, 2010, at 17:29:47
In reply to Re: Is anyone here taking a tricyclic that works?, posted by hopefullynow on March 30, 2010, at 14:26:32
> Hy, I am on a combination of Anafranil(TCA) 25 mg and Maprotiline (TCA-NRI) at 75 mg.As an addon i take 1000 mg of Glucophage to stop the ravenous hunger from the meds-by the way, it works wonderful!.Anafranil worked long time ago, and always pull me from the deepest episodes of depression and anhedonia.Being an anhedonic it's not a fiable option on the long run without an NRI, i suggest you nortryptiline, maprotiline is dirtier and harder to tolerate.The addition of a NRI gives me calm and energy - but strage, only combined with Anafranil.Anafranil....I can't compare with any ssri, snri or any ad, it really works, even better than amitryptiline.I could feel a sense of joy that no other AD ever gave me and i suppose that this different sense of well being is not given by the fact that it targets serotonin, i feel it's about a combination of serotonin and opoid systems involved in its action.
>
> As an add on i take risperdone 0.75 mg at bedtime and 2 mg clonazepam, anafranil could be very energetic, so i am sure i can sleep ok.Now, I try to augument the SRI+NRI with a tiny amount of buspirone(5 mg)for enhancing the AD's response.SO, REALLY, THERE IS HOPE AFTER SSRI...the ol' good tca's do wonders...sometimes.I'm in remission after 10 years of hundred of combinations, you name them.I don't have a phobia of drugs so i tried everything on this planet, except stimulants, MAOI, pot or other street drugs.
>
> This combo allows me to tweak doses independently and to change the ratio of SE/NE/DA/GABA after how it feels.
>
> So my regimen is:
> anafranil 25 mg
> maprotiline 75
> buspirone 5-10 mg
> risperdone 0.75
> clonazepam 2mg
> Glucophage (metformin)1000-1250 mg sperad all over the day in 3-4.
> All drugs except Glucophage are taken at night to avoid sedation and cravings.I woke up refreshed, after 7-8 hours of sleep, and i feel better and better!!!
>
> I hope this post will help, all the best economist!
>
>
>
> > I am done with the SSRIs and SNRIs. I'm on EMSAM right now with no effect. So I'd like to suggest something to my doctor next time. I'm suffering from anhedonia and lack of interest in everything around me.
>
>Very nice combo! I thought anafranil also targets ne? You seem to require such a large dose of maprotiline. Wouldn't this be the drug that plays the biggest part in your combo?
Here's a qoute of yours
Anafranil worked long time ago, and always pull me from the deepest episodes of depression and anhedonia.Being an anhedonic it's not a fiable option on the long run without an NRI, i suggest you nortryptiline, maprotiline.
Does it cause anhedonia? You say it pulls you out of anhedonia but being anhedonic it's not a viable option for the long run...What do you mean by this?
Any sexual sides on this combo?
Thanks for your great post..
Posted by hopefullynow on April 1, 2010, at 9:21:38
In reply to Re: Is anyone here taking a tricyclic that works? » hopefullynow, posted by bulldog2 on March 31, 2010, at 17:29:47
Hy Bulldog,
That's true, i was a little bit unclear about Anafranil.In small doses, i find it energetic, i regain my smell, my taste of foods, suddenly all the places were i live become very close to me, they give me a warm feeling of being in a safe place who accepts me; suddenly, all the people looks more friendly, i feel compasion, love for my wife and my daughter.Strange, huh?Anafranil was/is the only drug who does all these, plus a hedonic state, but just mentally,It's like "I want to
go outside to jog, but i feel phisically exhausted ".Here Maprotiline helps and suddenly i feel that i'd like to go out and i have the energy.Anafranil cures just a part of anhedonia, it brightens my mood and make me feel that I wanna do things long forgotten.Maprotiline, mobilize me phisically.It helps also with my social phobia or GAD.It's true, anafranil have a NE part, but the SE is more powerful to feel it, at least for me and at this small dose.
As side effects, this combo is neutral in the sexual department.The only caveat is the hunger, who, really is a big problem.
Thanks GOD I discovered metformin, who keeps my glycemia at normal levels.Without metformin, i failed many times in the past to tolerate this combo because i was in a perpetuum crave for foods (mainly sweets).I am very sensitive to side effects of AD's,like sexual disfunction, craving for food and muscle weakness, even mental clarity, because i resumed my workouts since anhedonia lifted and i HATE to feel weak, hungry, fogged and spacey.For me, this combo feels decently neutral, really after so many years of struggling, i cant ask more :)!!!
Also, i'm pretty sure that the low dose of risperdone and buspirone works in synergy.
hopefully
> Very nice combo! I thought anafranil also targets ne? You seem to require such a large dose of maprotiline. Wouldn't this be the drug that plays the biggest part in your combo?
>
> Here's a qoute of yours
>
> Anafranil worked long time ago, and always pull me from the deepest episodes of depression and anhedonia.Being an anhedonic it's not a fiable option on the long run without an NRI, i suggest you nortryptiline, maprotiline.
>
> Does it cause anhedonia? You say it pulls you out of anhedonia but being anhedonic it's not a viable option for the long run...What do you mean by this?
>
> Any sexual sides on this combo?
>
> Thanks for your great post..
>
Posted by softheprairie on April 3, 2010, at 17:34:15
In reply to Is anyone here taking a tricyclic that works?, posted by Economist on March 30, 2010, at 13:09:00
Desipramine is a winner for me. It is the daughter (metabolite) of imipramine. The only known neurotransmitter it acts on is norepinephrine. I take 300 mg per day. I have heard some others had worse effects from it, such as rage, but I love it. It does cause rapid heartbeat, heart palpitations, and increased anxiety for me, but those side effects are corrected by a beta blocker my primary care doctor added, Bystolic. I didn't think of it being related to my desipramine, but my primary care doctor also has me on metformin for my type 2 diabetes. And, the other psych meds I am on are perphenazine at 6 mg per day (plus PRN), and generic Cytomel (liothyronine) at 50 mcg per day.
Posted by conundrum on April 4, 2010, at 9:16:25
In reply to Re: Is anyone here taking a tricyclic that works? » Economist, posted by softheprairie on April 3, 2010, at 17:34:15
What do you feel that desipramine does for you that other drugs don't do? Interesting the addition of a beta blocker. I guess norepinephrine only needs to get to the alpha adrenergic receptors to help with depression.
Posted by softheprairie on April 4, 2010, at 18:53:14
In reply to Re: desipramine » softheprairie, posted by conundrum on April 4, 2010, at 9:16:25
> What do you feel that desipramine does for you that other drugs don't do?
Pretty much stopped the depression (feeling sad, hopeless, thoughts of my own death, frequent crying spells), though I am still on disability and not high functioning at the present; really low energy continues; neglect of showering or changing clothes for days on end, and I am sort of still being a recluse when I know I don't look public-worthy for a while.
This is the end of the thread.
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