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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Laney on May 12, 2011, at 21:35:39
desiprimine and it not having weight gain as a side-effect? I want to show my pdoc when I go to see him to talk about a med to add to paxil.
Thanks!
Laney
Posted by SLS on May 13, 2011, at 5:39:38
In reply to Scott: Could you show me where to find info on de, posted by Laney on May 12, 2011, at 21:35:39
Hi Lany.
There aren't a heck of a lot of investigations devoted to studying desipramine and weight gain. It is generally thought that the reduced tendency towards weight gain with desipramne is due to the lack of H1 histamine receptor blockade. The package insert for desipramine lists weight gain or loss as possible side effects. However, I don't think weight gain occurs as often as with nortriptyline. Interestingly, responders to desipramine tend to show a small gain of weight compared to non-responders. My guess is that this is due to food tasting better. This is what is seen in rat studies as well as human studies.
Weight gain:
amitriptyline > imipramine > nortriptyline > desipramine
- Scott------------------------------------------------
Body Weight Changes Associated With Psychopharmacology
http://psychservices.psychiatryonline.org/cgi/content/full/53/7/842"Imipramine was studied in a 16-week weight-monitoring trial of 53 persons with depression. An average gain of 2 kg was noted, and 15 percent of the study participants gained more than 6 kg (54). In a prospective double-blind study, persons who were taking imipramine tended to have a greater desire to eat but did not experience any weight changes (52).
Desipramine is less problematic. In an open, five-week study of 41 desipramine-treated patients, no alterations in weight were observed (55). However, this lack of association remains controversial. Desipramine may be a valuablebut unproventreatment alternative when weight gain is of concern because of its low potency at the histamine H1 receptor and because it has few anticholinergic effects."
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J Clin Psychiatry. 1987 Jan;48(1):27-8.The effect of desipramine on body weight in depression.
Levitt AJ, Joffe RT, Esche I, Sherret D.
AbstractTwenty-six patients with major depressive disorder were treated with desipramine for 4 weeks to determine the effect of the drug on body weight. Responders to desipramine showed a weight gain only at Weeks 3 and 4; nonresponders had a nonsignificant loss of weight. The increase in body weight of the responders was independent of dosage, sex, and hospitalization status. These findings suggest that the small increase in body weight that occurs in patients taking desipramine is associated with treatment response. In addition, desipramine may be a valuable treatment alternative for those patients in whom excessive weight gain is undesirable.
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Posted by floatingbridge on May 13, 2011, at 8:31:40
In reply to Scott: Could you show me where to find info on de, posted by Laney on May 12, 2011, at 21:35:39
Posted by Laney on May 13, 2011, at 10:50:04
In reply to Laney, fingers crossed. Good luck! (nm), posted by floatingbridge on May 13, 2011, at 8:31:40
Scott and FB,
Thanks so much! I think I'll give it a shot!
Laney
Posted by Laney on May 13, 2011, at 10:57:37
In reply to Re: Laney, fingers crossed. Good luck!, posted by Laney on May 13, 2011, at 10:50:04
So do you think because I did well on Nort that Desip will likely work as well or is it a 50-50??
Thanks again Scott.
Laney
Posted by Phillipa on May 13, 2011, at 11:17:21
In reply to Scott: One more thing..., posted by Laney on May 13, 2011, at 10:57:37
Laney so it's a go for you great luck!!! Phillipa
Posted by SLS on May 13, 2011, at 13:20:35
In reply to Scott: One more thing..., posted by Laney on May 13, 2011, at 10:57:37
> So do you think because I did well on Nort that Desip will likely work as well or is it a 50-50??
>
> Thanks again Scott.
>
> Laney
An old, old idea is that if you respond to one, there is a tendency that you won't respond to the other. I am not sure that this is accurate. I respond to both. However, I feel that I do better on nortriptyline than I do on desipramine.Overall, I would say that you are a TCA responder, and that it is very much worth investigating how you react to desipramine. You should be aware that Paxil will raise the blood levels of desipramine by approximately 100%. This is very important when combining these two drugs. Even though 10mg of Paxil is low, I would still expect that it will be necessary to cut the dosage of desipramine in half. 75-150mg should be the target range for desipramine.
- Scott
Posted by bleauberry on May 14, 2011, at 4:42:19
In reply to Scott: Could you show me where to find info on de, posted by Laney on May 12, 2011, at 21:35:39
It's hard to use studies to predict what might happen to us personally. Example. I was prescribed Nortriptyline so as to help me gain some weight. I could use the carbs craving and weight gain others have complained about. Instead, I lost weight rapidly and don't have any to spare!
I would think desipramine is much less likely to cause weight gain than nortriptyline.
Remeron is well documented as a weight gainer, and yet I could show you posts of people who lost appetite and weight while on it.
So while any studies we can find are interesting and maybe helpful in making some choices, they really can't be trusted when it comes to your own personal journey. I see them as good guides though, better than not having any guide at all.
Posted by SLS on May 14, 2011, at 5:37:45
In reply to Re: Scott: Could you show me where to find info on de, posted by bleauberry on May 14, 2011, at 4:42:19
Hi Bleauberry.
> Remeron is well documented as a weight gainer, and yet I could show you posts of people who lost appetite and weight while on it.At what dosages? There is a biphasic effect of Remeron on sedation and weight gain. The higher the dosage used, the less that sedation and weight gain are problems.
- Scott
Posted by Laney on May 18, 2011, at 12:04:37
In reply to Re: Scott: Could you show me where to find info on de » bleauberry, posted by SLS on May 14, 2011, at 5:37:45
I talked to Dr. Gillman of Psychotropical via skype and he showed me a couple of tables that show the differences in AD's and explained how desiprimine would be different than nortriptyline.
I'm not completely sure of him in the way that he thinks my paxil withdrawl issues are odd and that it's probably just a return of symptoms. Like I should have no problem getting off of this crap! That makes me question him.
Anyway, he does invite anyone here to skype him if they have any questions.
Thanks!
Laney
Posted by Laney on May 18, 2011, at 12:37:41
In reply to Dr. Gillman of Psychotropical and desiprimine, posted by Laney on May 18, 2011, at 12:04:37
http://www.ncbi.nlm.nih.gov/pubmed/21192146?dopt=Citation
http://onlinelibrary.wiley.com/doi/10.1038/sj.bjp.0707253/pdf
I hope I copied and pasted correctly.
Laney
Posted by SLS on May 18, 2011, at 12:55:14
In reply to Dr. Gillman of Psychotropical and desiprimine, posted by Laney on May 18, 2011, at 12:04:37
In what ways are desipramine and nortriptyline different?
> Anyway, he does invite anyone here to skype him if they have any questions.
That's very nice of him.
- Scott
Posted by floatingbridge on May 18, 2011, at 16:34:43
In reply to Dr. Gillman's links he sent me, posted by Laney on May 18, 2011, at 12:37:41
Laney, the second link looks like a good resource. I'll need to print it out and reread (and reread) and maybe give a copy to my doc.
Did Dr. Gillman make any suggestions for you?
Thanks for sharing this.
fb
(You aren't alone in Paxil difficulties, are you? I thought the site Paxil progress was started because the difficulty withdrawing can cause.)
Posted by Laney on May 20, 2011, at 10:59:33
In reply to Re: Dr. Gillman's links he sent me » Laney, posted by floatingbridge on May 18, 2011, at 16:34:43
FB,
Dr. Gillam said to definitely try the Desiprimine. That table is supposed to show how it affects weight differently than nortriptyline. It's all a little confusing to me. He did say that I wouldn't need nearly as much compared to the Nort. I think he said to start out at 10mg. and maybe all I'll need is 25.
Yes, I'm definitely not alone with paxil. Although that is a good site, they are pretty much anti med and I'm not willing to live my life miserable for who know's how long.
Laney
Posted by jono_in_adelaide on May 25, 2011, at 22:13:59
In reply to Re: Dr. Gillman's links he sent me » Laney, posted by floatingbridge on May 18, 2011, at 16:34:43
Re paroxetine withdrawl, a usefull trick is to change to fluoxetine (prozac) 20mg per day for 4 weeks, then stop. Fluoxetine has a halflife measured in weeks, so it is self tapering and rarely causes withdrawl symptoms.
Note that you shouldnt take desipramine or nortriptyline while taking fluoxetine
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