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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by BrainDamage on December 31, 2013, at 4:42:58
Hi everyone
I've been taking 75mg of Nardil for a Month now
Slowly working up
I wanted to add a TCA to combat fatigue & residual depression
So I added a starting dose, 70mg of Lofepramine, a TCA similar to Desipramine
supposedly it doesn't have a very strong affect on Serotonin
The next day I felt very agitated & ill
Trouble urinating, anxiety muscle twitches ectThis could be the onset of Sertonin Syndrome, or just Anxiety from to much Coffee
Lofepramine affects Noradrenaline
So what exactly is causing these side affects?!
Any thoughts?
Posted by BrainDamage on December 31, 2013, at 4:48:24
In reply to Nardil with Lofepramine=Serotonin Syndrome?, posted by BrainDamage on December 31, 2013, at 4:42:58
Hi
The more I think about it, the more I think what I was experiencing was Psycho-Somatic
Seems as if I was interpreting everything that was happening as being down to the combination
Much more likely it was to much Coffee & imagination!
Urinary hesitancy & constipation are the only things that still bother me
Posted by SLS on December 31, 2013, at 6:05:23
In reply to Nardil with Lofepramine=Serotonin Syndrome?, posted by BrainDamage on December 31, 2013, at 4:42:58
Lofepramine by itself is not active as an antidepressant. However, it is a pro-drug of imipramine. Lofepramine is converted into imipramine in the liver. Imipramine thus becomes an active metabolite. Imipramine significantly inhibits the reuptake of serotonin, and is quite capable of producing a toxic serotonin reaction (serotonin syndrome) when combined with MAOIs.
- Scott
Posted by BrainDamage on December 31, 2013, at 11:40:25
In reply to Re: Nardil with Lofepramine=Serotonin Syndrome? » BrainDamage, posted by SLS on December 31, 2013, at 6:05:23
> "Lofepramine by itself is not active as an antidepressant. However, it is a pro-drug of imipramine. Lofepramine is converted into imipramine"
No offense Scott, but I think Lofepramine is extensively metabolized to Desipramine, not Imipramine
Maybe enough of it is metabolized to Imipramine to cause problems???
Information on Lofepramine is like Gold-Dust!
Still not exactly sure what it does & how it does it.........
Posted by SLS on December 31, 2013, at 16:18:43
In reply to Lofepramine=Desipramine(?), posted by BrainDamage on December 31, 2013, at 11:40:25
> > "Lofepramine by itself is not active as an antidepressant. However, it is a pro-drug of imipramine. Lofepramine is converted into imipramine"
> No offense Scott, but I think Lofepramine is extensively metabolized to Desipramine, not Imipramine
No offense taken. You are right, of course. Sorry...
- Scott
Posted by SLS on December 31, 2013, at 16:56:01
In reply to Nardil with Lofepramine=Serotonin Syndrome?, posted by BrainDamage on December 31, 2013, at 4:42:58
> Hi everyone
>
> I've been taking 75mg of Nardil for a Month now
> Slowly working up
> I wanted to add a TCA to combat fatigue & residual depression
> So I added a starting dose, 70mg of Lofepramine, a TCA similar to Desipramine
> supposedly it doesn't have a very strong affect on Serotonin
> The next day I felt very agitated & ill
> Trouble urinating, anxiety muscle twitches ect
>
> This could be the onset of Sertonin Syndrome, or just Anxiety from to much Coffee
> Lofepramine affects Noradrenaline
> So what exactly is causing these side affects?!
> Any thoughts?Let me try again.
:-)
What you are experiencing is, as you say, noradrenergic side effects rather than serotonergic. I wouldn't worry about it. Desipramine can be harsh, especially at first. You might want to think about crossing over to nortriptyline if you cannot tolerate desipramine. Its noradrenergic side effects are less pronounced. I found Parnate + desipramine more tolerable than Nardil + desipramine with respect to hypotension, urinary retention, sweating, blurred vision, and shakiness. I tolerate Nardil + nortriptyline much better than Nardil + desipramine.
- Scott
Posted by Cee on January 3, 2014, at 0:06:12
In reply to Re: Nardil with Lofepramine=Serotonin Syndrome? » BrainDamage, posted by SLS on December 31, 2013, at 16:56:01
It is easy put your dose in a enteric capsule and get rid of all the other meds
Cee
This is the end of the thread.
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