Psycho-Babble Medication Thread 1098378

Shown: posts 1 to 19 of 19. This is the beginning of the thread.

 

Desiprimine augment SNRI

Posted by B2chica on April 28, 2018, at 11:38:14

I will be augmenting my pristiq with desiprimine, do I take the Tca at night or is it activating?
No info on Rx other than take two each day (25mg ea).
Im not even sure if that means at the same time???

Any info appreciated.
B2

 

Re: Desiprimine augment SNRI

Posted by rjlockhart37 on April 28, 2018, at 12:48:50

In reply to Desiprimine augment SNRI, posted by B2chica on April 28, 2018, at 11:38:14

desipramine is a norepinephrine serotonin re-uptake, it may not be best to take it at night, but do what your doctor says .... it's just desipramine is an activating antidepressant, very. Best you take it in the morning

 

Re: Desiprimine augment SNRI » rjlockhart37

Posted by B2chica on April 28, 2018, at 13:02:49

In reply to Re: Desiprimine augment SNRI, posted by rjlockhart37 on April 28, 2018, at 12:48:50

Thanks for info, long story short we had previously discussed desipramine as an option, but long time ago. This time due to (long story) my doc just called it in, had no conversation with him and the bottle only says take 2 tablets daily.
So I really didnt know. Ill start tomorrow, cautiously.
Thank you!


> desipramine is a norepinephrine serotonin re-uptake, it may not be best to take it at night, but do what your doctor says .... it's just desipramine is an activating antidepressant, very. Best you take it in the morning

 

Re: Desiprimine augment SNRI » B2chica

Posted by SLS on April 28, 2018, at 16:22:18

In reply to Desiprimine augment SNRI, posted by B2chica on April 28, 2018, at 11:38:14

Hi.

> I will be augmenting my pristiq with desiprimine,

I also recommend as possible augmenters nortriptyline and Wellbutrin.

What is the rationale for choosing desipramine rather than nortriptyline? I'm not questioning the choice. I'm just curious.

Desipramine is a particularly selective and potent norepinephrine reuptake inhibitor (NRI). It can be activating. However, it might actually sedate you during the first week. I don't think it matters when you take it once you've established regular dosing. I've always been one to take medication as multiple doses either twice or three times a day. You can take the whole dosage at night if you want. It is very important to understand that two people can react in opposite ways to the same drug. You might want to start desipramine on your day off from work as a morning dose of 25 mg to see how you react to it. If you become sedated, you can then dose another 25 mg at night. If, however, you find your morning dose stimulating, you might then take your second 25 mg by 3:00 PM to minimize sleep disturbance. The first time I started imipramine and desipramine, I felt strangely energized with a feeling of sedation at the same time. With each drug, I reached a dosage of 300 mg/day. I hope you find relief with lower dosages.

Desipramine might make your heart race with palpitations. Call your doctor if your resting rate reaches 100 beats per minute. Palpitations often disappear on their own, and are not necessarily indicative of cardiac distress. Prepare for some dry mouth and other side effects that look like those of an anticholinergic drug (pseudo-anticholinergia). These should mitigate over time.

If desipramine proves to be too harsh for you, nortriptyline might represent an alternative. The side effects are quite a bit milder. However, some people who respond to desipramine do not respond to nortriptyline and vice-versa.


- Scott

 

Re: Desiprimine augment SNRI » SLS

Posted by B2chica on April 29, 2018, at 1:01:44

In reply to Re: Desiprimine augment SNRI » B2chica, posted by SLS on April 28, 2018, at 16:22:18

hi Scott
so glad to hear from you. thank you for the info. i've been on Wellbutrin and it pooped out (and tried years later, no go).
We had talked about desipramine exactly because it was more norepinephrine. Since SSRI's are terrible for me (end up making depression worse and either giving me a little psychosis or down to suicidal) but Pristiq (hitting on more N) works (worked) well for me, we thought about Desipramine.
***
i was planning on starting it tomorrow i was thinking of taking the 25mg first thing in am and second in afternoon so were on the same page... i do like better the idea around 3pm as my depression seems to start to get worse later afternoon evening (about 4-ish on up).
important to know about the resting heart rate. My anxiety is Finally lowering to a livable level, so i'll have to be aware if its med or my anxiety.
Dry mouth is just about a daily thing anymore, so no worries there.

Good to know about nortriptyline as another option.
**
history-a couple years ago pdoc put me on amitriptyline, took a bit beause my episode was so bad but it worked well. only issue was after about 7 months it started giving me what i felt like were cognitive issues. slower thinking, trouble following conversations, muddy head feeling. just cog. slower in general. So he took me off. (i improved after that).
Anyway, we discussed next to try desipramine next but by then my great adderall company got bought out and stopped making so i was struggling with that. i tried a couple and ended up with Evekeo. Its ok, but not that great with my mood as the past one was.

this episode depression started around jan, but became an issue around Feb. built since then.- long story short, last month increased anxiety, depression, agitation/anger -S.ideation becoming intent all hitting peak last week. anyway, he called in rx for desipramine. hopefully it works with my brain chemistry better.

THanks for any input. and for reading.
b2c


> Hi.
>
> > I will be augmenting my pristiq with desiprimine,
>
> I also recommend as possible augmenters nortriptyline and Wellbutrin.
>
> What is the rationale for choosing desipramine rather than nortriptyline? I'm not questioning the choice. I'm just curious.
>
> Desipramine is a particularly selective and potent norepinephrine reuptake inhibitor (NRI). It can be activating. However, it might actually sedate you during the first week. I don't think it matters when you take it once you've established regular dosing. I've always been one to take medication as multiple doses either twice or three times a day. You can take the whole dosage at night if you want. It is very important to understand that two people can react in opposite ways to the same drug. You might want to start desipramine on your day off from work as a morning dose of 25 mg to see how you react to it. If you become sedated, you can then dose another 25 mg at night. If, however, you find your morning dose stimulating, you might then take your second 25 mg by 3:00 PM to minimize sleep disturbance. The first time I started imipramine and desipramine, I felt strangely energized with a feeling of sedation at the same time. With each drug, I reached a dosage of 300 mg/day. I hope you find relief with lower dosages.
>
> Desipramine might make your heart race with palpitations. Call your doctor if your resting rate reaches 100 beats per minute. Palpitations often disappear on their own, and are not necessarily indicative of cardiac distress. Prepare for some dry mouth and other side effects that look like those of an anticholinergic drug (pseudo-anticholinergia). These should mitigate over time.
>
> If desipramine proves to be too harsh for you, nortriptyline might represent an alternative. The side effects are quite a bit milder. However, some people who respond to desipramine do not respond to nortriptyline and vice-versa.
>
>
> - Scott

 

Re: Desiprimine augment SNRI

Posted by B2chica on April 29, 2018, at 2:21:20

In reply to Re: Desiprimine augment SNRI » B2chica, posted by SLS on April 28, 2018, at 16:22:18

Another question,
i was just reading a little about Desipramine and it does list off label uses for treatment of anxiety and ADHD (among others). Since i'm on meds for both do you think there's any concern of interaction? i couldnt find anything, but my source sites weren't that great.

currently i'm on:
Pristiq 100mg (1xdaily)
Evekeo 20mg BID
Gabapentin 300mg (have been taking 5xdaily but i think i'm back to 2-3 doses)
Lorazepam 1mg (have been taking 3x daily but i think i'm back to 1-2x daily)

i do have a couple sleep meds, but the lunesta really isn't evn working as of late so i haven't been taking it or ambien.

thanks for any info.
b2c


 

Re: Desiprimine augment SNRI » B2chica

Posted by Clearskies on April 29, 2018, at 2:29:48

In reply to Re: Desiprimine augment SNRI » SLS, posted by B2chica on April 29, 2018, at 1:01:44

Just a quick note to say *Hello!* and that
Nortryptaline and Wellbutrin are working well for me. I had to switch to Rexulti as my antidepressant, since sertraline made my hair fall out. It was as bad as any emotional crisis Ive had, good god! Now I have the shampoo, conditioner, potion, and supplements to get the hair back.

I hate this.

 

Re: Desiprimine augment SNRI

Posted by Christ_empowered on April 29, 2018, at 9:15:27

In reply to Re: Desiprimine augment SNRI » B2chica, posted by Clearskies on April 29, 2018, at 2:29:48

hi. I took a different tricyclic (Tofranil-PM...the over-priced, "improved" Tofranil) w/ Adderall. The results were...

mixed. lifted my mood rather quickly, also resulted in some anger and weird weight fluctuations.

but that was Tofranil (imipramine). I think the reason they created the PM (pamoate) was because Tofranil has a somewhat "balanced" effect on serotonin and NE reuptake inhibition, so cleaning up the old imipramine= creating a patented competitor to the new(er) breed of SSNRI drugs, something like that.

if i remember correctly, tca drugs as a class enhance the action of amphetamines. i could be wrong, though. could be the best thing ever, the worst thing ever...I'm guessing "real world" results usually fall somewhere in between those extremes.

i hope the tca helps you, and quickly. :-)

 

Re: Desiprimine augment SNRI » Clearskies

Posted by ed_uk2010 on April 29, 2018, at 10:29:35

In reply to Re: Desiprimine augment SNRI » B2chica, posted by Clearskies on April 29, 2018, at 2:29:48

Hi CS,

Sounds like you're doing a bit better.

Did the pdoc finally agree that sertraline might be the cause of the hair problem, or did you see a different doctor?


 

Re: Desiprimine augment SNRI » B2chica

Posted by SLS on April 29, 2018, at 10:31:40

In reply to Re: Desiprimine augment SNRI » SLS, posted by B2chica on April 29, 2018, at 1:01:44

> i do like better the idea around 3pm as my depression seems to start to get worse later afternoon evening (about 4-ish on up).

Some psychiatrists would label your depression as being endogenous or melancholic. TCA is supposed to be particularly effective for this type. By extension, I would say that SNRI would be better for you than SSRI.

> history-a couple years ago pdoc put me on amitriptyline, took a bit beause my episode was so bad but it worked well. only issue was after about 7 months it started giving me what i felt like were cognitive issues. slower thinking, trouble following conversations, muddy head feeling. just cog. slower in general.

This can happen with anticholinergic drugs, although I can't explain the latency. For instance, imipramine is called the "stupid drug". Amitriptyline is also very anticholinergic. Desipramine and nortriptyline are not really anticholinergic. If you experience brain-fog with desipramine early in treatment, I would say that it is likely to disappear.

> this episode depression started around jan, but became an issue around Feb. built since then.- long story short, last month increased anxiety, depression, agitation/anger -S.ideation becoming intent all hitting peak last week. anyway, he called in rx for desipramine. hopefully it works with my brain chemistry better.

I hope so, too. If desipramine is right for you, it should actually reduce anxiety, not increase it. It also has the potential to treat ADHD. However, you can add an amphetamine to it if necessary. Again, you should be wary of the emergence of a worsened depression, anxiety, and suicidality. In my experience, if these things appear, giving a treatment more time will not help. This happened to me with reboxetine.

Is anhedonia a problem? For me, nortriptyline 75-100 mg/day is better for anhedonia than is desipramine 300 mg/day.

Good luck.


- Scott

 

Re: Desiprimine augment SNRI » SLS

Posted by B2chica on April 30, 2018, at 11:59:04

In reply to Re: Desiprimine augment SNRI » B2chica, posted by SLS on April 29, 2018, at 10:31:40

>>This can happen with anticholinergic drugs, although I can't explain the latency.

the episode i had was so severe that by the time i got on meds i actually felt like i had a traumatic brain injury. i couldnt handle any noise that wasn't natural, i felt weak and my cog. processing was very slow. So for me even the 'sludge' i later experienced was still better than where i started... i just didnt realize it until i felt a little better and realized that the rest of me was better but i still wasn't functioning up to par.

anhedonia was a terrible problem a couple months ago. but it seems like my body kicked into gear this last month and started swarming along the useless, hopeless, might as well be dead- thinking. and then got in a terrible hole that i couldnt get myself out of.

****
yesterday i started, took 25 am and 25 at night. it certainly didnt rev me up, i dont know that it made me sleepy? but i do know that i got to bed before midnight which is a Huge deal for me. and the sleep i got was good. hoping this is a trend.
Only thing is i did have a bit of headache last night. but i'm hoping its just a weather change thing.

Thanks so much Scott.

 

Re: Desiprimine augment SNRI_SFX info please!

Posted by B2chica on May 1, 2018, at 13:24:52

In reply to Re: Desiprimine augment SNRI » B2chica, posted by SLS on April 28, 2018, at 16:22:18

Side Effects Question.

started Desipramine on Sunday, taking 25mg first thing in am about 8:30/9 and second 25mg around 2:00-ish.
This morning i woke up early-about 6:40 took normal meds about 8:00, then (in cool building)
i noticed myself sweating and then felt i may pass out-sort of hot flash..(flushing right?), and nausea. I went out to car and took my first dose around 8:30.
Since then if i'm moving around, i'm sweating and TERRIBLE nausea. Also i have somewhat of stomach ache along with nausea, its actually lower than my stomach-more like menstrual cramps or gas pains.

i've tried to read online about side effects and i'm not clear on what's typical and what's not.

seems like most of my symptoms are fairly common with other meds i've been on (except the stomach upset/cramp).
dizziness/light headed, nausea and flushing.

Anyway...are these pretty typical, especially since i'm only on 50mg daily?

Thanks
b2

 

Re: Desiprimine augment SNRI_SFX info please! » B2chica

Posted by SLS on May 1, 2018, at 19:57:31

In reply to Re: Desiprimine augment SNRI_SFX info please!, posted by B2chica on May 1, 2018, at 13:24:52

The first time I tried a tricyclic antidepressant, I couldn't stop sweating at first. I didn't experience nausea or cramps, though. The dizziness is normal as desipramine blocks the receptors that control the contraction of blood vessels. This should mitigate over time. Desipramine can be a harsh drug. You might want to go up more gradually. Actually, starting at 50 mg on the first day is a bit aggressive. They do make 10 mg pills.


- Scott


> Side Effects Question.
>
> started Desipramine on Sunday, taking 25mg first thing in am about 8:30/9 and second 25mg around 2:00-ish.
> This morning i woke up early-about 6:40 took normal meds about 8:00, then (in cool building)
> i noticed myself sweating and then felt i may pass out-sort of hot flash..(flushing right?), and nausea. I went out to car and took my first dose around 8:30.
> Since then if i'm moving around, i'm sweating and TERRIBLE nausea. Also i have somewhat of stomach ache along with nausea, its actually lower than my stomach-more like menstrual cramps or gas pains.
>
> i've tried to read online about side effects and i'm not clear on what's typical and what's not.
>
> seems like most of my symptoms are fairly common with other meds i've been on (except the stomach upset/cramp).
> dizziness/light headed, nausea and flushing.
>
> Anyway...are these pretty typical, especially since i'm only on 50mg daily?
>
> Thanks
> b2
>

 

Re: Desiprimine augment SNRI

Posted by beckett2 on May 1, 2018, at 20:41:25

In reply to Re: Desiprimine augment SNRI » B2chica, posted by Clearskies on April 29, 2018, at 2:29:48

> Just a quick note to say *Hello!* and that
> Nortryptaline and Wellbutrin are working well for me. I had to switch to Rexulti as my antidepressant, since sertraline made my hair fall out. It was as bad as any emotional crisis Ive had, good god! Now I have the shampoo, conditioner, potion, and supplements to get the hair back.
>
> I hate this.

Hey Clear Skies, are you taking the the nortryptaline and Wellbutrin with the rexulti? Glad you're getting some traction mood wise.

 

Re: Desiprimine augment SNRI_SFX info please! » SLS

Posted by B2chica on May 3, 2018, at 14:51:54

In reply to Re: Desiprimine augment SNRI_SFX info please! » B2chica, posted by SLS on May 1, 2018, at 19:57:31

Thanks so much Scott! I was worried about the sweating and the cramp thing.
Better today, only slight nausea and very little light-headedness.

One thing i thought of was that i really hadn't been able to eat much this last month, forcing it down when i did. One of the first things -beside 'darkness' subsiding- was feeling hungry. So the cramps may also have been just from my starting to eat more than i had the previous month.
I am just glad to stay on this drug for a while. I was in such a dark place, i need a reprieve-even if only a little while. Even reading my last post, just a few days ago i couldnt handle even reading the website information on the drug.

it may just be 'startup' kicking in but I was able to do work this morning, not as much of course as i would have liked, but i will take any little scrap of focus and energy i can get.

Thank you again very much for the quick reply.

(also, this is a re-post... my other post never showed up?)
b2


> The first time I tried a tricyclic antidepressant, I couldn't stop sweating at first. I didn't experience nausea or cramps, though. The dizziness is normal as desipramine blocks the receptors that control the contraction of blood vessels. This should mitigate over time. Desipramine can be a harsh drug. You might want to go up more gradually. Actually, starting at 50 mg on the first day is a bit aggressive. They do make 10 mg pills.
>
>
> - Scott
>
>
> > Side Effects Question.
> >
> > started Desipramine on Sunday, taking 25mg first thing in am about 8:30/9 and second 25mg around 2:00-ish.
> > This morning i woke up early-about 6:40 took normal meds about 8:00, then (in cool building)
> > i noticed myself sweating and then felt i may pass out-sort of hot flash..(flushing right?), and nausea. I went out to car and took my first dose around 8:30.
> > Since then if i'm moving around, i'm sweating and TERRIBLE nausea. Also i have somewhat of stomach ache along with nausea, its actually lower than my stomach-more like menstrual cramps or gas pains.
> >
> > i've tried to read online about side effects and i'm not clear on what's typical and what's not.
> >
> > seems like most of my symptoms are fairly common with other meds i've been on (except the stomach upset/cramp).
> > dizziness/light headed, nausea and flushing.
> >
> > Anyway...are these pretty typical, especially since i'm only on 50mg daily?
> >
> > Thanks
> > b2
> >
>
>

 

Desiprimine augment SNRI_SFX | What's up? (nm) » B2chica

Posted by SLS on May 8, 2018, at 18:18:04

In reply to Re: Desiprimine augment SNRI_SFX info please! » SLS, posted by B2chica on May 3, 2018, at 14:51:54

 

Re: Desiprimine augment SNRI_SFX | What's up? » SLS

Posted by b2chica on May 10, 2018, at 12:30:13

In reply to Desiprimine augment SNRI_SFX | What's up? (nm) » B2chica, posted by SLS on May 8, 2018, at 18:18:04

Hey Scott,
I am doing well. Very well. The Sfx only lasted a couple days, though i still am a little sensitive to the orthostatic reactions (standing up to fast) and have to be a little careful there.

i am only on 50mg of this med (see pdoc in two weeks), it has impacted me in a few way that no other med has in a long long time. If i remember right, it is fairly similar to how i reacted to wellbutrin (though maybe not the energy increase) But it fairly quickly rid me of thoughts of suicide. I am enjoying things, able to relax. The largest difference that i noticed (and quickly) was the extreme decrease in anxiety (on a scale of 0-10, 10 the highest) it was at about an 11 and now down to about a 1-2.
It had become severe that i had increased meds to about 3x what i was normally taking, almost daily for the last month. And now, barely any.

I actually feel..."normal". Noticing mostly that i'm not worrying/thinking about my emotional state 'constantly'.

Thank you for Asking and i can't thank you enough for the quick responses!

B2Chica

 

Yay!

Posted by SLS on May 10, 2018, at 13:51:30

In reply to Re: Desiprimine augment SNRI_SFX | What's up? » SLS, posted by b2chica on May 10, 2018, at 12:30:13

Yay!

:-)


- Scott


> Hey Scott,
> I am doing well. Very well. The Sfx only lasted a couple days, though i still am a little sensitive to the orthostatic reactions (standing up to fast) and have to be a little careful there.
>
> i am only on 50mg of this med (see pdoc in two weeks), it has impacted me in a few way that no other med has in a long long time. If i remember right, it is fairly similar to how i reacted to wellbutrin (though maybe not the energy increase) But it fairly quickly rid me of thoughts of suicide. I am enjoying things, able to relax. The largest difference that i noticed (and quickly) was the extreme decrease in anxiety (on a scale of 0-10, 10 the highest) it was at about an 11 and now down to about a 1-2.
> It had become severe that i had increased meds to about 3x what i was normally taking, almost daily for the last month. And now, barely any.
>
> I actually feel..."normal". Noticing mostly that i'm not worrying/thinking about my emotional state 'constantly'.
>
> Thank you for Asking and i can't thank you enough for the quick responses!
>
> B2Chica
>
>

 

Re: Yay! pendulum mind...question » SLS

Posted by b2chica on May 11, 2018, at 11:18:02

In reply to Yay!, posted by SLS on May 10, 2018, at 13:51:30

So the only thing that i do slightly ruminate about, goes back and forth like a pendulum. i am able in current state to jump off now and again, but i cant help wondering. maybe you can answer a question?

bottom line, are there chances that this is totally a placebo reaction?
do i even try going up for any reason? SHould i try getting off for any reason?

down below are examples of what is becoming cyclical in my brain regarding these issues. if you have time... id love some advice.
thanks Scott!
b2


Cycle 1:
what do you think are the chances that this is a placebo reaction? I know this is such a low dose, (usually only to titrate up, AND many of the stressors/triggers that were contributing are either gone or have greatly lessened. )

This time i know i was dealing with both psychological stressors turning to biological -being triggered by the former. (major stressors, major events, time restrictions, lack of family/friend support, and major marital issues).
the physical affects: that muddy brain feeling - visual and brain fog/sludge, crying first thing in the mornings, apathy, anhedonia, lethargy, oversleeping, not sleeping well, no appetite and ever increasing biological anxiety (affect was physical which eventually went up to my head).

Cycle 2:
To be honest right now...it Doesnt matter... i'll take what i can get, especially if its like this.
But there is that little nagging thing in the back of my head saying, its really only placebo, and eventually if something triggers again, i will spin into where i was before.

Cycle 3:
i dont want to be on any extra meds if i dont need to. BUT
why not add just one extra pill if it can do THIS much relief??

Cycle 4:
I guess what it comes down to is that i am worried about 2 things. IF it is a placebo effect than it can strike out of nowhere again. and i wont be prepared because i think i have some coverage.

And secondly...i'm afraid. Scott this (possibly mixed episode) had me so destraught, so aggitated and angry at myself, almost uncontrollable impulsivity, that when i wanted to die... it was a different feeling than i've had before. i was very impulsive and could NOT for all i tried to pull myself OUT of my head. i could NOT see reality to rationalize why i would not want to die. I could only see pain, feel pain and predict more pain.
To be honest with you folks here... i really should have been in the hospital. and it scares me that both my T and pdoc (who are really great at what they do, and know me quite well) did not see this, or maybe were not seeing it in the same way i was.
*and if i don't have them as a defensive line between me and the hospital. well, it scares me.

HOWEVER, i am not going to discuss my suicidal desire with either because i'm starting to get a little worried. paranoid, but not clinically. because i have had tendencies to get suicidal ideation when my depression gets severe, i feel that i'm to the point of age in my life where i just shouldnt be going there anymore. and i dont want to end up with another doctor that thinks i should be 'committed'.

> Yay!
>
> :-)
>
>
> - Scott
>
>
> > Hey Scott,
> > I am doing well. Very well. The Sfx only lasted a couple days, though i still am a little sensitive to the orthostatic reactions (standing up to fast) and have to be a little careful there.
> >
> > i am only on 50mg of this med (see pdoc in two weeks), it has impacted me in a few way that no other med has in a long long time. If i remember right, it is fairly similar to how i reacted to wellbutrin (though maybe not the energy increase) But it fairly quickly rid me of thoughts of suicide. I am enjoying things, able to relax. The largest difference that i noticed (and quickly) was the extreme decrease in anxiety (on a scale of 0-10, 10 the highest) it was at about an 11 and now down to about a 1-2.
> > It had become severe that i had increased meds to about 3x what i was normally taking, almost daily for the last month. And now, barely any.
> >
> > I actually feel..."normal". Noticing mostly that i'm not worrying/thinking about my emotional state 'constantly'.
> >
> > Thank you for Asking and i can't thank you enough for the quick responses!
> >
> > B2Chica
> >
> >
>
>


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