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Re: Antidepressants and sedation, etc. old pro

Posted by Ritch on May 7, 2002, at 22:21:14

In reply to Antidepressants and sedation, etc., posted by old pro on May 7, 2002, at 20:44:48

> I would like to receive input from members of this group re which antidepressant medication might be the most sedating. I would like to take an antidepressant with the greatest sedative effects.
> Insomnia (including early morning awakening, difficulty in falling asleep, and difficulty in staying asleep) is one of the most troubling symptoms of my depression. I have done some research into the sedative effects of depression. According to the book "Drug facts and comparisons, 1999 edition" amitriptyline has the greatest sedative effects of tricyclic drugs. According to a book titled "The management of depression" edited by Stuart Checkley, trimipramine has the greatest sedative effects of the tricyclic antidepressants. The format of the table re sedative effects (actually the table is titled "Comparison of adverse effects of tricyclic drugs") in the Checkley book is quite similar to the format of the info. in the book titled "Drug facts and comparisons". Perhaps the info. in the Checkley book was taken from an edition of "Drug facts and comparisons" that was different from the edition that I have.
> I am currently taking doxepin (and I have taken it for several years). The sedative effects of doxepin are the best of any antidepressant drug that I have taken. But, I would like to know if there is something better.
> I do know that different persons taking a given drug can have vastly different side effects. I have read some posts from members of this group that Effexor caused marked sedation. I recently received samples of that drug from my pdoc. The drug caused me to have elevated BP and my insomnia was worse, and I soon discontinued taking it.
> I would like to have members of this group know that doxepin has helped me a lot. However, when I am having an episode of depression, it doesn't completely eliminate the depression. But, it does allow me to function fairly well. I would like to find some drug or other antidepressant therapy that would completely eliminate my symptoms of depression. At the present time I am into my fifth month of depression. I have suffered periodic episodes of depression (unipolar major depression) for about 42 years. And, I would like to find something that would relatively quickly cure my depression. For several years I have taken doxepin as a preventative when my symptoms of depression have gone away. But, it hasn't prevented recurrences of depression.


I have never tried trimipramine, but I have found doxepin to be more sedative than amitritpyline in my experience. I have found that Remeron (an atypical antidepressant) to be as sedative as amitriptyline or doxepin, but I had less daytime drowsiness with either tricyclic (esp. amitriptyline) than Remeron. You could try that and see what happens. I don't think there is any contraindication to taking Remeron with your doxepin (if you wanted to continue the doxepin and add-on Remeron). You mentioned a desire to *prevent* recurrences. Are the recurrences-predictable?





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