Posted by JohnL on March 17, 2000, at 3:27:05
In reply to Re: Me and My Thyroid -- aside to JohnL, posted by bob on March 16, 2000, at 18:39:59
> > Another great choice would be Desipramine or Nortriptyline. There is a test that is sometimes predictive....a positive effect of Ritalin on mood predicts a good response to Desipramine....the absence of a good effect of Ritalin on mood predicts a good response to Nortriptyline. In either case, I think one of these tricyclics should be tried and compared.
>
> Is this documented anywhere? Just curious, because I've had a pretty good response to nortriptyline (cf. to SSRIs) and in just starting on Ritalin, I've had a very promising response to it as well. Is this "test" sound enough to suggest that I might have a better response to desipramine?
>
> (sorry for butting in on you and your thyroid, Noa ... but you know what a pain in the neck I can be =^P)
>
> Bobvv
Am J Psychiatry 1983 Feb;140(2):212-4
The methylphenidate test for differentiating
desipramine-responsive from nortriptyline-responsive
depression.Sabelli HC, Fawcett J, Javaid JI, Bagri S
Monitoring tricyclic antidepressant concentrations in the plasma of 43 patients with major
depressive disorders indicated that some responded to imipramine or desipramine but not to
amitriptyline or nortriptyline, or vice versa, even though plasma levels were within therapeutic
ranges. Mood elevation by methylphenidate predicted marked improvement from treatment
with imipramine or desipramine but not with amitriptyline or nortriptyline. When
methylphenidate failed to improve mood, patients responded to amitriptyline or nortriptyline
but not to desipramine. These results suggest differential drug responses with different
tricyclic antidepressants, the clinical utility of the methylphenidate test, and the heterogeneity
of depressions. The authors question the mechanism of action of nortriptyline via blockade of
norepinephrine reuptake.
poster:JohnL
thread:26901
URL: http://www.dr-bob.org/babble/20000312/msgs/27300.html