Posted by fachad on June 13, 2002, at 22:12:02
In reply to Re:Doxepin » fachad, posted by Chloe on June 13, 2002, at 20:46:27
> I was only on 20 of ami, and have been taking ten for the last 3 days. Today, I have the worst epigastric pain. I know it's a withdrawal thing from ami.
That is a pretty small dose, but I bet the epigastric pain is ami withdrawal.
>I just picked up 10 mg size of Doxepin. I am supposed to take one or two at night. So I guess I will just jump in and take 2 caps of doxepin...
I would. When used for depression, ami, doxepin, trimip, typical doses are 150mg/day, and can be as high as 300mg/day. So even if you still had 20 mg of ami in your system, and you took the full 20 mg of doxepin, it would be a relatively tiny total TCA dose.
> What was the stomach ailment of your wife, if you don't mind me asking.
She has pain dominant Irritable Bowel Syndrome (IBS). Here's a link to the full story of how ami worked when nothing else did. (I referred to ami by it's brand name, "Elavil" in that post.)
http://www.dr-bob.org/babble/20020322/msgs/99806.html
Anyway, that whole ordeal was quite amazing, and left me with a renewed respect for TCAs.
>The constipation on ami for me is awful. Even with flaxseed oil, fiberous diet, lots of water. It's a loosing battle with ami!
Yes, the ami constipation is pretty bad.
>I assume dox would be binding with less ACh?
Yes. For blenderized rat brains it is almost 5 times less potent at blocking ACH, and ACH blockade is definitely the cause of dry mouth and constipation. ACH neurons mediate both salivation and intestinal motility. ACH blockade is the highest thing on my personal "yuck" scale.
> I am so glad the H1 doesn't necessarily mean terrible dry mouth. You should see the inside of my mouth. It's so raw. I try to use rinses for mouth sores, but they burn so...
No, H1 blockade does not mean dryness. Some people believe that because most conventional H1 blockers (antihistamines) cause dryness, that H1 blockade is the culprit. But those antihistamines also block ACH, and that's why they cause dry mouth. But it's the ACh, not the H1, that's drying them out.
Regarding the mouth sores, in the past few weeks I've had a few mouth ulcers spring up, and I found an OTC remedy that seems to help. It's called DGL, de glyceryzed licorice. It sooths the sores, and it contains some chemical which stimulates the flow of mucous to the membranes, helping them heal. You can get it in lozenge form at a health food store.
>And Dox is supposed to be good for itching. I have ezcema, and when I get under stress, I can really get scatching. So lets hope this is a bit more targeted to my needs.
Dox is stronger at H1 blockade, so it should be better for both blocking itching and inducing sleep. Regarding the itching, they acutally make a doxepin topical creme for severe itching. People say it works better than anything else, but it makes them too tired, just from being absorbed thru the skin!
> Oh, one last thing. I did read that dox has a much shorter half life than ami. Dox, about 6-8 hours, where ami is 10-50 hours. Do you ever find some rebound anxiety or edginess the next day from the dox?
For me that is a big plus because it means less next day grogginess. I was a little worried that because trimp has so much longer half life than dox that I would want to sleep thru the next morning, but it's been OK.
One final comment since we're talking about doxepin pharmacokenetics: doxepin has a very high "first pass" effect. This means that after it is absorbed from your GI, it passes thru the liver before it gets to your brain. All meds do this, but doxepin is broken down very extensively during this first pass, so much less of it gets to your brain than ami, even though you've taken the same dose. So you might need a higher dose of dox to do the same job as the ami because of this. Just a possibility to consider if it seems like it's not working.
poster:fachad
thread:108844
URL: http://www.dr-bob.org/babble/20020609/msgs/109743.html