Posted by smittay17 on November 26, 2003, at 14:41:10
In reply to Re: WHERE? BLOOD TEST for ratio of Sero / NE ?????? » smittay17, posted by zeugma on November 25, 2003, at 22:38:40
> There's no test to determine reliably the amounts of monoamines in your CNS. That's one reason psychiatry is the series of shots in the dark that it is.
>
> You can get your blood levels of imipramine taken, and you can in effect determine if you're a slow of or fast metabolizer of the drug. Fast metabolizers have more of the desipramine metabolite leading to a stronger NE effect. Some think the only TCA that has a pronounced 5-HT effect is clomipramine. Personally, I think it comes down to finding a drug that alleviates your symptoms without being too costly in terms of side effects. I'd guess that if a couple of SSRI's don't work, then desipramine or nortriptyline (or Effexor) are rational next moves.Zeugma,
Thank you so much for your input. So I'm trying to get off 200mg of Imipramine (that TOTALLY cured my Panic Disorder for 8 years). As I stated above, I HAVE to get off the Imipramine because it is swelling my tongue and causing sleep apnea, which is leading to no sleep and a weakened immune system.I don't know what is worse... feeling chronically sick, but mentally stable or feeling panic and healthier... its like choosing the lesser of 2 evils.
Zeugma (or anyone else) So you think this is a good idea??... getting on Celexa (SSRI) for Serotonin and Desipramine (TCA) for NE to replace the Imipramine (TCA-which give both SERO & NE)?
My doctor thought it would be a good idea, because moving the SERO over to SSRI'S (Celexa) will give me less of the TCA side effect of Edema (swelling) of the tongue, which is causing my sleep apnea... this is the hardest thing ever! I've been essentially fine since 1996 and now its all panicky again.
What do you think a good "hypothetical dose" of the Celexa and Desipramine would be to mimic the 200mg of Imipramine I have been taking? or would you recommend another drug besides Celexa and Desipramine to change to? I tried Remeron and Effexor in the past before I was put on Imipramine cause they just didn't work (the doc knew the side effects were less, but then opted Imipramine).
My doc suggested Desipramine cause its the breakdown product of Imipramine and then what he claims is the best of the SSRI's- Celexa.
I just wonder if my body needs 200mg of Desipramine instead of 200mg of Imipramine. I hope not. My goal was to get on 40-60mg of Celexa and 50-100mg of Desipramine (therefore cutting the 200mg of TCA down to 50-100mg of TCA).
Does this sound plausible anyone? I really, really appreciate all your help. Its so scary now that i'm married and have a corporate job to be going through this, whereas before i was in college in 1996 and was able to take time off. I really appreciate this and any other suggestions or help anyone could offer. Or if someone knows of a good Psychiatrist/Neurologist North of Boston that takes HMO Blue and is open :)
Thanks,
Erik
smittay1975@hotmail.com
poster:smittay17
thread:280491
URL: http://www.dr-bob.org/babble/20031126/msgs/284137.html