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Re: Desipramine advise ( a good night's sleep) wan » CraigD

Posted by Ilene on December 4, 2003, at 15:42:50

In reply to Desipramine advise ( a good night's sleep) wanted, posted by CraigD on December 3, 2003, at 13:40:05

> To get through the holidays, a bad breakup, and an HIV diagnosis, I've decided it's time to break my self-imposed moretorium on psych meds.
>
> Reluctant to go back to SSRI's, my doc put me on desipramine yesterday. I got a pure placebo effect from his optimism...
>
> But I never got to sleep last night. My mind would "dream" without me ever going to sleep.
>
> And today, I am flush, no appetite, heartburn, kinda week. Feel a little dopy, too, especially at the computer.
>
> Anyone familiar with Desipramine or other TCA's?
>
> I started at 50 mgs (for four nights) and will ween upwards at 50 mg increments.
>
> When can I expect my sleep to return and when will I feel "better?" My impression of the TCA's is that they relieve depression in a muffly, wet-blanket way. I don't want to wade through these side effects to become a zombie.
>
> I would be back on Celexa if it weren't for the sexual SEs and the hypomanic (maybe) traits it brought out in me.
>
> Any advice?


Desipramine was my very first AD experience. It worked for a long time but I had to deal w/ the SEs. I'm now on it again and working up to an effective dose. I'm just at 100mg. (My pdoc is ploddingly slow.)

I didn't notice any difference between it and Prozac. They both worked, once upon a time.

Overall there is little difference in effectiveness between the TCAs and the SSRIs. The latter have fewer side effects and are safer.

Desipramine can be stimulating. Take it first thing in the morning. I take Neurontin to help my sleep. It doesn't work incredibly well, but it helps. Benzos help too. So does a little alcohol, which is not supposed to be good for sleep in the long run, but a glass of red wine for nighty-night hasn't been a problem.

In fact, I wonder why you *aren't* taking a benzo. I take clonazepam (Klonopin) off and on.

SEs: I take docusate sodium (generic Colace) for constipation and sugar-free hard candies for dry mouth. Haven't found anything that helps with the blurred vision or the dizziness on standing (postural hypotension).

The SEs you are experiencing could be from the other garbage in your life. Your underlying depression (or anxiety) can cause insomnia.

Anxiety can also kill your appetite and ramp up your stomach acid. Try famotidine (generic Pepcid). You might need to take it at night if you wake up with heartburn or nausea. My internist told me to take 2 doses when I went to bed for nausea and no appetite (I lost 5 lb in a month, and I *never* lose weight without strenous dieting).

Sleep deprivation is an AD, so if you really don't sleep you ought to be a cheerful zombie.

*When* you are going to feel better? Maybe you will, maybe you won't. ADs don't work very well, but they are better than nothing at all. You should stick with it.

Ilene


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