Posted by Keith Talent on January 31, 2004, at 0:07:17
In reply to Desipramine's the thing that makes me swing!, posted by Chairman_MAO on January 30, 2004, at 22:28:32
> I wish I'd tried this stuff two years ago; I would have probably aborted a fruitless quest of self-medication. I wish doctors hand't shoved serotonergic drug after serotonergic drug in my face! Even Strattera did not make me feel this lively, and it is purportedly a more "selective" NE reuptake inhibitor. This confirms my suspicion that "selective", despite the many studies to the contrary", is more a marketing tool than an indicator of clinical utility. I enjoy exercising for the first time in my life (I suffer from a lifetime of dysthymia/cyclothymia)! (I am 23) Even amphetamine did not have this outstanding, sustained effect on my mood, and I have no idea why desipramine is working so well where so many other drugs have failed.
>
> I do, however, have some disconcerting side effects, and I'm wondering if anyone could give me some insight on:
>
> 1) Impotence. One could call this "shrinkage" or the "cold water effect". I have a feeling that it's due to NE overactivity in the bladder/genital tissue. I'm wondering if anyone's had this go away over time. I have used trazodone, which has alpha-1 adrenergic blocking activity, to remedy this. Unfortunately, the dose of trazodone needed to produce this effect is not compatible with, umm, walking or thinking. I've heard of Flomax or Cardura being used to combat urinary hesitancy of reboxetine; think this could be used here? It's driving me crazy to have my libido finally restored and non-working equipment!
>
> 2) Tachycardia. My normal resting heart rate is 70-80, and now it's about 90-110. I exercised this morning and felt a subtle pain in my upper chest, by the heart, after 20 minutes on an elliptical trainer, and my heart rate was probably about 150bpm. I experienced a "runner's high" for the first time! I will be insanely frustrated if I have to stop taking the first drug that feels like it will produce "remission" because of cardiotoxicity. Did anyone build a tolerance to this effect, or should I just give up on the drug now (after only day 5 at 75mg!)
>
> Perhaps I'll just have to advocate for Parnate after all. :(
>
> Thanks for any help,
>
> --cm
>
>
I remember watching a web presentation by Elliot Richelson, MD, where he said that desipramine was twelve times more potent than reboxetine at blocking noradrenaline reuptake. Don't know about atomoxetine, but this could explain your experiences. By the way, if you later miss the serotonergic feelings, you can get the same noradrenergic oomph from clomipramine (its metabolite desmethylclomipramine is about as potent as desipramine at blocking noradrenaline reuptake - see Sheldon Preskorn's (MD) website preskorn.com).The impotence seems to be related to alpha-1 antagonism. The same problem happens with alpha-1 blockers that can be used for hypertension (not used so much now). Not sure what to recommend.
poster:Keith Talent
thread:307564
URL: http://www.dr-bob.org/babble/20040127/msgs/307595.html