Posted by Sad Panda on June 9, 2004, at 23:22:31
In reply to Re: Maprotiline or Doxepine? Maprotiline for Burno » Sad Panda, posted by rod on June 9, 2004, at 6:52:32
> > > Well, I actually started Doxepine (Sinequan) at only 25mg a few days ago. I am not sure if this is the right drug for me, because its really sedating and prolongs my sleep time, which is already too long. And also not really makes a social life at night possible, because of its unpleasant sedation.
> > > But it seems to reduce cortisol secretion, because I look less ugly in the morning, if I interpretate this right.
> > > Anyway, there is also Maprotiline, which I could often read in context with burnout or "exhaustion depression" (sorry, if the spelling is wrong).
> > > Can anyone compare this two drugs. Is Maprotiline energizing, disstressing? The right thing if one permanently feels exhausted for no reason?
> > >
> > >
> > > Other drugs I take are
> > > Nortriptyline 150mg
> > > Lamictal 50mg (dropping this)
> > > Neurontin 1500mg
> > > Abilify 7,5mg (I am not sure about this drug)
> > > Amisulpride 50mg
> > > Diphenhydramine 100mg
> > > Clonazepam 0,5mg
> > >
> > > thanks for reading
> > > Roland
> >
> >
> > Hi Roland,
> >
>
> Hi Sad Panda
>
> > Maprotiline & Doxepin are nearly gone & forgotten because the remaining TCA's do everything they can but better. Doxepin comes with the same side effects as Amitriptyline but it isn't an SRI which renders it rather useless except for sleep.
> >
>Hi Roland,
> Well, yes, but Doxepines side effects are much lesser than Amitriptyline. Ami has much higher affinity for cholinergic receptors for example.My bad, my info for M1 blockade says Ami is by far the worst while Doxepin compares with Nort. My info for A1 blockade say they are both the same and are the worst.
> > I would be inclined to use Amitriptyline at a dosage you can live with and adjust your Nortriptyline level accordingly using blood tests.
>
> Amitriptyline was the best drug that I have taken, but I doesnt work anymore and makes me somewhat worse now. I once was quite happy on 150mg of Amitriptyline until a super smart doctor didnt want to increase beyond 150mg and put me on the Prozac - Zyprexa combo. I still was on 75mg of Ami. when I was taking 40mg of Prozac. 20mg of Prozac can increase, via liver enzyme interaction, 75mg Ami up to if one takes 300mg of Ami alone. And I took 40 mg. Who knows. Since then, I dont respond to ami anymore. But luckily to Nortripyline :) .
>
>My knowledge of P450 enzymes is vague, I would have to look that up, but I thought Ami was metablised by more than one enzyme.
> These TCAs, Maprotiline and Doxepine, are one of the few I havent tried out yet. Anafranil is serotonergic nonsense for me like the SSRIs...
>What kind of Serotinergic nonsense do you experience?
Have you tried Trimipramine?
> And good idea, I will make a blood test for Nortripyline, because I havent made one yet, just out of curiosity. But adjusting it by the results isnt a must I think, because I just take as much that I feel good. Everyone respondes different to it IMO.
>I suggest a blood test so you know what level of Nort is your blood does the most good. As you would know Ami metabolises to Nort, so if you were to take some Ami you would have to take less Nort to get the Nort level in your blood the same as before. No matter what TCA you use, you are probably going to have to lower your Nort intake to avoid NE overload.
> >You could drop Diphenhydramine too, it is rather weak compared to Amitriptyline & especially Doxepin. Also, it takes me about a month to develop tolerance to histamine blockade & then my sleep becomes very normal, YMMW.
>
> But Diphenhydramine has also a weak but valuable antidepressing, refreshing effect for me. I dont know exactly why is that. But Diphen. is also a weak dopamine reuptake inhibitor, and is effective in treating Neuroleptic Malignant Syndrome, maybe because of its reuptake inhibition.
>In teresting that you like Diphenhydramine and Prozac, I have read somewhere that Diphenhydramine was the original molecule the Lily worked on to come up with Prozac.
I'd like to have info on Phenergan just for entertainment as it spawned the TCA's & a fleet of AP's.
> >
> > As for your AED's & AP's, I think you might feel better after you get rid of one or two of them.
>
> Yes, I am already tapering down Lamictal. But in general, Neuontin is a good Lamictal augmentor for Bipolar depression, I could read (there was a study about this).
> Amisulpride works agains dystymic symptoms, but also lost much of its effect. And I wont quit it, because there is still some effect.
> And about Abilify. Amisulpride and Abilify have different mechanisms of action. So it inst a studip idea to combine them. And Abilify is also a 5-HT7 antagonist, which schould, as far as I know, relax cerebral blood vessels, but dont quote me on that. Feel free to correct me on that if its wrong.
> But I a not sure about Abilify, because on the one hand is motivating, but on the other hand makes me a bit dysphoric. Might sound strange, but thats how I experience it.
>
> >It's an impressively long list, what is your DX? :)
> >
>
> Thats a good question! :)
> I heard many DXs in the past. I think I fit best on dystymia with deficit syndrome like symptoms, social withdrawness, ipaired concentration, attention and memory, and inreased sleep time. Its not classic major depression, because I am not crying, am not suicidal. But never heard schizophrenia, nor had I psychotic episodes.
> And maybe also ultra rapid (speaking in terms of hours) cycling with a 5% up and 95% down ratio.
>I am just depressed & thankfully only need just two AD's to cover it. However I am taking a bunch of tablets for other problems & I too rattle when I walk. :)
Cheers,
Panda.
poster:Sad Panda
thread:354847
URL: http://www.dr-bob.org/babble/20040608/msgs/355276.html