Posted by King Vultan on August 1, 2004, at 10:20:45
In reply to Re: Stimulants as an Antidepressant » King Vultan, posted by fayeroe on July 31, 2004, at 22:16:04
> Todd, the elavil keeps my panic attacks at bay. Would it help any to drop the prozac? I understood your post, but after taking the elavil, I quit waking up totally panicked. Thanks a big bunch!! pat
Well, it's up to you, as this is one of those cases where it appears you are taking the bad (weight gain) with the good (anxiolytic properties)--both of these almost certainly coming from the Elavil (amitriptyline). If you dropped the Prozac, I believe you would still be left with the weight gain problems from the amitriptyline. These are some possibilities for what you could do:
Replace the amitriptyline with
Nortriptyline: This has less of a weight gain tendency than amitriptyline and is not as sedating, but apparently, it is too stimulating for some people. I found it intolerably sedating myself, but I think I'm an exception.
Imipramine: This ancient drug might not actually be a bad choice. If you can tolerate amitriptyline, you can probably tolerate imipramine, which is not as sedating and prone to induce weight gain as amitriptyline but is anxiolytic. This was the standard drug in the psychiatric field for years.
Trazodone: A drug that is similar in sedation level to amitriptyline but regarded as not as bad on weight gain. It should be relatively anxiolytic.
You might also look at replacing the Prozac, which has the least tendency of the SSRIs to induce weight gain but is also the most stimulating. A good rule is to replace only one thing at a time, though. If it were me, I guess I would talk to my doctor about imipramine.
Todd
poster:King Vultan
thread:371725
URL: http://www.dr-bob.org/babble/20040730/msgs/372852.html