Posted by ed_uk on March 26, 2005, at 9:08:26
In reply to Re: Cymbalta - teensy weensy dose still working great!, posted by JKL on March 26, 2005, at 4:42:41
Hello,
Some people are slow metabolisers of tricyclic antidepressants, perhaps you are. Different people get massively different blood concentrations from taking the same dose. You probably had quite a high blood concentration even though you took a tiny dose. You could be a slow hydroxylator of desipramine, this is due to genetic factors. Desipramine is hydroxylated by the enzyme CYP2D6, you may have a low level of this enzyme.
Since many other psych drugs are also metabolised by the same enzyme (CYP2D6) as desipramine, it would make sense for you to start all drugs that are metabolised by this enzyme at low doses to test your response. You may have a lot of side effects from 'standard' doses, this could be overcome by taking a smaller dose.
If you were taking any other medication at the time you took desipramine, that may have increased the blood level of desipramine. You might not be a slow metaboliser! Certain drugs such as Paxil can greatly increase desipramine blood levels by inhibiting CYP2D6. Many other drugs also inhibit CYP2D6.
Another possibility is that you are just very sensitive to the pharmacological properties of desipramine ie. NE reuptake inhibition, anticholinergic.
Ed.
poster:ed_uk
thread:475145
URL: http://www.dr-bob.org/babble/20050326/msgs/475739.html