Posted by ed_uk on April 14, 2005, at 10:00:54
In reply to Survector (amineptine), tianeptine's cousin, posted by sukarno on April 14, 2005, at 7:16:44
Hi Paul!
>imipramine 25mg
Imipramine was very effective at only 25mg/day??? I wonder whether you are a slow metaboliser of tricyclic antidepressants ie. low activity of the enzyme CYP2D6. Most ADs are metabolised by CYP2D6, not just TCAs. Slow metabolisers may need very low doses of most ADs, 'standard' doses may cause severe side effects.
>She then prescribed nortriptyline 25mg. I was ok on that for a few months and put up with the "skipped beats" and finally decided to taper off it.
In terms of effectiveness and side effects, did you prefer nortriptryline or imipramine?
>When I quit nortriptyline my panic did not return for at least 10 days.........
It seems that you only need very low doses of TCAs. Perhaps you would do well on an extremely low dose of nortriptyline eg. 10mg/day. Even after you discontinued nortriptyline, it was still effective for several days, perhaps you had a high serum level on 25mg and it took several days to drop below the therapeutic range. If you decided to try nort, your doctor could monitor your nortriptyline serum concentration and also your ECG.
>Later on I tried desipramine (Norpramin) in 1990 but it made me feel faint all of the time.
What dose did you try?
If you are a slow metaboliser of TCAs, you are also likely to be a slow metaboliser of certain SSRIs such as paroxetine. Many people are slow metabolisers of TCAs, people who are slow metabolisers will have high drug serum levels at low doses. Slow metabolisers can often be effectively treated with unusally low doses, 'standard' doses may cause severe side effects. You might actually do well on a micro-dose of Paxil, you could use the oral solution.
>Ativan..........
Yes, I've tried Ativan. I found it less sedating than Valium but it did seem to cause a lot of amnesia.
>The only problem I had with it was elevation of my liver enzymes.
Were your LFTs elevated on Tranxene as well? Perhaps you could try Tranxene again.
I'm not sure whether your elevation of liver enzymes on diazepam was important. With many drugs, mild elevation of LFTs occurs in the absense of any evidence of liver disease. Did you see a liver specialist?
>Xanax is very short-acting and much easier on the liver, although I have read in the BNF and other books that Serax (oxazepam) is the easiest on it.
AFAIK, it's not really a case of oxazepam being easier on the liver, it's more a case of oxazepam being safer than diazepam in patients with established liver disease because it is more rapidly eliminated. Serious liver damage is very rare with benzodiazepines, including diazepam.
>The cognitive effects I did feel from Valium only occurred during the beginning of treatment.
Did the sedation wear off? You said you found it very sedating at first.
>What benzos have you tried so far?
I've mainly used diazepam 10-15mg when required. I've also tried lorazepam and alprazolam. Alprazolam isn't available on the National Health Service in the UK, a friend gave me a few Xanax tablets that he bought on the internet! I didn't like Xanax at all- it made me feel extremely dumb and it didn't seem to treat my anxiety very well! I prefer Valium to be honest. Lorazepam was effective but only at high doses, 3mg 'when required' seemed to work ok. I also once tried clobazam (Frisium) which was rubbish, it didn't make me drowsy but it made me feel confused and my anxiety got worse! I like diazepam's muscle relaxant, it relieves the tension.
>For physical side effects, I would rank it like this:
Valium
Tranxene
Ativan
XanaxWhat physical side effects did Valium cause? It sometimes makes me feel weak due to the muscle relaxation.
>I was in a great mood today and laughing at jokes I was reading online.......
:-)
>Should I try Survector, or will that make me more nervous than tianeptine?
It's hard to predict. Have you ever taken a stimulant such as Ritalin or an amphetamine? Survector is often said to be quite stimulant-like. I not sure how long the supply of amineptine will last, I don't think it's being manufactured anymore.
>The reason I am interested in Survector is because of low libido and lack of motivation/ambition/drive. Despite not feeling depressed one bit, I just don't have any motivation or libido. Is Xanax doing this to me perhaps?
Possibly :-(
>I had read that Xanax can also cause hyperprolactinaemia.
Various benozos have rarely been implicated in causing hyperprolactinemia. Diazepam can cause mild hyperprolactinemia at very high doses, I don't think it's generally significant.
>My doctor is willing to give me Survector but I forgot to ask her if I can take Stablon and Survector at the same time.
I don't know whether they interact, I've never heard of anyone taking them together.
Kind regards,
Ed.
poster:ed_uk
thread:474445
URL: http://www.dr-bob.org/babble/20050413/msgs/484087.html