Posted by med_empowered on June 5, 2005, at 16:12:35
In reply to Re: Ascendin, posted by SLS on June 5, 2005, at 14:12:45
hi! Amoxapine has been of interest to me for a while, and I considered asking my doctor for it but changed my mind. I have Bipolar I/NOS, so I have some pretty severe depressive episodes to deal with now and then. What attracted me to amoxapine was the ability, based mostly on anecdotal evidence, to treat: teatment-resistant depression (both people who fail to respond and those who fail to achieve remission w/ standard antidepressant treatment), psychotic depression (my variant of BPD involves this form of depression), and depression with significant agitation and extreme anxiety (in this respect its kind of like Triavil, the Elavil+perphenazine combo). The good news is that while it doesn't seem anymore effective than other TCAs, it does seem better at the hard-to-treat cases mentioned above. The other piece of good news is that the anti-psychotic component *may* act as a built-in mood-stabilizer, so "switching" in bipolar and/or activation of psychosis in schizophrenia isn't as big a problem as it would be with a standard TCA. The problems, though, are pretty significant: basically you have all your standard TCA problems (minus the mania/psychosis one), plus some anti-psychotic problems (EPS, prolactin elevation), though these problems are milder than "typical" antipsychotics. I can't really offer advice without knowing you and your situation. A lot of the attention lately has been on using it as a full-fledged antipsychotic, since it could elevate the mood of those with schizoaffective disorder and also those with "moody schizophrenia." Since its so old, it is pretty cheap, and although there are definite EPS problems (including, of course, neuroleptic malignancy syndrome and some cases of tardive dyskinesia), it doesn't seem to have the weird metabolic effects (diabetes, massive sudden weight gain) that you see with the atypical antipsychotics. If it works, it works fast; 80% of responders report an improvement within 4-14 days. On the other hand, there are tolerance problems, which sucks b/c with all TCAs you want to stay at a the lowest-possible dose; factor in EPS+NMS and this is even more important. So, I guess I'd say that if you **need** something unique that you haven't tried before, this may be it for you. I wouldn't recommend it if you respond well to other antidepressants, nor would I recommend it if you do well on atypical AP/anti-depressant combos. I also wouldn't recommend it for long-term use, unless you're inclined to treatment-resistant and/or psychotic depressive epsidoes that are both severe and recurrent.
poster:med_empowered
thread:507989
URL: http://www.dr-bob.org/babble/20050601/msgs/508043.html