Posted by ed_uk on January 18, 2006, at 9:38:10
In reply to Re: Depressed/agitated/wired - soft bipolar? » ed_uk, posted by 4WD on January 17, 2006, at 22:40:10
Hi Marsha
>When I was on imipramine in 1986-87, I was taking 50mg t.i.d. And doing well (except for pretty bad side effects). Is it possible that such a low dose would help without such bad SEs?
10mg is very unlikely to help - it's a good starting dose though. Starting TCAs at low doses reduces the severity of the side effects. You won't necessarily need 150mg/day though, some people are helped by lower doses eg. 75mg.
>Do you know why SSRIs are so much more likely to cause anxiety than TCAs?
Part of the problem is that people tend to take high(ish) doses of SSRIs right from the start eg. 20mg Prozac. People usually start TCAs at a low dose and work their way up to a therapeutic dose gradually.
>I thought serotonin was supposed to the "calming" neurotransmitter.
SSRIs consistently produce an initial increase in anxiety. After several weeks treatment, an anti-anxiety effect is often observed, especially in patients with OCD or panic disorder. Some find the SSRIs always aggravate their anxiety though - this is especially common in bipolar disorder, but is *not* 'diagnostic' of bipolar disorder.
Regards
Ed
poster:ed_uk
thread:596894
URL: http://www.dr-bob.org/babble/20060115/msgs/600281.html