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Re: Increased anxiety on MAOI?

Posted by SLS on April 11, 2009, at 6:50:18

In reply to Increased anxiety on MAOI?, posted by sowhysosad on April 10, 2009, at 16:12:14

> Just pondering what med might dent my depression once again...
>
> I'm contemplating MAOIs again, and was wondering:
>
> Does anyone have experience of both tricyclics and MAOIs? Did you react badly to the norepinephrine boost from the tricyclic, with that characteristic sense of dread and heightened startle response?
>
> If so, did you experience the same effects on an MAOI? Or did the serotonin and GABA boost level things out?

Well, I don't know about serotonin or GABA being compensatory for norepinephrine (I shy away from simple abstractions), however, these two classes of drugs do affect me differently. The initial effect from tricyclics does often produce a strange sort of heightened state of arousal that can occasionally manifest as anxiety, but this usually passes. If it doesn't, you simply try another tricyclic if that is the class of drug you would like to focus on. Regarding MAOIs, the same caution must be taken not to let any initial anxiogenic psychotropic effects persuade you that the drug is no good for you. Parnate can cause some people to feel as if they are taking a stimulant at first. Again, this usually passes.

To generalize, the order of anxiogenesis might look something like this:

protriptyline > desipramine > imipramine > Parnate > nortriptyline > amitriptyline > Nardil > doxepin > trimipramine

Perhaps someone else with more knowledge can set this order more appropriately. It's just off the top of my head.

How long were you on a tricyclic before you discontinued it for the presence of intolerable anxiety?


- Scott

 

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