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Re: Everything is good, except for depression

Posted by SLS on December 1, 2017, at 21:13:36

In reply to Re: Everything is good, except for depression » SLS, posted by linkadge on December 1, 2017, at 15:18:24

Hi, Linkadge.

> As you mentioned, many people take desipramine without apparent significant cardiac effects.

I wish I knew how often CV side effects emerge with desipramine. I think your concern is well-founded. However, my impression remains that the absolute risk perceived by today's doctors is currently exaggerated.

> I suppose if there was a compelling reason that desipramine would provide a benefit that other medicaitons wouldn't then it would be worth a shot, with monitoring.

My doctor was reluctant to add desipramine to Parnate, but had no problem with nortriptyline. Desipramine energized me in a way that nortriptyline did not.

> I do know that some health orginaziations discourage the use of desipramine for ADHD because of an apparent excess incidence of cardiac side effects.
>
> I would (personallay) look to explore other NRI's such as fetzima and/or nortriptyline.
>
> But hey, who knows.
>
> Linkadge

Unfortunately, some very important treatment insights and experience are disappearing as we lose older psychiatrists. These doctors found that some responders to desipramine did not respond to nortriptyline and vice-versa. Atomoxetine and reboxetine are extremely selective NE reuptake inhibitors. As antidepressants, they suck. I don't see that Fetzima is much better, despite its 5-HT reuptake inhibition. Of course, not being a doctor who has used it on multiple people, I don't know its true value. For me, milnacipran was inert.

All in all, I will keep my mind open about these things. You input is always appreciated by me.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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poster:SLS thread:1096046
URL: http://www.dr-bob.org/babble/20161215/msgs/1096134.html