Posted by Christ_empowered on January 13, 2019, at 14:12:25
In reply to Not Obsolete: Continuing Roles for TCAs and MAOIs, posted by Hordak on January 12, 2019, at 21:30:21
hi. the drug later known as Tofranil was considered a "breakthrough" in psychiatry. the molecule is a rip off of chlorpromazine. the idea was to generate a me-too drug, another tranq. and then...
I forget the exact numbers, but when they sprayed it on committed patients, something like 25% turned manic, gradually. then, they turned their gaze to the people hospitalized w/ depression, which...back then, was diagnosed differently, so the 'depressed inpatients' back then were generally -not doing well-, and the hospital environment often made things worse. so...
for a good % of people, there was definite mood elevation. the stuff is sedating, so at a time when psych drugs consisted mostly of uppers, downers, opioids, and Thorazine...this was a BFD.
the tca drugs, as a whole class, tend to be lethal in overdose. long term use sometimes brings with it risks of cardio problems (?), according a to former prescriber. there's supposedly more of a 'switch' into (hypo)mania than the ssri and i think also ssnri drugs...
and the drug-drug interactions can be a major problem, because even if the tca levels don't go toxic, something else can, and in older patients and/or patients with health problems...it can mean running into more weight gain, sedation, now and then seizures. and yet...
personally, i found Tofranil to be too rough to tolerate long term, -but- it did lift my mood without creating as much of that stimulated, yet quite apathetic feeling that many find with the newer drugs. i may be wrong, but i think akathisia is -less- of an issue with many tca drugs (obviously, this probably doesn't apply to amoxapine) than the ssri drugs.
most people ive known prescribed tca drugs for depression are given Elavil, which...seems an odd choice, to me. doxepin seems to remain somewhat popular as a night time sedative. my current prescriber told me that she does not use amoxapine often, but she's seen it in older people w/ delusions and such. I'm guessing its because the tranq action is sufficient in those cases without causing the same level of problems as most tranqs.
anafranil remains a valid option for the severe ocd people, in some cases. Hoffer, the orthomolecular psych I reference so often, used it frequently in his 'severely mentally ill' (usually 'schizophrenic') patients, because he said something like 'its hard to find a cheerful schizophrenic.'
amoxapine has been studied here and there as a low(er) cost alternative to risperidone, etc., in schizophrenia. I read a brief abstract of one such study that found it controlled positive symptoms just as well as Haloperidol, with less EPS, less prolactin elevation, and with the added bonus of elevating mood and reducing anxiety (which one would hope to find in a drug marketed for mood disorders, of course).
ok. the maois...i dunno. some people report amazing results. i find them frightening.
poster:Christ_empowered
thread:1102748
URL: http://www.dr-bob.org/babble/20181024/msgs/1102757.html