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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by SLS on May 21, 2003, at 21:56:31
Hi.
I'll be starting trimipramine (Surmontil) next week. It is a tricyclic antidepressant that is supposed to be sedating. That sucks. Sedation only compounds the problems I have functioning on a day to day basis. Does anyone know if the sedation eventually wears off?
I am marginally responsive to other tricyclics like imipramine and amitriptyine. However, trimipramine is an odd-ball TCA because it does not inhibit the reuptake of serotonin or norepinephrine. Does anyone know how it works? Mysterious.
- Scott
Posted by Caleb462 on May 22, 2003, at 2:05:40
In reply to Starting trimipramine (Surmontil) next week., posted by SLS on May 21, 2003, at 21:56:31
> Hi.
>
> I'll be starting trimipramine (Surmontil) next week. It is a tricyclic antidepressant that is supposed to be sedating. That sucks. Sedation only compounds the problems I have functioning on a day to day basis. Does anyone know if the sedation eventually wears off?
>
> I am marginally responsive to other tricyclics like imipramine and amitriptyine. However, trimipramine is an odd-ball TCA because it does not inhibit the reuptake of serotonin or norepinephrine. Does anyone know how it works? Mysterious.
>
>
> - ScottI've done a little research, and apparently, trimipramine acts much like an atypical anti-psychotic, by effectively blocking 5-HT2 and dopamine receptors. 5-HT2 antagonism has been shown to cause an anti-depressant/anxiotylic response, so that is one possible mechanism. Also, trimipramine has some anti-cortisol properties which may have something to do with it's AD effect.
Overall though, it seems to be quite the mystery drug.
Posted by Ron Hill on May 22, 2003, at 7:48:08
In reply to Starting trimipramine (Surmontil) next week., posted by SLS on May 21, 2003, at 21:56:31
Hi Scott,
Best wishes on your upcoming trimipramine trial. I know nothing about it.
As an aside, did the Enada NADH help at all? Did you try the ENADAlert NADH sublingual formulation? How much did you take? Just curious.
-- Ron
Posted by SLS on May 22, 2003, at 8:21:38
In reply to Re: Starting trimipramine (Surmontil) next week. » SLS, posted by Ron Hill on May 22, 2003, at 7:48:08
> Best wishes on your upcoming trimipramine trial. I know nothing about it.
Thanks, Ron.I have put off retrying NADH only because I didn't want to confound interpreting the other changes that were being made. I think I will do it now, before adding the trimipramine.
What have you settled on regarding dosing frequency?
- Scott
Posted by SLS on May 22, 2003, at 8:24:01
In reply to Re: Starting trimipramine (Surmontil) next week., posted by Caleb462 on May 22, 2003, at 2:05:40
Hi Caleb.
Thanks for taking the time to respond.
> > I'll be starting trimipramine (Surmontil) next week. It is a tricyclic antidepressant that is supposed to be sedating. That sucks. Sedation only compounds the problems I have functioning on a day to day basis. Does anyone know if the sedation eventually wears off?
> Overall though, it seems to be quite the mystery drug.
Where on the Internet might I find more information about this drug?
Thanks.
- Scott
Posted by Ron Hill on May 22, 2003, at 11:12:21
In reply to Re: Starting trimipramine (Surmontil) next week. » Ron Hill, posted by SLS on May 22, 2003, at 8:21:38
Scott,
> What have you settled on regarding dosing frequency?
As a maintenance dose, 2.5 mg of Enada NADH once per week currently seems to be a fairly good happy-medium for me. I'd like to take 2.5 mg twice or three times a week in order to better treat my atypical depression, but when I increase the dosing frequency, I get irritable. It's a balancing act between depression and a dysphoric mood state. For example, I just went two weeks between 2.5 mg doses, but I fell into an atypical depressive state. The good news is that I took a dose yesterday afternoon and I came out of the depression last night.
Further, thanks to information from Johnj and Larry Hoover, I have begun to experiment with vitamin B3 (niacin, niacinamide) in the 500 mg/day range to treat my irritability. The early results are very promising.
Enough about me; let’s talk about you. As I've told you before, Scott, I recommend that you take 10 mg/day of the sublingual ENADAlert NADH during the acute treatment phase for your atypical depression. If (when) you start to feel irritable, then back off on the dosage and switch to the enteric-coated down-the-hatch Enada NADH. If your atypical depression does not begin to improve within the first week or two of the acute treatment phase, my guess is that it probably is not the answer for you.
Buy a box of the sublingual stuff today, put a tablet under your tongue in the morning, and see what it does. It might not do diddly-squat, but it won't cost you much to try it and it’s not going to hurt you. I agree that you should do this before you begin your trimipramine trial.
Whatever you decide, my well wishings are with you as always.
-- Ron
Posted by Jack Smith on May 22, 2003, at 20:27:13
In reply to Starting trimipramine (Surmontil) next week., posted by SLS on May 21, 2003, at 21:56:31
> I am marginally responsive to other tricyclics like imipramine and amitriptyine. However, trimipramine is an odd-ball TCA because it does not inhibit the reuptake of serotonin or norepinephrine. Does anyone know how it works? Mysterious.
>You know what is going to be even more mysterious? One day in the not so distant future, maybe with trimipramine or maybe with something else, you are going to post on this board that your depression has remitted. Some med is just going to mysteriously do the trick. I just have this feeling it's going to happen for you.
JACK
Posted by stjames on May 23, 2003, at 1:25:50
In reply to Starting trimipramine (Surmontil) next week., posted by SLS on May 21, 2003, at 21:56:31
However, trimipramine is an odd-ball TCA because it does not inhibit the reuptake of serotonin or norepinephrine. Does anyone know how it works? Mysterious.
>
>
> - Scott
I was on it for a year, mostly for sleep and agument of Effexor. I was finding doxipin flattened my affect too much. Flat as a pancake.
I choose Surmontil because it was not as sedating as Doxipin but still enough for good sleep. Also
I liked the fact it did not work with serotonin but (I thought) did with norepinephrine.I found it less sedating, not as anticolinergic or antihistaminic as Doxipin, but that was no surprise as Doxipin is tops in all of these issues.
I liked it, it did augment the Effexor, but I was only taking 100 mgs, which is below the level
at which TCA's kick in for me.I need some sedation, so I liked it, but even for me the sedation was too much at first, but this resolved in 1-2 weeks. Daytime AM sedation was less than Doxipin. Gone were the cravings for sweets, but not carbs. Better affect wise.
None of the nasty perfuse sweating and funky
dreams that I had on Tofrinil.However, back in the good old days, when all we had were TCA's, Doxipin knocked me flat on my
a** for a week, when I started it. Then it kicked in and I was no longer massivly sedated. Quite normal with a normal energy level.As with all the TCA's be carefull about raising the dose at any rate but very slow. Unless you
enjoy being 2D for a few days and sloth like.
Posted by Caleb462 on May 23, 2003, at 2:43:15
In reply to Re: Starting trimipramine (Surmontil) next week. » Caleb462, posted by SLS on May 22, 2003, at 8:24:01
> Hi Caleb.
>
> Thanks for taking the time to respond.
>
> > > I'll be starting trimipramine (Surmontil) next week. It is a tricyclic antidepressant that is supposed to be sedating. That sucks. Sedation only compounds the problems I have functioning on a day to day basis. Does anyone know if the sedation eventually wears off?
>
> > Overall though, it seems to be quite the mystery drug.
>
> Where on the Internet might I find more information about this drug?
>
> Thanks.
>
>
> - Scottwww.biopsychiatry.com/trimipramine.html
www.biopsychiatry.com/trimipvcloz.htm
and a VERY interesting one...
http://link.springer.de/link/service/journals/00702/bibs/8105002/81050329.htm
"It may be concluded that, like other tricyclic antidepressants studied previously, TRI given repeatedly increases the responsiveness of brain dopamine D2 and D3 (locomotor activity but not stereotypy) as well as <alpha>1-adrenergic receptors to their agonists. A question arises whether the re-uptake inhibition is of any importance to the adaptive changes induced by repeated antidepressants, suggested to be responsible for the antidepressant activity."
Very interesting indeed!
Posted by stjames on May 23, 2003, at 10:48:51
In reply to Re: Starting trimipramine (Surmontil) next week., posted by Caleb462 on May 23, 2003, at 2:43:15
> Very interesting indeed!
>I did my research and was on Surmontil prior
to 1998, so I was not aware of this at the time.
This is the end of the thread.
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