![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by socialdeviantjeff on February 14, 2004, at 2:45:25
Here's the scoop:
Iv'e tried nearly every psych drug known to man. So far, I couldn't tolerate the SE's.
Out of a combination of desperation and just plain curiosity, I was wondering if rechallenging with a tricyclic be a good or bad idea.
Last time I tried them, I was 16. I took desimpramine (day) and Amytriptaline (night). Day 2 or 3, I was having A FULL-BLOWN PSYCHOTIC EPISODE. It wore off two days after an abrupt stop of the meds.
The one thing I don't remember is having other bad SE's like fatigue, cognition, weakness etc. I realize that brains and bodies change. Would maybe trying another TCA now like Nortriptaline, etc. be a good or bad idea?
Posted by cubbybear on February 14, 2004, at 4:47:27
In reply to Reintroducing failed drugs-Tricyclics, posted by socialdeviantjeff on February 14, 2004, at 2:45:25
Definitely--what have you got to lose? Only this time, don't play around combining them. Hopefully your doctor is knowledgeable enough to recommend one tricyclic in particular that would be the best candidate. If it doesn't work after about 3 weeks, then wean off it and try one from the other tricyclic class.
By the way, you say you've tried most every AD known to man. Does this include MAOI Parnate and/or Nardil?
Posted by PsychoSage on February 14, 2004, at 5:21:09
In reply to Re: Reintroducing failed drugs-Tricyclics » socialdeviantjeff, posted by cubbybear on February 14, 2004, at 4:47:27
go for it! I forget where I read it or saw it, but the side effect profiles of the old ones compared to the new ones are not as much as a contrast as first suggested. naturally, the new ones are more selective, but that doesn't mean the old ones are completely ineffective. Good luck!
Posted by Sad Panda on February 14, 2004, at 7:21:23
In reply to Reintroducing failed drugs-Tricyclics, posted by socialdeviantjeff on February 14, 2004, at 2:45:25
> Here's the scoop:
>
> Iv'e tried nearly every psych drug known to man. So far, I couldn't tolerate the SE's.
>
> Out of a combination of desperation and just plain curiosity, I was wondering if rechallenging with a tricyclic be a good or bad idea.
>
> Last time I tried them, I was 16. I took desimpramine (day) and Amytriptaline (night). Day 2 or 3, I was having A FULL-BLOWN PSYCHOTIC EPISODE. It wore off two days after an abrupt stop of the meds.
>
> The one thing I don't remember is having other bad SE's like fatigue, cognition, weakness etc. I realize that brains and bodies change. Would maybe trying another TCA now like Nortriptaline, etc. be a good or bad idea?
>How much were you taking of each at the time? Amitriptyline at bed time becomes Nortriptyline at breakfast time so you were taking that + Desipramine to give you two stimulants at once?
If I had to take just one I would make it Clomipramine. Given a choice I would take an SSRI with Desipramine or Nortriptyline.
Cheers,
Panda.
Posted by Ilene on February 14, 2004, at 16:52:11
In reply to Reintroducing failed drugs-Tricyclics, posted by socialdeviantjeff on February 14, 2004, at 2:45:25
> Here's the scoop:
>
> Iv'e tried nearly every psych drug known to man. So far, I couldn't tolerate the SE's.
>
> Out of a combination of desperation and just plain curiosity, I was wondering if rechallenging with a tricyclic be a good or bad idea.
>
> Last time I tried them, I was 16. I took desimpramine (day) and Amytriptaline (night). Day 2 or 3, I was having A FULL-BLOWN PSYCHOTIC EPISODE. It wore off two days after an abrupt stop of the meds.
>
> The one thing I don't remember is having other bad SE's like fatigue, cognition, weakness etc. I realize that brains and bodies change. Would maybe trying another TCA now like Nortriptaline, etc. be a good or bad idea?
....how much do you enjoy psychosis?I recently tried desipramine after a more than 10-year hiatus. It had pooped out then, and this time it didn't do anything except give me some SEs.
BTW, my pdoc said mixing TCAs was a bad idea, but I think yours is more psychopharmaceutically sophisticated than mine.
Which mood stabilizers have you tried? Perhaps you would like to join the MAOI club? And BTW, did you ever try a high-intensity light for your delayed sleep phase syndrome?
I.
Posted by socialdeviantjeff on February 15, 2004, at 3:07:48
In reply to Re: Reintroducing failed drugs-Tricyclics » socialdeviantjeff, posted by Ilene on February 14, 2004, at 16:52:11
Thanks, guys!
Next time I talk to my pdoc we'll discuss a trial with low doses of just one TCA.
As MAIO's go, I'm concerned about some sort of underlying dysautonomia or neuropathy that I might have. Given that you lose a big chunk of your blood pressure regulation, I'm pretty hesitant to try it. Plus the fact that I've responded sooooo badly to a very wide range of drugs; mood stabilizers et al, 4 SSRI's, 2 TCA's, Wellbutrin, Effexor, Benzos and homeopathic remedies. It seems my brain has a level of homeostasis
(although I feel emotionally crappy) that cannot be tampered with. I don't know. Any thoughts on that?Ilene - I'd like to try light therapy but I can't afford the box. I wonder how hard it would be to make one...
Posted by Ilene on February 15, 2004, at 7:54:42
In reply to Re: Reintroducing failed drugs-Tricyclics, posted by socialdeviantjeff on February 15, 2004, at 3:07:48
> Thanks, guys!
>
> Next time I talk to my pdoc we'll discuss a trial with low doses of just one TCA.
>
> As MAIO's go, I'm concerned about some sort of underlying dysautonomia or neuropathy that I might have. Given that you lose a big chunk of your blood pressure regulation, I'm pretty hesitant to try it. Plus the fact that I've responded sooooo badly to a very wide range of drugs; mood stabilizers et al, 4 SSRI's, 2 TCA's, Wellbutrin, Effexor, Benzos and homeopathic remedies. It seems my brain has a level of homeostasis
> (although I feel emotionally crappy) that cannot be tampered with. I don't know. Any thoughts on that?
>I have a mild dysautonomia (neurally mediated hypotension) that triggers my chronic fatigue syndrome. I'm taking Florinef for it. I haven't noticed anything, but I haven't done anything (such as exercise) that provokes symptoms. I don't know if I was born w/ nmh or acquired it. The whole thing is not well understood, including how it triggers cfs, but the connection was discovered in about 1996 by a pair of cardiologists at Johns Hopkins.
Stress and anxiety also trigger the nmh & cfs. My anxiety got much worse since my father died, and keeping it at bay is now a daily struggle. One of the reasons I take Klonopin is because I hope it will dampen the anxiety enough to keep it from triggering the other things.
I had quite a bit of postural hypotension w/ desipramine when I first used it, about 12 years ago. Hardly any the 2nd time around.
The 3 MAOIs available in this country vary in their hypotensive effects. I think Nardil is the worst.
> Ilene - I'd like to try light therapy but I can't afford the box. I wonder how hard it would be to make one...The box is just a light box. The bulbs are the key. Mine has a pair of special fluorescent-type tubes. I'm sure I can get some info for you later.
You could try eBay for a used one.
I.
Posted by Ilene on February 15, 2004, at 11:00:37
In reply to Re: Reintroducing failed drugs-Tricyclics, posted by socialdeviantjeff on February 15, 2004, at 3:07:48
> Ilene - I'd like to try light therapy but I can't afford the box. I wonder how hard it would be to make one...
Here's a list of companies that make light therapy products. It says "S.A.D." because most people who are interested in light therapy suffer from it, not a sleep disorder.
http://www.geocities.com/HotSprings/7061/saddev.html
The key is the spectrum and the intensity of the light. If you can get the right kind of bulbs you should be able to make your own box. Some of the sites have lots of good background info. on spectra and intensity, even if you can't afford the products.
I got my light box from Alaska Northern Lights. When I researched what was out there, their products seemed the least expensive while still producing enough light to be effective. The light is really, really bright.
If you google "delayed sleep phase syndrome" you should get some good background info. Looks like there's even a clinical trial.
You can probably get a used light on eBay or some other auction site.
I used to fly cross-country with my light as a carry-on. You can imagine what happened when I went through security. Glad I'm not a dark-skinned, bearded, male.
Wishing you a good night's sleep,
I.
Posted by socialdeviantjeff on February 15, 2004, at 23:07:52
In reply to Light therapy for delayed sleep phase syndrome » socialdeviantjeff, posted by Ilene on February 15, 2004, at 11:00:37
Thanks for the info!
I looked at few of the companies, and then dug a little deeper. I believe the light spectrum is about the same as my aquarium lights, albeit brighter. Unfortunately, even the cheapest ones I saw were a bit too much money right now.
On the upside, my parents owna a major photography studio. I'm gonna see if they could source the right bulbs or tubes. They might even have a good fixture. At any rate, I'm a bit of a tinkerer whn I feel up to it. I have some sheet metal mfg equipment and some scrap metal (even nice reflective stuff). couldn't be all that hard. Maybe some extra money could be made...
Posted by Dr. Bob on February 16, 2004, at 18:32:34
In reply to Light therapy for delayed sleep phase syndrome » socialdeviantjeff, posted by Ilene on February 15, 2004, at 11:00:37
> Here's a list of companies that make light therapy products.
FWIW, here's another:
Bob
Posted by socialdeviantjeff on February 17, 2004, at 1:20:39
In reply to Re: companies that make light therapy products, posted by Dr. Bob on February 16, 2004, at 18:32:34
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.