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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Maxime on February 23, 2006, at 10:57:19
Hi
I added 50 mg of desipramine to my 80 mg of Prozac. I'm not positive, but I think it's helping. I can't go any higher than 50 mg otherwise I start to lactate. But I think that the Prozac increases the level of desipramine ... is this correct?
Maxime
Posted by zeugma on February 23, 2006, at 11:45:30
In reply to I think the desipramine is working, posted by Maxime on February 23, 2006, at 10:57:19
yes, prozac increases desipramine plasma levels.
It's excellent news!
-z
Posted by Phillipa on February 23, 2006, at 19:10:13
In reply to Re: I think the desipramine is working » Maxime, posted by zeugma on February 23, 2006, at 11:45:30
Great news Maxie. Finally some relief!!!!Fondly, Phillipa
Posted by med_empowered on February 23, 2006, at 22:30:57
In reply to Re: I think the desipramine is working, posted by Phillipa on February 23, 2006, at 19:10:13
EXCELLENT! I'm **so** happy for you. I'm so glad you're feeling better.
Posted by Maxime on February 24, 2006, at 15:07:05
In reply to Re: I think the desipramine is working, posted by med_empowered on February 23, 2006, at 22:30:57
Hi, I started taking 50 mg of Desipramine with my 80 mg of Prozac. I have noticed some improvement, but I am still very depressed.
Here is my stupid question: If the Prozac increases the level desipramine in my system, does that mean it would increase the side effects as well? I ask because at 75 mg I lactate.
Maxime
Posted by Maxime on February 25, 2006, at 20:27:40
In reply to A stupid question, posted by Maxime on February 24, 2006, at 15:07:05
Can anyone answer my stupid question below. I need to know.
Thanks,
Maxime> Hi, I started taking 50 mg of Desipramine with my 80 mg of Prozac. I have noticed some improvement, but I am still very depressed.
>
> Here is my stupid question: If the Prozac increases the level desipramine in my system, does that mean it would increase the side effects as well? I ask because at 75 mg I lactate.
>
> Maxime
Posted by med_empowered on February 26, 2006, at 1:22:31
In reply to Anyone?, posted by Maxime on February 25, 2006, at 20:27:40
hi! its **not** a stupid question, especially when you have experienced such uncomfortable side effects with this medication before.
From what I understand, boosting the blood levels is a lot like upping the dosage; your 50mgs packs more of a "punch," which means you can get more good and bad side effects. That said..I don't think its all that predictable, unless you get blood levels measured (this was once done for TCAs; I think now its only done for Pamelor, but I may be wrong).
I guess the only thing you can do is enjoy the good effects, and wait it out. If you experience undesirable side effects such as lactation, then you'll probably need to adjust the dosage downward, or discontinue.
I remember you once took Adderall for your depression; could you revisit that (or use another stimulant..dexedrine, ritalin, provigil, etc.) ? Another option (**IF** side effects become troublesome) would be switching out the TCA for something TCA-ish, but a little cleaner; Wellbutrin, for instance, could jumpstart the prozac w/o the same side effects as a TCA (although obviously you might have other side effects). Switching out both for something like Cymbalta, which pumps up neuroepinephrine and serotonin about equally (and is chemically related to Prozac) might be another option..so might something like the "california rocketfuel" combo of remeron and effexor.
That said..I'd just enjoy the good effects for now, and try not to worry about problems until you come across them.
Good luck!
Posted by ed_uk on February 26, 2006, at 10:49:20
In reply to Anyone?, posted by Maxime on February 25, 2006, at 20:27:40
Hi Maxie
>If the Prozac increases the level desipramine in my system, does that mean it would increase the side effects as well?
Not really, it just means that you'll need a lower dose of desipramine to acheive the same effects ie. benefits and side effects.
Love
Ed xx
Posted by Maxime on February 27, 2006, at 10:14:32
In reply to Re: Anyone?, posted by med_empowered on February 26, 2006, at 1:22:31
Thanks for the information. I've been on it now for a full week. No signs of lactation. But sometimes it takes a couple of weeks.
Cymbalta isn't available in Canada. I've tried a lot of stimulants and Adderall XR was the only one that worked without sending me into a deep depression at the end of the day. But now my doctor doesn't want me to use stimulants. Wellbutrin made me psychotic ... twice.
Thanks again.
Maxime
> hi! its **not** a stupid question, especially when you have experienced such uncomfortable side effects with this medication before.
>
> From what I understand, boosting the blood levels is a lot like upping the dosage; your 50mgs packs more of a "punch," which means you can get more good and bad side effects. That said..I don't think its all that predictable, unless you get blood levels measured (this was once done for TCAs; I think now its only done for Pamelor, but I may be wrong).
>
> I guess the only thing you can do is enjoy the good effects, and wait it out. If you experience undesirable side effects such as lactation, then you'll probably need to adjust the dosage downward, or discontinue.
>
> I remember you once took Adderall for your depression; could you revisit that (or use another stimulant..dexedrine, ritalin, provigil, etc.) ? Another option (**IF** side effects become troublesome) would be switching out the TCA for something TCA-ish, but a little cleaner; Wellbutrin, for instance, could jumpstart the prozac w/o the same side effects as a TCA (although obviously you might have other side effects). Switching out both for something like Cymbalta, which pumps up neuroepinephrine and serotonin about equally (and is chemically related to Prozac) might be another option..so might something like the "california rocketfuel" combo of remeron and effexor.
>
> That said..I'd just enjoy the good effects for now, and try not to worry about problems until you come across them.
>
> Good luck!
Posted by Maxime on February 27, 2006, at 10:17:38
In reply to Re: Anyone? » Maxime, posted by ed_uk on February 26, 2006, at 10:49:20
So that means I will have the bad side effects. I went up to 75 mg on this med before and I lactated. Now I am on 50 mg. I already have trouble urinating. Sigh.
I have to see my endocrinologist and have my prolactin level tested. I'm tired of this.
Thanks Ed. xx
Maxime
> Hi Maxie
>
>
> Not really, it just means that you'll need a lower dose of desipramine to acheive the same effects ie. benefits and side effects.
>
> Love
>
> Ed xx
Posted by ed_uk on February 27, 2006, at 13:51:43
In reply to Re: Anyone? » ed_uk, posted by Maxime on February 27, 2006, at 10:17:38
Hi Maxie
Is the desipramine helping your depression?
>So that means I will have the bad side effects.
Not necessarily Maxie. A small dose of a dopamine agonist could be used to inhibit lactation if necessary. Close monitoring of dopamine agonist therapy would be essential.
>Now I am on 50 mg. I already have trouble urinating.
You could reduce the dose a bit if you like. Desipramine is available as 10mg tabs in Canada, which can be useful for dosage adjustment.
Ed xx
Posted by Maxime on February 27, 2006, at 15:05:02
In reply to Re: Anyone? » Maxime, posted by ed_uk on February 27, 2006, at 13:51:43
Thanks ED. I think the desipramine has lifted some of the fog. When I see my pdoc on Friday he is going to give me a script for Mirapex which is a dopamine agonist.
I wonder if Nortrip would be better for me than Desipramine?
SIGH. I'm tired of all this.
Maxime xxx
> Hi Maxie
>
> Is the desipramine helping your depression?
>
> >So that means I will have the bad side effects.
>
> Not necessarily Maxie. A small dose of a dopamine agonist could be used to inhibit lactation if necessary. Close monitoring of dopamine agonist therapy would be essential.
>
> >Now I am on 50 mg. I already have trouble urinating.
>
> You could reduce the dose a bit if you like. Desipramine is available as 10mg tabs in Canada, which can be useful for dosage adjustment.
>
> Ed xx
Posted by zeugma on February 27, 2006, at 18:42:30
In reply to Re: Anyone? » ed_uk, posted by Maxime on February 27, 2006, at 15:05:02
> Thanks ED. I think the desipramine has lifted some of the fog.>>
That is exactly the effect nortriptyline has.
>
> I wonder if Nortrip would be better for me than Desipramine?
>
apparently it's less likely to elevate prolactin levels. It seems to work at lower dosages/plasma levels- which, according to my doctor, means fewer side effects.I can't compare it directly with desipramine, unfortunately. But it does have less of an effect on prolactin.
-z
> > Is the desipramine helping your depression?
> >
> > >So that means I will have the bad side effects.
> >
> > Not necessarily Maxie. A small dose of a dopamine agonist could be used to inhibit lactation if necessary. Close monitoring of dopamine agonist therapy would be essential.
> >
> > >Now I am on 50 mg. I already have trouble urinating.
> >
> > You could reduce the dose a bit if you like. Desipramine is available as 10mg tabs in Canada, which can be useful for dosage adjustment.
> >
> > Ed xx
>
>
Posted by Maxime on February 27, 2006, at 19:17:35
In reply to Re: Anyone? » Maxime, posted by zeugma on February 27, 2006, at 18:42:30
Then maybe I should try nortriptyline. I feel like I am going to lactate... my breasts are sore and larger.
Thanks for the info.
Maxime
> > Thanks ED. I think the desipramine has lifted some of the fog.>>
>
> That is exactly the effect nortriptyline has.
> >
> > I wonder if Nortrip would be better for me than Desipramine?
> >
> apparently it's less likely to elevate prolactin levels. It seems to work at lower dosages/plasma levels- which, according to my doctor, means fewer side effects.
>
> I can't compare it directly with desipramine, unfortunately. But it does have less of an effect on prolactin.
>
>
>
> -z
> > > Is the desipramine helping your depression?
> > >
> > > >So that means I will have the bad side effects.
> > >
> > > Not necessarily Maxie. A small dose of a dopamine agonist could be used to inhibit lactation if necessary. Close monitoring of dopamine agonist therapy would be essential.
> > >
> > > >Now I am on 50 mg. I already have trouble urinating.
> > >
> > > You could reduce the dose a bit if you like. Desipramine is available as 10mg tabs in Canada, which can be useful for dosage adjustment.
> > >
> > > Ed xx
> >
> >
>
>
This is the end of the thread.
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