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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by TriedEveryDrug on May 31, 2009, at 22:10:05
So... Desipramine REALLY helps my ADD. It works so well for me. Nothing else comes close.
Unfortunately, it also makes me highly irritable, angry, unhappy, social phobic and anxious even at low doses.
But it works so well. I've endured it for as long as 3 months before I couldn't stand it anymore.
I was wondering if anyone had any ideas for a good combo for desipramine to ease these side effects.
What I have tried so far in combination with desipramine:
abilify - seemed to destroy the anxiety, but I was still irritable and angry.
paxil - mistake. couldn't get out of bed for 2 days.
pristiq - insomnia
gabapentin - dulled me mentally.
Any other ideas?I was considering asking my doctor about cymbalta + desipramine (I tried cymbalta alone in the past - relaxed me but not much else)
Posted by desolationrower on June 1, 2009, at 2:49:08
In reply to Ideas for a combo w/ Desipramine?, posted by TriedEveryDrug on May 31, 2009, at 22:10:05
valproate, maybe with alprazolam.
-d/r
Posted by bladewalker on June 1, 2009, at 17:29:01
In reply to Ideas for a combo w/ Desipramine?, posted by TriedEveryDrug on May 31, 2009, at 22:10:05
From my current expirience I would suggest combo:fluoxetine+low dose abilify+desipramine.
fluoxetine is not as sleepy ssri as paxil and via enzyme CYP2D6 is increasing level of desipramine so you do not have take high doses of it. Alltogether works very well for me.
My dosage:10mg fluoxetine/3,75 abilify/25mg Desipramine (+ Hydergine and low dose selegiline against anhedonia from ssri and cognitive enhancement).
peace bladewalker
Posted by TriedEveryDrug on June 1, 2009, at 21:17:50
In reply to Re: Ideas for a combo w/ Desipramine?, posted by bladewalker on June 1, 2009, at 17:29:01
Hi bladewalker,
Interesting. Prozac is one of the few meds I haven't tried. I'll ask my doc about this combo.
Thanks!
Posted by softheprairie on June 2, 2009, at 4:28:56
In reply to Re: Ideas for a combo w/ Desipramine? » bladewalker, posted by TriedEveryDrug on June 1, 2009, at 21:17:50
Wow. Your reaction to desipramine is pretty different from mine. I really get depression relief from it, no help with concentration or attention. I don't get the anger, irritability part from it, but you're not the first person I've heard of getting that from it. I did get anxiety, heart palpitations that disturbed me, and heartrate sometimes >100 bpm from it. My primary care doctor added the beta blocker Bystolic/nebivolol for the fast heartrate, which also greatly helps the anxiety. I had previously felt no anxiety relief from lorazepam that my pdoc let me try when I asked for a benzo try. I got up to 1.5 mgs a day of lorazepam, and didn't want to develop a tolerance for it if it wasn't giving me any benefit, so I soon tapered off. I guess I was unusual in not feeling any benefit from it. I also take an old antipsychotic, perphenazine, at night, and I can use it prn during the day, but it is somewhat sedating. I feel depression and anxiety relief from it. I also take a thyroid medication for depression assistance.
I really feel for your pretty stuck state. There may not be a combo that includes desipramine that takes away all or even most of the negative side effects you are getting. Have you ever tried Strattera for ADD? I haven't, but I understand it is chemically similar to desipramine. (I remember SLS calling desipramine "poor man's Strattera.") It's possible you could get the ADD benefit like desipramine on it, without the negative side effects you get from desipramine.
I am curious about your dose. I saw the other poster took 25 mg in a combination with other meds. Desipramine has a wide range in possible doses. I think the pills start as low as 10 mg, and a standard dose for depression can go to thirty times that (!), which is what I'm at, 300 mg/day. I've really liked being on it for the most part, but I'm still on disability, and not very functional in getting things done.
Posted by TriedEveryDrug on June 2, 2009, at 10:56:43
In reply to Re: Ideas for a combo w/ Desipramine?, posted by softheprairie on June 2, 2009, at 4:28:56
Hi,
My dose range was from 10-50mg. At that range it was great for concentrating for college classes. I went from a 1.7GPA to straight As in general chemistry and calculus at berkeley (chem there is pretty tough - a weed-out course).
Desipramine starts working the next day for me when I start taking it.
I did try strattera several times. It makes me so miserable though even at tiny doses that I cannot take it long enough to give it a good trial. I guess it takes 6 weeks to kick in. I'm a basket case after a week from the insomnia it causes though.
Funny - benzos make me more agitated and don't do anything for anxiety for me.
Regards.
> Wow. Your reaction to desipramine is pretty different from mine. I really get depression relief from it, no help with concentration or attention. I don't get the anger, irritability part from it, but you're not the first person I've heard of getting that from it. I did get anxiety, heart palpitations that disturbed me, and heartrate sometimes >100 bpm from it. My primary care doctor added the beta blocker Bystolic/nebivolol for the fast heartrate, which also greatly helps the anxiety. I had previously felt no anxiety relief from lorazepam that my pdoc let me try when I asked for a benzo try. I got up to 1.5 mgs a day of lorazepam, and didn't want to develop a tolerance for it if it wasn't giving me any benefit, so I soon tapered off. I guess I was unusual in not feeling any benefit from it. I also take an old antipsychotic, perphenazine, at night, and I can use it prn during the day, but it is somewhat sedating. I feel depression and anxiety relief from it. I also take a thyroid medication for depression assistance.
>
> I really feel for your pretty stuck state. There may not be a combo that includes desipramine that takes away all or even most of the negative side effects you are getting. Have you ever tried Strattera for ADD? I haven't, but I understand it is chemically similar to desipramine. (I remember SLS calling desipramine "poor man's Strattera.") It's possible you could get the ADD benefit like desipramine on it, without the negative side effects you get from desipramine.
>
> I am curious about your dose. I saw the other poster took 25 mg in a combination with other meds. Desipramine has a wide range in possible doses. I think the pills start as low as 10 mg, and a standard dose for depression can go to thirty times that (!), which is what I'm at, 300 mg/day. I've really liked being on it for the most part, but I'm still on disability, and not very functional in getting things done.
Posted by TriedEveryDrug on June 2, 2009, at 12:27:22
In reply to Ideas for a combo w/ Desipramine?, posted by TriedEveryDrug on May 31, 2009, at 22:10:05
Anyone ever try this?
TIA
Posted by softheprairie on June 2, 2009, at 20:03:17
In reply to Re: Ideas for a combo w/ Desipramine? » softheprairie, posted by TriedEveryDrug on June 2, 2009, at 10:56:43
I'm so sorry you've already tried Strattera and it didn't work; even around the time I wrote it, I got to thinking you may have already, but I thought I should throw it out just in case.
Your Provigil question is interesting, too. I have wondered that as well. I wish I had the answer for you. A "real" stimulant, generic Adderall in my case, was too much for me in terms of personally-disturbing cardiac events when mixed with desipramine and some physical exertion, so I determined I personally can't mix them. But maybe Provigil wouldn't be that bad. I've asked my psychiatrist about it, but he's not a Provigil fan. He had said he'd rather go with a "real" stimulant. I wasn't quick enough at the time to say that I had tried that, it was too much. I have decided to wait a while until it's available as a generic. I have insurance, but Provigil is outrageously expensive.
My fear for you is that it could add to the negative side effects you are getting from the desipramine. But, if you and the doctor are willing to risk that, it could also be great.
> Hi,
>
> My dose range was from 10-50mg. At that range it was great for concentrating for college classes. I went from a 1.7GPA to straight As in general chemistry and calculus at berkeley (chem there is pretty tough - a weed-out course).
>
> Desipramine starts working the next day for me when I start taking it.
>
> I did try strattera several times. It makes me so miserable though even at tiny doses that I cannot take it long enough to give it a good trial. I guess it takes 6 weeks to kick in. I'm a basket case after a week from the insomnia it causes though.
>
> Funny - benzos make me more agitated and don't do anything for anxiety for me.
>
> Regards.
>
> > Wow. Your reaction to desipramine is pretty different from mine. I really get depression relief from it, no help with concentration or attention. I don't get the anger, irritability part from it, but you're not the first person I've heard of getting that from it. I did get anxiety, heart palpitations that disturbed me, and heartrate sometimes >100 bpm from it. My primary care doctor added the beta blocker Bystolic/nebivolol for the fast heartrate, which also greatly helps the anxiety. I had previously felt no anxiety relief from lorazepam that my pdoc let me try when I asked for a benzo try. I got up to 1.5 mgs a day of lorazepam, and didn't want to develop a tolerance for it if it wasn't giving me any benefit, so I soon tapered off. I guess I was unusual in not feeling any benefit from it. I also take an old antipsychotic, perphenazine, at night, and I can use it prn during the day, but it is somewhat sedating. I feel depression and anxiety relief from it. I also take a thyroid medication for depression assistance.
> >
> > I really feel for your pretty stuck state. There may not be a combo that includes desipramine that takes away all or even most of the negative side effects you are getting. Have you ever tried Strattera for ADD? I haven't, but I understand it is chemically similar to desipramine. (I remember SLS calling desipramine "poor man's Strattera.") It's possible you could get the ADD benefit like desipramine on it, without the negative side effects you get from desipramine.
> >
> > I am curious about your dose. I saw the other poster took 25 mg in a combination with other meds. Desipramine has a wide range in possible doses. I think the pills start as low as 10 mg, and a standard dose for depression can go to thirty times that (!), which is what I'm at, 300 mg/day. I've really liked being on it for the most part, but I'm still on disability, and not very functional in getting things done.
>
>
Posted by TriedEveryDrug on June 6, 2009, at 21:41:07
In reply to How about provigil + desipramine?, posted by TriedEveryDrug on June 2, 2009, at 12:27:22
Ok, so I tried provigil + desipramine for 3 days.
100mg provigil, 20mg desipramine.Too much overstimulation. I did find myself less angry on it that desipramine alone.
Couldn't do more than 3 days though.
This is the end of the thread.
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