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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Maxime on November 7, 2010, at 23:14:08
I can't take this pain much longer. I never knew that Nortriptaline was blocking the pain for me. Prior to being on Panate and Nortriptaline , I was on Cymbalra which I believe was also blocking the pain.
I am taking way too much Tylenol, Advil and Aleve (I don't take all 3 at once, I alternate).
So would Desipramine help with the pain? Please say yes. I understand that Desipramine doesn't cause the same weight gain as Nortriptaline. Is this true? If so, why doesn't it because I thought all TCA were weight gainers?
I patiently await your responses.
Thanks guys!
Posted by Phillipa on November 7, 2010, at 23:37:30
In reply to Desipramine for pain - Ed? Scott? Link?, posted by Maxime on November 7, 2010, at 23:14:08
What happens if you add some cymbalta bad things with parnate pretty sure. Is it the cold weather as I know I hurt more. Phillipa
Posted by Maxime on November 7, 2010, at 23:51:53
In reply to Re: Desipramine for pain - Ed? Scott? Link? » Maxime, posted by Phillipa on November 7, 2010, at 23:37:30
> What happens if you add some cymbalta bad things with parnate pretty sure. Is it the cold weather as I know I hurt more. Phillipa
Serotonin syndrome if I add Cymbalta to Parnate. I am okay with the cold weather. I am used to it and I know how to dress for it. I think dressing properly is key. I have 3 different winter coats that I use depending on the temperature. And I layer a lot. But yes, a lot of people hurt more in the winter months. I hurt more when it is damp.
Posted by softheprairie on November 8, 2010, at 0:09:41
In reply to Desipramine for pain - Ed? Scott? Link?, posted by Maxime on November 7, 2010, at 23:14:08
You can try it and see. I take desipramine and really love it. I take it for depression, and treat a bit of pain relief as bonus. But, I don't think it will help all of your pain. I am still taking some ibuprofen and acetamenophen for my menstural pain today (effectiveness-wise, just the ibuprofen works best for me, but I do worry some about it harming my stomach, so I have compromised and partly gone to the less-effective but gentler-on-the-stomach acetamenophen). I take 400 mg of desipramine daily. The normal upper limit is usually 300 mg. I had a malabsorptive weight loss surgery this summer, and was crying more there for a while and my blood level of desipramine was below the optimal/therapeutic range, so we went higher. It takes quite a while to ramp up the doses (at least for me, it did). Ironically, since you are wanting to take it for pain, I did face headaches for a while each time I moved to a higher dose.
I do find it more or less weight-neutral.
There can be cardiac side effects. I got a fast heart rate from it (over 100 beats per minute, aka tachycardia) (even at a lower dose than I am currently at). I also felt heart palpitations and some anxiety from it. My family doctor put me on a beta blocker called Bystolic/nebivolol to slow down my heart rate, and it also helped with the heart palpitations and anxiety. Otherwise, my EKG showed my heart rate was fine.
Two other adjuncts I take are liothyronine and perphenazine.
Posted by Maxime on November 8, 2010, at 0:22:58
In reply to Re: Desipramine for pain - Ed? Scott? Link?, posted by softheprairie on November 8, 2010, at 0:09:41
Thank you for your post. What sort of pain do you experience (other than menstrual pain)?
At 400 mg you must have a lot of side effects. Do you?
I am really glad you posted. :)
Posted by Conundrum on November 8, 2010, at 10:25:43
In reply to Desipramine for pain - Ed? Scott? Link?, posted by Maxime on November 7, 2010, at 23:14:08
> I can't take this pain much longer. I never knew that Nortriptaline was blocking the pain for me. Prior to being on Panate and Nortriptaline , I was on Cymbalra which I believe was also blocking the pain.
>
> I am taking way too much Tylenol, Advil and Aleve (I don't take all 3 at once, I alternate).
>
> So would Desipramine help with the pain? Please say yes. I understand that Desipramine doesn't cause the same weight gain as Nortriptaline. Is this true? If so, why doesn't it because I thought all TCA were weight gainers?
>
> I patiently await your responses.
>
> Thanks guys!Well nortriptyline is an anti histamine which increases the munchies. It is also a potent
5 HT2C antagonist, which can slow metabolism. So you're eating more and your metabolism could slow down on nortriptyline.Desipramine barely touches histamine and 5 HT2C receptors so you have much more stimulation with desipramine as NRI, without other side effects.
Posted by softheprairie on November 8, 2010, at 11:12:24
In reply to Re: Desipramine for pain - Ed? Scott? Link? » softheprairie, posted by Maxime on November 8, 2010, at 0:22:58
> Thank you for your post. What sort of pain do you experience (other than menstrual pain)?
I don't currently have chronic pain like you do. I think I've been on the desipramine for around a year and a half, and it is probably masking some aches. I used to have some bad lower back pain and painful plantar fasciitis, probably related to being morbidly obese, but my highest weight was a few years ago. Those pains seem to have resolved. I was on narcotic pain relievers for a while after my surgery this summer and while I had a complication from it (infected incision that had to be repacked with guaze daily), but it's healed now, and I'm off the med for it.
>
> At 400 mg you must have a lot of side effects. Do you?
>
> I am really glad you posted. :)Mostly just the side effects that I mentioned, that Bystolic/nebivolol takes care of. Oh, also sometimes profuse sweating around my forehead. Worse in the summer. I'm not sure how much of that is related to the med and how much my weight. The thyroid adjunct I am allowed to also take may also contribute to the sweating, I'm not sure.
Posted by creepy on November 8, 2010, at 13:01:35
In reply to Desipramine for pain - Ed? Scott? Link?, posted by Maxime on November 7, 2010, at 23:14:08
desipramine is great on my pain, but my pain is probably a lot milder than what you are dealing with. I just have what I think is fibromyalgia and body aches.
I notice now that things that really hurt before are dulled somewhat. I know there is pain but I can deal with it.
I found that desipramine gave me some headaches at first. It was best to take it at night along with some benadryl to stay asleep until I could manage without it. I think the headaches were related to blood presure changes.
Posted by ed_uk2010 on November 8, 2010, at 13:54:55
In reply to Desipramine for pain - Ed? Scott? Link?, posted by Maxime on November 7, 2010, at 23:14:08
>So would Desipramine help with the pain?
Quite possibly. I think it might help.
>I understand that Desipramine doesn't cause the same weight gain as Nortriptyline. Is this true?
It is believed to be true. Desipramine is quite selective as an NRI whereas nortriptyline isn't. Nortriptyline has an antihistamine effect, which may cause weight gain.
Posted by Maxime on November 8, 2010, at 21:17:36
In reply to Re: Desipramine for pain - Ed? Scott? Link?, posted by creepy on November 8, 2010, at 13:01:35
> desipramine is great on my pain, but my pain is probably a lot milder than what you are dealing with. I just have what I think is fibromyalgia and body aches.
> I notice now that things that really hurt before are dulled somewhat. I know there is pain but I can deal with it.
> I found that desipramine gave me some headaches at first. It was best to take it at night along with some benadryl to stay asleep until I could manage without it. I think the headaches were related to blood presure changes.
>
>I am sure that your fibromyalgia pain is worse than what I am experiencing because it's nerve pain. Right?
What dosage do you take?
Posted by Maxime on November 8, 2010, at 21:19:21
In reply to Re: Desipramine for pain - Ed? Scott? Link?, posted by ed_uk2010 on November 8, 2010, at 13:54:55
> >So would Desipramine help with the pain?
>
> Quite possibly. I think it might help.
>
> >I understand that Desipramine doesn't cause the same weight gain as Nortriptyline. Is this true?
>
> It is believed to be true. Desipramine is quite selective as an NRI whereas nortriptyline isn't. Nortriptyline has an antihistamine effect, which may cause weight gain.
>
>Thanks Ed. If there is a chance that it will help my pain ... then I should try it. I just cannot afford to gain anymore weight. My doctors would freak out!
Maxie
Posted by ed_uk2010 on November 9, 2010, at 13:42:45
In reply to Re: Desipramine for pain - Ed? Scott? Link? » ed_uk2010, posted by Maxime on November 8, 2010, at 21:19:21
>Thanks Ed. If there is a chance that it will help my pain ... then I should try it. I just cannot afford to gain anymore weight. My doctors would freak out!
If I were you, I'm pretty sure I'd try it. If it doesn't work out you can easily stop.
Posted by Maxime on November 10, 2010, at 8:01:43
In reply to Re: Desipramine for pain - Ed? Scott? Link? » Maxime, posted by ed_uk2010 on November 9, 2010, at 13:42:45
> >Thanks Ed. If there is a chance that it will help my pain ... then I should try it. I just cannot afford to gain anymore weight. My doctors would freak out!
>
> If I were you, I'm pretty sure I'd try it. If it doesn't work out you can easily stop.
>
>
>Oh God Ed, you WOULDN'T want to be me! ;) But you are right. What have I got to lose? What are the "normal" dosages for Desipramine. Although I do want to stay on the lowest effective dosage.
Posted by creepy on November 10, 2010, at 11:28:19
In reply to Re: Desipramine for pain - Ed? Scott? Link? » creepy, posted by Maxime on November 8, 2010, at 21:17:36
My pain isnt that bad. Its like body aches and pain in my back, hips and knees. Especially when I get out of bed.
I only take 25mg and it makes a nice dent in the pain without giving me much in the way of side effects.
It is a pretty potent andrenergic but it doesnt really mess with my PTSD until I take too much adderall and drink too much coffee.
You may have headaches on it at first, just take it at night. Also I think it makes coffee a little more potent. Maybe it inhibits CPY1A2 a little I forget.
Posted by ed_uk2010 on November 10, 2010, at 13:40:49
In reply to Re: Desipramine for pain - Ed? Scott? Link? » ed_uk2010, posted by Maxime on November 10, 2010, at 8:01:43
>Oh God Ed, you WOULDN'T want to be me! ;)
I often wonder what it would be like to be someone else. I suspect things would be very different.
>What are the "normal" dosages for Desipramine.It's a difficult question because desipramine is given at a wide range of different doses. Here's a link to the doses recommended in the US...
http://www.rxlist.com/norpramin-drug.htm
Posted by emmanuel98 on November 10, 2010, at 19:42:32
In reply to Re: Desipramine for pain - Ed? Scott? Link? » Maxime, posted by ed_uk2010 on November 10, 2010, at 13:40:49
I don't know what age you are, but I have noticed, at 53, that I have pain when I get out of bed, when I get out of a car after a semi-long ride. My knees hurt, I am still all over. It sucks. I was reading this book by Richard Russo and this woman was musing on aging and thought, things that were once injuries become conditions. Sad, but true.
Posted by Phillipa on November 10, 2010, at 20:36:02
In reply to Re: Desipramine for pain - Ed? Scott? Link?, posted by emmanuel98 on November 10, 2010, at 19:42:32
"Arthur" come to visit after 40 they say:). Maybe we need a board for old people? Phillipa
Posted by Maxime on November 10, 2010, at 21:26:39
In reply to Re: Desipramine for pain - Ed? Scott? Link?, posted by emmanuel98 on November 10, 2010, at 19:42:32
I am more than 10 years younger than you ... but yes, I have a lot of pain when I get out bed. I have pain during the night as when I roll. It hurts SO MUCH. Good thing I don't have sex life right now, I would probably end up in traction!
Posted by Maxime on November 11, 2010, at 21:20:14
In reply to Re: Desipramine for pain - Ed? Scott? Link? » Maxime, posted by ed_uk2010 on November 10, 2010, at 13:40:49
I would like to know what it's like to be tall. I am just under 5 feet and I see the world ... through people's armpits! I hate the short jokes. I hate being told that I am "cute". And I hate that nothing ever fits me.
I would also like what it's like to be ignorant and not worry about things.
And of course, I would like to know what it's like to live without depression and all the sh*t that comes with it.
Sigh. I should really just learn to like myself. It would be a lot easier.
Posted by SLS on November 15, 2010, at 5:14:50
In reply to Re: Desipramine for pain - Ed? Scott? Link? » ed_uk2010, posted by Maxime on November 11, 2010, at 21:20:14
Hi Maxime.
> Sigh. I should really just learn to like myself. It would be a lot easier.
It's easier once you are on the other side. However, it can be quite a bit of work to get there. I have a feeling that with the right teaching tools, it is a journey that you are able to make. If you can get a job feeling as bad as you do now, there is no telling what you will be able to do - ill or healthy.
- Scott
Posted by Maxime on November 17, 2010, at 0:00:26
In reply to Re: Desipramine for pain - Ed? Scott? Link? » Maxime, posted by SLS on November 15, 2010, at 5:14:50
> Hi Maxime.
>
> > Sigh. I should really just learn to like myself. It would be a lot easier.
>
> It's easier once you are on the other side. However, it can be quite a bit of work to get there. I have a feeling that with the right teaching tools, it is a journey that you are able to make. If you can get a job feeling as bad as you do now, there is no telling what you will be able to do - ill or healthy.
>
>
> - ScottScott, you always manage to make me feel better. Thank you.
Maxie
This is the end of the thread.
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