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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 Kizzie2 on March 22, 2011, at 6:48:32
Hi I would really appreciate advice on this.
I was on 50mg of anafranil but have had to reduce (slowly) to 35mg because of drowsiness side effect which was affecting my driving and ability to do my job. (I had tried taking the medication at different times of the day but didnt make any difference.) I am very sensitive to medications and seem to be hit by side effects at quite low doses.If at all possible I dont want to switch to a different ad because I tend to get much much worse on them when I first start them :-(
Anyway I just wondered if anyone could help me work what my body is 'missing' with 15mg less on anafranil? I feel very jittery now with waves of lows/ anxiety / panic and depression.
I know lots of people here really understand the 'chemistry' behind the medication so Im hoping that i might be able to work out what my body is missing and then find other ways to replace it (eg reducing cortisol with light exercise???)
I hope this message makes sense. Apologies if it doesnt and I will try and explain more clearly.
I would really appreciate any advice / help.
Thanks x
Posted by Lou Pilder on March 22, 2011, at 8:24:39
In reply to What is anafranil 'actually' doing for me ?, posted by Kizzie2 on March 22, 2011, at 6:48:32
> Hi I would really appreciate advice on this.
> I was on 50mg of anafranil but have had to reduce (slowly) to 35mg because of drowsiness side effect which was affecting my driving and ability to do my job. (I had tried taking the medication at different times of the day but didnt make any difference.) I am very sensitive to medications and seem to be hit by side effects at quite low doses.
>
> If at all possible I dont want to switch to a different ad because I tend to get much much worse on them when I first start them :-(
>
> Anyway I just wondered if anyone could help me work what my body is 'missing' with 15mg less on anafranil? I feel very jittery now with waves of lows/ anxiety / panic and depression.
>
> I know lots of people here really understand the 'chemistry' behind the medication so Im hoping that i might be able to work out what my body is missing and then find other ways to replace it (eg reducing cortisol with light exercise???)
>
> I hope this message makes sense. Apologies if it doesnt and I will try and explain more clearly.
>
> I would really appreciate any advice / help.
>
> Thanks xKizzie2,
You wrote,[...I would really appreciate advice...much worse...if anyone could help me...waves of lows...the chemistry...what my body is missing...].
I am unsure as to what you are wanting to mean here. If you could post answers to the following, then I could have tthe opportunity to respond accordingly.
A. Are you under the mind-set, as fact, that you are led to believe that you are lacking in a chemical and thearfore have a chemical imbalance, and a psychiatric drug replaces the chemical that you lack?
B. If so, why have you accepted that as fact?
C. Are you aware of the potential of the caliber of disaster that there could be to you by taking psychotropic drugs?
D. Are you aware of that there could be life-ruining conditions and/or death associated with the taking of mind-altering drugs?
E. other aspects
Lou
Posted by Phillipa on March 22, 2011, at 11:13:57
In reply to What is anafranil 'actually' doing for me ?, posted by Kizzie2 on March 22, 2011, at 6:48:32
Kizzie hi hoping one of the experts you speak of chimes in with some knowledge. Do you have OCD? Phillipa
Posted by mtdewcmu on March 22, 2011, at 15:00:51
In reply to What is anafranil 'actually' doing for me ?, posted by Kizzie2 on March 22, 2011, at 6:48:32
> Anyway I just wondered if anyone could help me work what my body is 'missing' with 15mg less on anafranil? I feel very jittery now with waves of lows/ anxiety / panic and depression.
That sounds miserable. I'm sorry. My thought as to why you feel jittery now is that perhaps anafranil is more potent at boosting NE (the stimulating part) than at blocking histamine (the sedating part). So you have hit a dose where the sedation is not prominent, but it is still fairly stimulating.
The reason you are feeling depressed is probably a symptom of your disorder, not the anafranil.
Maybe you should consider boosting the dose a little to find a better balance between stimulation and sedation.
Posted by mtdewcmu on March 22, 2011, at 15:12:17
In reply to Re: What is anafranil 'actually' doing for me ?, posted by mtdewcmu on March 22, 2011, at 15:00:51
I'm going to amend that a little. The source of the jitters could have to do with serotonin (5-ht) as well as NE.
> That sounds miserable. I'm sorry. My thought as to why you feel jittery now is that perhaps anafranil is more potent at boosting NE (the stimulating part) than at blocking histamine (the sedating part). So you have hit a dose where the sedation is not prominent, but it is still fairly stimulating.
Posted by Phillipa on March 22, 2011, at 21:05:53
In reply to Re: What is anafranil 'actually' doing for me ?, posted by mtdewcmu on March 22, 2011, at 15:12:17
Glad you responded to Kizzie. If anafranil is both norepenphrine and serotonin for Ocd how come Luvox is only serotonin? Phillipa
Posted by mtdewcmu on March 22, 2011, at 21:56:22
In reply to Re: What is anafranil 'actually' doing for me ? » mtdewcmu, posted by Phillipa on March 22, 2011, at 21:05:53
Are you saying that because Luvox is FDA approved for OCD? My guess is that most any antidepressant could get approved for OCD, it's just a matter of which drug companies go through the process. Doctors can prescribe any drug off-label for OCD, so getting FDA approval is a matter of costs versus profits for the drug company. Luvox is unpopular, so it was probably worth getting it approved.
I didn't look up the data on Anafranil before I mentioned NE, I just assumed that since tricyclics are "dirty" drugs it would hit NE. According to wikipedia, Anafranil is about 385 times more potent at 5-ht than NE. Wikipedia also says Luvox is about 100 times more potent at 5-ht than NE. So, ironically, Luvox is less selective for 5-ht over NE than Anafranil. Don't even try to rationalize it; psychiatry is not a precise thing. We can speculate about reasons, but that's all.
> Glad you responded to Kizzie. If anafranil is both norepenphrine and serotonin for Ocd how come Luvox is only serotonin? Phillipa
Posted by desolationrower on March 23, 2011, at 5:28:48
In reply to What is anafranil 'actually' doing for me ?, posted by Kizzie2 on March 22, 2011, at 6:48:32
adrafinil is a very dirty (aka effective) drug.
It is almost the point of taking it to surrender to chance and hope for the best...
But to violate that...i would guess it is too much antihistamine effect causing the drowsiness.
- [oops says pharma] d/r
Posted by bleauberry on March 23, 2011, at 5:37:01
In reply to What is anafranil 'actually' doing for me ?, posted by Kizzie2 on March 22, 2011, at 6:48:32
I can't really comment much on your questions. I wanted to say that when I see exquisite sensitivities to very low doses, that is a strong clue to me that there is something else going on....not psychiatric, but manifests in psychiatric symptoms.
My Lyme doctor saw a lot of this. Most Lyme patients fit your description. I'm the same way. What he did was keep doses very low and gently ramp it up higher over an extended period of time....months, not weeks or days. My guess is at this time you are feeling not the lower dose, but rather a withdrawal type of phenomenon from going down in dose. With time the lower dose should adjust.
Another option....switch straight over to nortriptyline plus zoloft combination. You'll get much the same mechanism as anafranil, except with a lot less side effects, and more ability to customize both sides of the cocktail for more or less of each of serotonin and norepinephrine.
Posted by Roslynn on March 24, 2011, at 13:34:06
In reply to What is anafranil 'actually' doing for me ?, posted by Kizzie2 on March 22, 2011, at 6:48:32
Hi Kizzie2,
I don't understand the mechanisms either, wish I did. I tried 100mg anafranil but my body could not adjust to it. I couldn't tolerate the side effects anymore and went back to 75mg.
Roslynn
Posted by kizzie2 on April 6, 2011, at 5:55:48
In reply to Re: What is anafranil 'actually' doing for me ?, posted by mtdewcmu on March 22, 2011, at 21:56:22
Thank you to everyone who replied to this. For some reason I missed the replies (due to not looking at the site correctly) but appreciate you taking the time. Thanks
This is the end of the thread.
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