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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Laney on October 12, 2011, at 10:34:39
So I was having depression along with anxiety just before starting the desiprimine. Usually don't get anxiety along with it.
Anyway, I am only on day four of desiprimine and at a very low startup dose. 10mg. the first day and 5mg. the next two days. Yesterday I starting getting not just the regular startup anxiety with a TCA but more like muscle tension anxiety along with it.
My throat felt like it was tight and constricted for a good part of the day yesterday and I woke up with a sore neck, etc.
I can handle most aspects of anxiety but the throat constriction bothers me the most and I'm not sure what to do?
I was getting some anxiety before I started the desiprimine. I thought about increasing the paxil.
Right now I think I should hold off on the desiprimne and take a look at my anxiety and get that settled before continuing with something like desiprimine.
Does that sound prudent?
Thanks for your replies...
Laney
Posted by Christ_empowered on October 12, 2011, at 10:39:48
In reply to Need some advice on anxiety I'm experiencing....., posted by Laney on October 12, 2011, at 10:34:39
I don't want to push you to take something that's making you feel uncomfortable, but have you considered temporarily increasing the Klonopin while you start your new AD? I mean, just to like 2mgs/day. Or add in a *very* low dose antipsychotic for a couple weeks, just to keep things calm?
Posted by Laney on October 12, 2011, at 11:47:23
In reply to Re: Need some advice on anxiety I'm experiencing....., posted by Christ_empowered on October 12, 2011, at 10:39:48
Hi CE,
Don't know anything about AP's. I could ask my doctor what he thinks and go from there I guess.
Any other ideas? I actually took some extra magnesium and vitamin C after I googled vitamins for anxiety. Who knows if that will work.
Laney
Posted by Phillipa on October 12, 2011, at 12:30:37
In reply to Re: Need some advice on anxiety I'm experiencing....., posted by Laney on October 12, 2011, at 11:47:23
Laney does the paxil decrease anxiety for you? If so I think I would look at raising the dose and maybe TCA's aren't for you. Always could take more klonopin. But don't know. Gooing to google desipramine. Phillipa
Posted by Phillipa on October 12, 2011, at 12:36:28
In reply to Re: Need some advice on anxiety I'm experiencing..... » Laney, posted by Phillipa on October 12, 2011, at 12:30:37
From google sounds like desipramine does help anxiety and panic. Phillipa
Posted by jono_in_adelaide on October 12, 2011, at 18:35:47
In reply to Need some advice on anxiety I'm experiencing....., posted by Laney on October 12, 2011, at 10:34:39
Could you ask your doctor about a low dose benzo for a few weeks, to help control the start up anxiety?
This woul help ypu get to an effective dose more quickly without any start up anxiety getting in the way.
Posted by Laney on October 12, 2011, at 19:51:31
In reply to Re: Need some advice on anxiety I'm experiencing....., posted by jono_in_adelaide on October 12, 2011, at 18:35:47
Thanks everyone. It was a little better today.
Laney
Posted by Chairman_MAO on October 12, 2011, at 21:40:39
In reply to Need some advice on anxiety I'm experiencing....., posted by Laney on October 12, 2011, at 10:34:39
Why are you taking paxil with desipramine? If there's a rationale, go for it, but there are myriad antidepressants on the market which inhibit uptake of SE (SSRIs) and NE (desipramine) that don't have anticholinergic side effects.. Presently, we have venlafaxine (and Pristiq), milnacipran, and duloxetine, AFAIK.
Posted by Laney on October 13, 2011, at 18:09:40
In reply to Re: Need some advice on anxiety I'm experiencing..... » Laney, posted by Chairman_MAO on October 12, 2011, at 21:40:39
What do you mean by the anticholinergic side effects? Like what?
An SSRI + TCA is suppose to be a really good way to go as you can adjust the effect of the neurotransmitters instead of getting a fixed amount.
Thanks!
Laney
Posted by Phillipa on October 13, 2011, at 20:50:43
In reply to Re: Need some advice on anxiety I'm experiencing....., posted by Laney on October 13, 2011, at 18:09:40
Laney google anticholenergic effects. Phillipa
Posted by Chairman_MAO on October 14, 2011, at 19:23:41
In reply to Re: Need some advice on anxiety I'm experiencing....., posted by Laney on October 13, 2011, at 18:09:40
"An SSRI + TCA is suppose to be a really good way to go as you can adjust the effect of the neurotransmitters instead of getting a fixed amount."
I think I know what you're trying to say, namely, that it is better to be able to adjust the dose of the drug that blocks reuptake pump X independently of the drug that blocks reuptake pump Y.
However:
(*) We have several selective NE uptake inhibitors now that aren't TCAs. I advise trying those first, if that's what you want.
(*) It is not a matter of adjusting "levels", but even if it were,
(*) The clinical effect is all that matters.It only makes sense to try an SSRI + TCA combination, IMHO, if you've tried all the other dual action drugs which have the same mechanism of action that don't have anticholinergic side effects.
Posted by Laney on October 15, 2011, at 12:57:02
In reply to Re: Need some advice on anxiety I'm experiencing..... » Laney, posted by Chairman_MAO on October 14, 2011, at 19:23:41
thoughts about this? I'm just curious if you agree.
Thanks!
Laney
This is the end of the thread.
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