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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by orochi on November 18, 2014, at 19:27:40
Hello,
I hope someone here can help me.
I recently started with Anafranil from depression,anxiety,ocd. I tried various other newer drugs before (ssri,ndri,remeron,stablon) and they all failed.
Currently I am at 50mg and so far I have no effects and no side effects.However, there are things which worry me.
For example I read that certain drugs which are metabolized the same paths as Anafranil can raise the Anafranil blood levels and then cause very dangerous side effects.
I don't take any drugs which could interact with Anafranil, but I wonder what about foods and herbs?
For example I knew that grapefruits are problematic but recently I saw something in a documentary about garlic where they said that garlic has the same effects as grapefruits!
I never heard of that before.
Now I'm worried cause I frequently eat garlic.
And what about other foods or herbs/spices?
I mean how shall I know wether a certain herb or spice which I use is allowed or not?
It's virtually impossible to test every food or herb for drug interactions.
Spices which I use almost daily are:
Cinnamon,curcuma,black pepper,ginger,chili,garlicI also used to take spirulina tablets daily as supplements. But now I worry, that spirulina could interfere with Anafranil. I mean how shall I know by which enzymes spirulina is metabolized in the liver?
I feel really uneasy about this situation cause now I worry about eating something forbidden without knowing it.I also read that some cruciferous vegetables also influence liver enzymes. Now I don't know what kind of vegetables I can still eat and in which amounts.
What also worries me is the D2 antagonism of Anafranil. Does this not mean that Anafranil can have the same dyskinisia side effects as antipsychotics?! That would be really scary.
Posted by phidippus on November 21, 2014, at 14:51:17
In reply to Anafranil questions [side effects + interactions], posted by orochi on November 18, 2014, at 19:27:40
I was on Anafranil for a very a long time and during that time time cconsumed plenty of grapefruit juice and garlic.
I spoke with my shrink about spirulina and Anafranil and he was sure there was no interaction between the two.
The D2 antagonism effects of Anafranil are so small that the chance of getting tardive dyskinesia are as remote as getting struck by lightning. D2 receptor (Ki = 162 nM), D3 receptor (Ki = 30 nM, D1 receptor (Ki = 219 nM). The smaller the number, the stronger the bond.
Listen, don't worry about side effects and interactions until something happens. You're not going to fall dead. You'll get sick enough for the docs to figure out its the Anafranil before you die.
Eric
Posted by orochi on November 23, 2014, at 16:37:06
In reply to Re: Anafranil questions [side effects + interactions] » orochi, posted by phidippus on November 21, 2014, at 14:51:17
Hi Eric,
thanks for the reply.How much anafranil were you taking back then?
What sucks though is that I also have adhd and now where I'm on anafranil I cannot take ritalin. My doc said that this is too dangerous. This is really a huge disadvantage.
I don't know how the Ki stuff works. I always thought that the higher the number the stronger the affinity. Is it the other way around?
And is it even true that anafranil has a stronger affinity for serotonin than newer SSRI? I'm asking cause SSRI didn't work for me at all. I wonder why anafranil should work if SSRI don't work.
Posted by phidippus on November 24, 2014, at 13:15:26
In reply to Re: Anafranil questions [side effects + interactions], posted by orochi on November 23, 2014, at 16:37:06
>How much anafranil were you taking back then?
I was taking 300 mg of Anafranil.
>I'm on anafranil I cannot take ritalin.
This is simply not true. I took 72 mg of Concerta (a long acting formula of ritalin) while I was on Anafranil.
>I always thought that the higher the number the stronger the affinity. Is it the other way around?
Yes, the lower the Ki the greater the affinity, because affinity is finite.
>anafranil has a stronger affinity for serotonin than newer SSRI?
I can't find a lot of data supporting this supposition.
>SSRI didn't work for me at all. I wonder why anafranil should work if SSRI don't work
Though Anafranil does some serotonin reuptake inhibition, it mainly acts as a tricyclic antidepressant.
Eric
Posted by orochi on December 7, 2014, at 11:15:20
In reply to Re: Anafranil questions [side effects + interactions] » orochi, posted by phidippus on November 24, 2014, at 13:15:26
Hi Eric,
but in the leaflet of anafranil it simply says that ritalin can intefere with the metabolization of TCAs!
This sounds scary to me. It sounds like nobody knows what might happen. What if for example ritalin raises the blood levels of anafranil? This could be really dangerous.
My psychiatrist also said that even if there are no liver enzyme interactions then ritalin would still affect the same neurotransmitters (I assume he means NE) which anafranil also affects and that this could cause problems.
I am worried now and don't dare to take ritalin.
But at the same time not being able to take ritalin for adhd is very negative I really miss it. :(
Posted by phidippus on December 8, 2014, at 12:25:40
In reply to Re: Anafranil questions [side effects + interactions], posted by orochi on December 7, 2014, at 11:15:20
>ritalin can intefere with the metabolization of TCAs
This is concerning if you are taking higher doses of Anafranil, say 200 mg. Otherwise I think you'd be pretty safe taking Ritalin.
>My psychiatrist also said...ritalin would still affect the same neurotransmitters
Anafranil has little affinity for norepenephrine or dopamine, the main neurotransmitters Ritalin affects.
Eric
Posted by orochi on December 15, 2014, at 17:40:14
In reply to Re: Anafranil questions [side effects + interactions] » orochi, posted by phidippus on December 8, 2014, at 12:25:40
Hi,
I have to get off anafranil. It raises my resting pulse to around 90. I cannot tolerate this. I dont know what to try next.
Posted by phidippus on December 15, 2014, at 18:31:20
In reply to Re: Anafranil questions [side effects + interactions], posted by orochi on December 15, 2014, at 17:40:14
I think your anxiety about Anafranil make your resting pulse 90
Eric
This is the end of the thread.
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