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Dr. Bob is Robert Hsiung, MD,
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Posted by linkadge on May 8, 2010, at 20:12:19
In reply to Question for Linkadge (anyone can comment though), posted by Bob on May 8, 2010, at 17:40:51
hmm. Thanks for asking as I am currently questioning the same thing.
I think overal, the feeling of being "drugged". You feel better from your depression but then there is this chemical barrier in the way.
I also feel that the medicaiton is just bad for my brain. I get very obsessed with brain health and the stuff just feels toxic. When I feel better from the depression too, I become focused on my overall health and then the drug just seems incompatible with where I want to be.
Also the drug make me feel wimpy and submissive, which in my present job is not an option.
If that makes any sense.
Linkadge
Posted by linkadge on May 8, 2010, at 20:14:07
In reply to Question for Linkadge (anyone can comment though), posted by Bob on May 8, 2010, at 17:40:51
Its a damn good antidepressant. Perhaps if I was a janitor or woking at McDonnalds again I wouldn't give much care about the way it affects me.
Linkadge
Posted by SLS on May 8, 2010, at 20:28:25
In reply to Question for Linkadge (anyone can comment though), posted by Bob on May 8, 2010, at 17:40:51
> Hey Linkadge - What were the most troubling sides for you with regard to amitriptyline? Could you get past the sedation? -Bob
I was on amitriptyline for only six weeks, but it felt disgusting the whole time. I don't know if that disgusting feeling is the sedation you are describing, though.
- Scott
Posted by Bob on May 8, 2010, at 21:12:44
In reply to Re: Question for Linkadge (anyone can comment though), posted by linkadge on May 8, 2010, at 20:12:19
So I'm guessing that sedation is not a big issue for you on amitriptyline.
Posted by Bob on May 8, 2010, at 21:16:00
In reply to Re: Question for Linkadge (anyone can comment though), posted by SLS on May 8, 2010, at 20:28:25
> > Hey Linkadge - What were the most troubling sides for you with regard to amitriptyline? Could you get past the sedation? -Bob
>
> I was on amitriptyline for only six weeks, but it felt disgusting the whole time. I don't know if that disgusting feeling is the sedation you are describing, though.
>
>
> - Scott
That's really saying something considering how many meds you seem to be able to tolerate pretty well.
Posted by SLS on May 8, 2010, at 21:56:59
In reply to Re: Question for Linkadge (anyone can comment though) » SLS, posted by Bob on May 8, 2010, at 21:16:00
> > > Hey Linkadge - What were the most troubling sides for you with regard to amitriptyline? Could you get past the sedation? -Bob
> >
> > I was on amitriptyline for only six weeks, but it felt disgusting the whole time. I don't know if that disgusting feeling is the sedation you are describing, though.
> >
> >
> > - Scott
>
>
> That's really saying something considering how many meds you seem to be able to tolerate pretty well.Yes. It scares me sometimes that these drugs no longer produce side effects of the same magnitude as they once did. Perhaps my brain has become just as impervious to the therapeutic effects.
- Scott
Posted by Bob on May 8, 2010, at 22:01:01
In reply to Re: Question for Linkadge (anyone can comment though), posted by SLS on May 8, 2010, at 21:56:59
> > > > Hey Linkadge - What were the most troubling sides for you with regard to amitriptyline? Could you get past the sedation? -Bob
> > >
> > > I was on amitriptyline for only six weeks, but it felt disgusting the whole time. I don't know if that disgusting feeling is the sedation you are describing, though.
> > >
> > >
> > > - Scott
> >
> >
> > That's really saying something considering how many meds you seem to be able to tolerate pretty well.
>
> Yes. It scares me sometimes that these drugs no longer produce side effects of the same magnitude as they once did. Perhaps my brain has become just as impervious to the therapeutic effects.
>
>
> - Scott
It's just as scary when the therapeutic effects dwindle over the years yet the side effects get worse, and worse and worse.Neither situation is so good obviously.
Posted by SLS on May 8, 2010, at 22:09:52
In reply to Re: Question for Linkadge (anyone can comment though) » SLS, posted by Bob on May 8, 2010, at 22:01:01
> It's just as scary when the therapeutic effects dwindle over the years yet the side effects get worse, and worse and worse.
Is this what is considered to be med sensitivity?
Yes. Very scary. It is a confounding phenomenon.
- Scott
Posted by ed_uk2010 on May 9, 2010, at 6:16:17
In reply to Re: Question for Linkadge (anyone can comment though), posted by SLS on May 8, 2010, at 20:28:25
>I was on amitriptyline for only six weeks, but it felt disgusting the whole time.
Was that a long time ago? I wonder how it would affect you now. I suspect that the side effects would be milder since you have taken various different TCAs recently for prolonged periods.
For what it's worth, I can't take amitriptyline. It makes me feel extremely tired and the anticholinergic side effects are very strong.
Posted by SLS on May 9, 2010, at 6:57:23
In reply to Re: Question for Linkadge (anyone can comment though) » SLS, posted by ed_uk2010 on May 9, 2010, at 6:16:17
> >I was on amitriptyline for only six weeks, but it felt disgusting the whole time.
>
> Was that a long time ago? I wonder how it would affect you now. I suspect that the side effects would be milder since you have taken various different TCAs recently for prolonged periods.That's a good thought (among the many that evolve from that brain of yours).
Thanks.
- Scott
Posted by ed_uk2010 on May 9, 2010, at 7:29:10
In reply to Re: Question for Linkadge (anyone can comment though) » ed_uk2010, posted by SLS on May 9, 2010, at 6:57:23
>That's a good thought..
Thanks! I was thinking that you might be more tolerant to the side effects of tricyclics which were previously not tolerated. Are there any others which were previously unpleasant?
Posted by SLS on May 9, 2010, at 10:02:26
In reply to Re: Question for Linkadge (anyone can comment though) » SLS, posted by ed_uk2010 on May 9, 2010, at 7:29:10
> >That's a good thought..
>
> Thanks! I was thinking that you might be more tolerant to the side effects of tricyclics which were previously not tolerated. Are there any others which were previously unpleasant?Protriptyline (Vivactil) was the worst. It produced the worst anticholinergic/adrenergic side effects and additionally worsened my depression. I have not tried doxepin (Sinequan).
- Scott
Posted by Roslynn on May 9, 2010, at 12:23:24
In reply to Re: Question for Linkadge (anyone can comment though) » ed_uk2010, posted by SLS on May 9, 2010, at 10:02:26
Hi Scott,
Now I am scared...my pdoc is starting me this week on protriptyline...I had asked him about clomipramine but he said it would be too sedating..he thought protriptyline would be more activating..but you said it was sedating?
Thank you,
Roslynn
>
> Protriptyline (Vivactil) was the worst. It produced the worst anticholinergic/adrenergic side effects and additionally worsened my depression. I have not tried doxepin (Sinequan).
>
>
> - Scott
Posted by Bob on May 9, 2010, at 12:34:09
In reply to Re: Question for Linkadge (anyone can comment though) » SLS, posted by Roslynn on May 9, 2010, at 12:23:24
> Hi Scott,
>
> Now I am scared...my pdoc is starting me this week on protriptyline...I had asked him about clomipramine but he said it would be too sedating..he thought protriptyline would be more activating..but you said it was sedating?
>
> Thank you,
> Roslynn
>
>Keep in mind that everyone is different. What about imipramine?
> >
> > Protriptyline (Vivactil) was the worst. It produced the worst anticholinergic/adrenergic side effects and additionally worsened my depression. I have not tried doxepin (Sinequan).
> >
> >
> > - Scott
>
>
Posted by linkadge on May 9, 2010, at 12:46:10
In reply to Re: Question for Linkadge (anyone can comment though) » linkadge, posted by Bob on May 8, 2010, at 21:12:44
The sedation can be an issue, but it has faded somewhat. Morning coffee usually counteracts this effect. It helps if I take the med earlier in the evening (i.e. 6 pm).
Linkadge
Posted by linkadge on May 9, 2010, at 12:53:30
In reply to Re: Question for Linkadge (anyone can comment though) » Roslynn, posted by Bob on May 9, 2010, at 12:34:09
I don't mind the TCA's being dirty. They kind of fill a need for me for a med that just wacks you out. WIth the SSRI's my brain is still too much "there" to forget about my problems.
With the TCA's (at least amitriptyline) I can really get a break from negative moods. Somtimes just taking 20mg and sleeping through saturday and sunday is enough to reset my brain for the next week. Sometimes it takes a few days untill I start feeling the same thought patterns coming back.
No, not something I can tollerate long term, but I fufils a need that other meds don't. Like shock therapy I guess. You wake up wondering what the hell just happened, but it works for some - relapse or not.
Doxapin was even more so this way - but very effective in its own right.
Linkadge
Posted by ed_uk2010 on May 9, 2010, at 12:59:05
In reply to Re: Question for Linkadge (anyone can comment though) » ed_uk2010, posted by SLS on May 9, 2010, at 10:02:26
>Protriptyline (Vivactil) was the worst. It produced the worst anticholinergic/adrenergic side effects and additionally worsened my depression. I have not tried doxepin (Sinequan).
I'm not convinced that doxepin is a good antidepressant. It's mainly an antihistamine. I think that amitriptyline is more effective for depression, if you can tolerate it.
Posted by Phillipa on May 9, 2010, at 13:45:05
In reply to Re: Question for Linkadge (anyone can comment though) » SLS, posted by ed_uk2010 on May 9, 2010, at 12:59:05
Vivactil that's the name of the one a doc gave me once when nursing was in dream like state for over 24 hours scarey. Phillipa
Posted by linkadge on May 9, 2010, at 14:10:34
In reply to Re: Question for Linkadge (anyone can comment though) » SLS, posted by ed_uk2010 on May 9, 2010, at 12:59:05
To play the devils advocate, some would say that surmontil is not an effective antidepressant. Although comparitively, doxapin does not have the same affinity for monoamine uptake (compared with antihistamine action), it still has affinity for 5-ht2m muscarinic receptors as well as opiate receptor interaction.
Although highly sedating, in clinical doses of 75mg (if you can tollerate it) doxapin is (IMO) an effective antidepressant. It has marked HPA normalizing and sleep improving effects. This alone, would be expected to produce intrinsic AD effect (at least with certain depressions).
Linkadge
Posted by ed_uk2010 on May 9, 2010, at 14:42:35
In reply to Re: Question for Linkadge (anyone can comment though) » ed_uk2010, posted by linkadge on May 9, 2010, at 14:10:34
Hi Link,
I imagine that doxepin and trimipramine are more effective for depression when sleep is disturbed. Do you think that's correct?
> To play the devils advocate, some would say that surmontil is not an effective antidepressant. Although comparitively, doxapin does not have the same affinity for monoamine uptake (compared with antihistamine action), it still has affinity for 5-ht2m muscarinic receptors as well as opiate receptor interaction.
>
> Although highly sedating, in clinical doses of 75mg (if you can tollerate it) doxapin is (IMO) an effective antidepressant. It has marked HPA normalizing and sleep improving effects. This alone, would be expected to produce intrinsic AD effect (at least with certain depressions).
>
> Linkadge
>
>
>
>
Posted by bulldog2 on May 9, 2010, at 18:05:21
In reply to Question for Linkadge (anyone can comment though), posted by Bob on May 8, 2010, at 17:40:51
> Hey Linkadge - What were the most troubling sides for you with regard to amitriptyline? Could you get past the sedation? -Bob
I am on low dose clomipramine 75 mg. This is the cleanest of the tcas which I have tried. I don't feel as drugged as on others. Linkadge is right about the amitriptyline. You feel like a fog is on your brain. If you can respond to low dose clomipramine I would recommend it however if you have to go up to 200 -300 mg than it probably has significant sides.
Sometimes its like a merryagoround. You get to where you feel better than you decide the sides are not worth enduring. So you stop and eventually back down and start the whole process over.
Posted by tonyz on May 19, 2010, at 11:55:22
In reply to Question for Linkadge (anyone can comment though), posted by Bob on May 8, 2010, at 17:40:51
I took amitriptyline a number of times. I didn't really notice the sedation that much and had to take it along with other sleep meds, but it is hard to say because there was a lot of anxiety with my depression.
The side effects I remember were dry mouth, constipation (miralax works best for that at least for me), orthostatic hypotension - if you've been sitting for a while you may experience some dizziness or almost a black out on standing. It does have an effect on the prostate gland and you may find a little more difficulty when you start to urinate. Increased ocular pressure is also a possibility - I thought I experienced this, but glaucoma tests were always normal. As far as memory, the anticholinergic drugs supposedly interfere with memory but depression also effects memory so I can't say for sure how memory was affected.
It did pull me out of some deep depressions. I would consider it as something to use temporarily and then switch to something else, but that is just my opinion. The side effects are manageable.
Posted by Brainbeard on May 23, 2010, at 14:50:39
In reply to Re: Question for Linkadge (anyone can comment though), posted by tonyz on May 19, 2010, at 11:55:22
I've been on and off low doses of amitriptyline for quite a while now - have been on 25mg for the last couple of months.
Based on its pharmacological profile, it should approach the perfect antidepressant to my taste. Reality, as ever, is slightly different. As soon as I go up with the dose, I wind up with a state of being in which I can see the beauty of the world surrounding me, but it's as if I can't fully partake in it, 'cause the side-effects of the drug are bothering me too much. The sedation/brain fog depresses me, the constipation makes me worry..
Currently, I'm using amitriptyline as an add-on to my sertraline (original brand name Zoloft). Biochemically, this oughta make sense. (Countering 5HT2A-over-activation. Dr. Bob, please don't move this to 'Neurotransmitters'). One advantage of combining amitriptyline with an SSRI is that you don't have to worry about constipation anymore, while the amitriptyline gets rid of SSRI induced dhiarrhoea or loose stools too.
In my experience, the brain fog and sedation were horrible in the beginning, but if I build the dose up slowly , tolerance to these side-effects develops rather quickly. I think I should give a higher dose a fair chance. If I go up with the dose too quickly, I become very irritable.
I have combined low dose amitriptyline with low dose imipramine several times and that made for a damn fine combination. The imipramine has enough noradrenergic Kaboom! to make up for amitriptyline induced sedation and brain fog. Taken together, I do suffer from dry mouth, especially in stressful situations.
I have my amitriptyline prescribed these days, and I get them as little round ocre 25mg pills. I used to buy the Indian generic produced by Lundback before, and those pills were somewhat larger and thicker, and dirty, chocolate brown.. That seemed like the perfect colour match for this drug. It's dirty, but it's good!
Posted by Conundrum on May 25, 2010, at 22:38:08
In reply to Amitriptyline... Brown, Dirty, Sweet.., posted by Brainbeard on May 23, 2010, at 14:50:39
Could you add a stimulant?
Posted by Brainbeard on May 26, 2010, at 4:18:02
In reply to Re: Amitriptyline... Brown, Dirty, Sweet.. » Brainbeard, posted by Conundrum on May 25, 2010, at 22:38:08
> Could you add a stimulant?
Well, I have used dextro-amphetamine along with amitriptyline succesfully a couple of times, although I did seem to have a little more dizziness upon standing up quickly than usual.
I also use Ritalin every now and then, with fine results.
So yes, I could, and I do.
This is the end of the thread.
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