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Re: clomipramine insomnia - does it ever go away? TriedEveryMedication

Posted by SLS on January 27, 2023, at 13:46:49

In reply to Re: clomipramine insomnia - does it ever go away? SLS, posted by TriedEveryMedication on January 26, 2023, at 19:34:33

Hi.

I wrote a long response to you, but it disappeared into the ether.

> Well, no - he told me it would be sedating. I've had experience with other TCAs so I thought I knew what the side effects might be (dry mouth, constipation etc). I should have known - many of the drugs that are sedating for most people don't sedate me at all. Like Mirtazapine - keeps me awake.

You have a weird brain. In actuality, all brains are weird. Your reaction to drugs that are supposed to be sedating or hypnotic keep you awake. I guess you would considerate them paradoxical reactions that are idiosyncratic to your brain specifically. However, I'm sure that, at some point in the future, your reactions to these drugs will be used to help choose effective treatments. In 1983, after becoming familiar with the medical literature that existed at that time, I came to the conclusion that I was born 50 years too early.

I am very glad that your treatment is being guided by a doctor. I hope they are receptive and take your thoughts into consideration. You might know more than your doctor about the neurobiology of depression, but he most likely knows better than you as to which treatments yield positive results based on your symptomatology and your reactions to different treatments along the way. There are a growing number of brain tissue stimulating devices. Elecro-convulsive therapy (ECT); repetitive transcranial magnetic stimulation (rTMS); magnetic seizure therapy (MST); MRI-guided TMS; vagus nerve stimulation (VNS); deep brain stimulation (DBS); Stanford accelerated intelligent neuromodulation therapy (SAINT); transcranial direct current stimulation (tDCS)...

https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies

I had written a bunch of stuff to you about hope and uncertainty. Uncertainty is your best friend. Uncertainty allows for hope. Uncertainty has kept me alive for 40 years. I could never say to myself with certainty that I would never be successfully treated. Therein lied my reason to hope. Certainty might have made suicide very easy for me. Baron Shopsin, MD was one of the doctors I saw in the 1980s. He was a giant among the first cohort of psychopharmacologists. I respected him and genuinely liked him. However he did something to me that was cruel and of no clinical value. He asked me, "If God came down and told you that you would never get well, what would you do?" In other words, he assaulted me with certainty. I was left sitting in my chair speechless and motionless. I was unable to process the hopelessness to be found in such certainty. I tried to smother the predictable thoughts from surfacing. I knew that in this hypothetical scenario, suicide was inevitable. I would most likely choose death if God were to tell me that I would live the rest of my days struggling in the painful altered state of consciousness that is depression.

This was suppose to renew your sense of hope had you lost it. I hope it doesn't have the opposite effect.

By the way, how do you react to amphetamine and methylphenidate? Perhaps you react to these stimulants as if they were calming rather than stimulating.


- Scott



Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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poster:SLS thread:1121637
URL: http://www.dr-bob.org/babble/20230117/msgs/1121663.html