[null0trooper]

Lee, on Jun 17 2005, 10:10 AM, said:

sorry correct spelling is Norpramine.................and why would they give this for ADD if it is an anti-depressant???

A number of adult ADDers are also clinically depressed, which is one of the reasons wellbutrin is
a popular prescription. So there's the idea of killing two birds with one stone.

In this case, desipramine and imipramine are known for increasing dopamine and noradrenaline
(while monkeying with other things) which is good for ADD. So you have an alternate to stimulants
and bupropion that *might* not jack up the folks with anxiety issues as badly, nor kill the appetite
of someone who can't afford to lose more weight, nor feed a known addiction. There's also
that little seizure potential with bupropion, not that TCAs are completely without that risk either.

The trouble is that they are dangerous in overdose and, as they aren't as specific in the systems
affected as the SSRIs, they have a reputation for a broad variety of side effects.

[Velvet Elvis]

Just to be nit-picky, it doesn't touch DA, just NA.

Common side effects are the same as SSRI's plus drymouth and urinary retention.

If this is the first med you've ever taken for ADD, find a new doc as your current one is insane.  You'll get a comperable effect with fewer side effects from Strattera or Ednorax (Ednorax is not available in the US.)  If you're dirt poor, adderal, dexidrine and ritaline are all available as generics.

The norepenephric TCAs are really where you go when you've tried everything else and it hasn't worked or you couldn't tolerate it.  I've been trying shit for ADD for ten years without finding anything that works as well as it should and I haven't even gotten to the TCAs yet. 

From the crazymeds TCA page:

Quote

Norpramin (desipramine hydrochloride). Freakiest side effects: enlargement of breasts for both men and women, "disturbance of accommodation." The usual adult dose is 100 to 200 mg per day. In more severely ill patients, dosage may be further increased gradually to 300 mg/day if necessary. Dosages above 300 mg/day are not recommended. Initial therapy may be administered in divided doses or a single daily dose. Maintenance therapy may be given once a day. Plasma level variations and half-life varied too wildly to pin down a half-life. Hoechst Marion Roussell.

Expect all of the side effects you'd get from an SSRI and an SNRI - nausea, headache, dry mouth, dizziness, blurry vision, constipation, sedation, weight gain - just worse And for longer.  Plus SSRI discontinuation syndrome, although that's usually not as bad as these meds don't work on serotonin as strongly as the newer meds. They all tend to mess with your hormones, your heart and make you photosensitive.  Whatever you do, don't drink if you take a TCA.  You'll end up like one of your favorite rock stars, as the TCAs really potentiate the booze, so you get suddenly and unexpectedly drunker.  Sometimes to the point of alcohol poisoning.

[null0trooper]

Velvet Elvis, on Jun 18 2005, 03:54 PM, said:

Just to be nit-picky, it doesn't touch DA, just NA.

Rechecking what I'd looked at online ...

Sorry, I was mixing in what are suspected to be adaptive changes in dopamine receptor sensitivity.
Definitely a "don't even bother checking your calendar"-level effect.  They might still make sense as a
first-line if Lee were an anorexic recovering crank addict with AD(H)D and no other conditions
(There has to be at least ONE out there)

This post has been edited by null0trooper: 19 June 2005 - 05:53 AM

[MeDiCaTioN TiMe]

Desipramine is much like Strattera or Edronax, they are NRI's. The side effects of TCA's are largely exagerated, they aren't any worse than the SSRI's, just different. Desipramine is a good one to try for ADD, the other one you want to try if sleep or anxiety is a problem is Nortriptyline. Both have a half life about around 36 hours which smoothes out the ups & downs. Both are Alpha-1 NE antagonists which helps to counter the blood pressure boost that cleaner NRI's deliver, but can cause orthostatic hypotension. Possible urinary retention & increased heart rate are NRI side effects common to the old TCA's & the newer NRI's like Strattera.

[minteresting]

going with the nitpicking theme:  the actual spelling is norpramin (no 'e' at the end).

if you're prone to stomach upset, i'd surely never say the side-effects aren't worse.  by day 3, norpramin was chewing up my stomach so much, i HAD to discontinue.  (btw, i'm a real trooper/ no weanie & usually get thru this).  also too stimulating for me & i can manage most stimulating ads (other than wellbutrin and parnate.)  (i realize for add/ adhd dx a paradoxical effect happens, so likely not a worry for those here.)

pamelor (nortrip.) IS smoother, w/a neatO combo of stimulating and relaxing effects.  i really liked it!  BUT if you have reflux/ GERD like me - no way will you be able to tolerate for long....if at all.  so, just a couple heads up/s. also, both are quite constipating, altho less so than any of the other TCAs.

another TCA, vivactil *may* be another option, but side-effects are simply too harsh for many.

[herpie]

Velvet Elvis, on Jun 18 2005, 09:54 PM, said:

If this is the first med you've ever taken for ADD, find a new doc as your current one is insane.  You'll get a comperable effect with fewer side effects from Strattera or Ednorax (Ednorax is not available in the US.)

Wasn't that Edronax? (reboxetine)

I think writing the doc off as insane is a bit unjust. Desipramine has somewhat low side-effect profile comparing to the most TCAs. It's deadly in overdose, but as long as you're not suicidal and not taking meds like fluoxetine, the chance of harming yourself is rather low. However, it works for some, but not other, types of ADHD. In particular, it works for my anxiety-related GI problems, but not for core ADHD symptoms! However, it worked like charm for other people.

I believe it's equally effective as Strattera, yet it's cheaper.

Quote

Plus SSRI discontinuation syndrome, although that's usually not as bad as these meds don't work on serotonin as strongly as the newer meds.

That, I believe, is not true. The serotonin effect of desipramine is negligible. If it wasn't for mild antimuscarinic action, I would call desipramine an NARI.

This post has been edited by herpie: 25 June 2005 - 03:22 AM

[Bryan]

In Driven to Distraction, a book by Peter Russell et. al. about AD/HD, he mentions that Penny, a schoolgirl with blond pigtails with the inattentive type of ADHD who daydreams frequently, was put on Norpramin.  Apparently, her concentration improved on a low dosage, and the only side effect was a dry mouth, for which she was allowed beverages in class to compensate.