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Thinking of a Tricyclic Looking for suggestions Rate Topic: -----

#1 User is offline   Cuttlefish 

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Posted 13 August 2009 - 04:13 AM

I've been going up and down while on Wellbutrin, so if a dosage increase doesn't help, I'm trying a new class of antidepressants-the Tricyclics!

(I've exhausted the SSRI's, and other antidepressants like Effexor and Cymbalta at this point)

So I'm looking for suggestions on the first tricyclic I will suggest to my pdoc should the Wellbutrin increase not help. I'm looking for one that has relatively few side effects compared to the rest of the tricyclics, and I'd like to suggest a good antidepressant on the first try!

Those who have been on these older antidepressants, and have experiences to share, I would greatly appreciate your input. And others who have more knowledge of them would also be appreciated too.

Edit: Oh yeah, there is the old adage that medication affects different people differently. I still am interested in other peoples' experiences however.

This post has been edited by Cuttlefish: 13 August 2009 - 04:51 AM


#2 User is offline   DarkendHour 

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Posted 13 August 2009 - 04:36 AM

Wish I could help but my three antidepressants are all listed as "other" :blink:

And your already on the Wellbutrin anyway.

Hope you find one that works well for ya.
Current: Schizoaffective Bipolar Type, PTSD
Past history: SI, ED, Schizotypal PD, Major Depression, PD NOS, Anxiety NOS
Meds: none again... Still trying to figure out how to get coverage for meds

#3 User is online   bluelikejazz 

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Posted 13 August 2009 - 05:06 AM

I didn't respond to lexapro, cymbalta or mirtazapine (remeron) but Amitryptaline seems to be lifting me from a black suicidal depression to just feeling a bit sad. The dry mouth/eyes is a bit annoying (i'm on 175mgs) but it's worth it. Take some extra fibre or things can get blocked really fast.

I sleep pretty much through the night, and it's helping with pain too.

One of the reasons your pdoc might not agree is that it's quite dangerous if you overdose on it. If you've been suicidal you might need somebody to hang onto your meds for you.
PMDD is currently the most bothersome dx. Also PTSD and MDD.


rx: Amitriptyline 175mg, Celebrex, Nexium.
alternative rx: chasteberry, b6, magnesium, vitamin D, fish oil.

#4 User is offline   Rabbit37 

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Posted 13 August 2009 - 05:10 AM

Years ago I was prescribed desipramine. It worked well, but turned me into a raging insomniac. This was before I was dx'd BP, so that might have had something to do with it.
dx - BP, OCD and BPD, oh yeah, and some GAD as well
rx - abilify, tegretol, vistaril and vitamins

#5 User is online   karuna 

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Posted 13 August 2009 - 11:43 AM

I'm on Lofepramine. Have been for years, it works well for me.
Life shrinks or expands in proportion to ones courage : Anais Nin

'The attainment of wholeness requires one to stake one's whole being. Nothing less will do; there can be no easier conditions, no substitutes, no compromises': Jung

DX: borderline personality disorder/bipolar/psychosis/trauma history
RX: Lithium and Risperidone

#6 User is offline   sorrel 

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Posted 13 August 2009 - 11:55 AM

Some tricyclics are more sedating than others, so which you might wantdepends on if you want something to help with sleep, or if you don'twant to feel sedated.
Dx: bipolar I
Rx: lithium 1800mg, propanolol 40mg (for tremors)



#7 User is offline   sylvan 

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Posted 13 August 2009 - 10:26 PM

I'm a huge fan of amitriptyline. In can be rather sedating, especially in the beginning. I don't know what else to say about it. It is my wonder drug. It can pull me out of the depths of depression in a matter of days.

sylvan


Sometimes, you just have to put on your big girl panties and deal with it.

#8 User is offline   Mayteana 

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Posted 14 August 2009 - 07:47 AM

I have absolutely nothing useful to add to this discussion.

So instead I'm going to say how glad I am to see you ready to try something new to get better.

You've come a long way, sir.

~ May
One only needs two tools in life: WD-40 to make things go, and duct tape to make them stop.___________________
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When life itself seems lunatic, who knows where madness lies? Perhaps to be too practical is madness. To surrender dreams - this may be madness. To seek treasure where there is only trash. Too much sanity may be madness. And maddest of all, to see life as it is and not as it should be.-Don Quioxite, The Man of La Mancha

#9 User is offline   Cuttlefish 

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Posted 14 August 2009 - 08:27 AM

View PostMayteana, on 14 August 2009 - 07:47 AM, said:

I have absolutely nothing useful to add to this discussion.

So instead I'm going to say how glad I am to see you ready to try something new to get better.

You've come a long way, sir.

~ May


Thanks May :wub:. And thank you all for your suggestions. Lots to consider! My goal is to have only fair-moderate to sedation (I don't want too much, but then again I already sleep 10+ hours a day sometimes, so moderate is just fine, but I've read that most of the sedation wears off the longer you take a tricyclic), and hopefully a dirth of whatever other side effects tricyclics cause.

I've got two votes for Amitriptyline!

#10 User is offline   Tom 

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Posted 20 August 2009 - 12:44 PM

I'm on doxepin. Seems to help somewhat with the depression but not so much with anxiety. It works better than imipramine, which I also tried. Be ready to be knocked out for few weeks on doxepin though. It has a really strong anti histamine effect. I'm on 200mgs.

-Tom :ninja:
dx: anxiety and depression
current meds: Invega 3mg, Clonazepam 6mg, Inderal 40mg, Lamictal 100mg
previous meds: Paxil (did nothing except i wasn't able to achieve the big O), Zyban, Effexor, Celexa, Remeron, Xanax, Ativan, Neurontin, Zoloft (useless), Wellbutrin XL (a joke), Buspar (made me suicidal), Moclobemide (made anxiety worse), Nardil (crapshot. Didn't do anything good and made me faint from low BP), Zyprexa, Seroquel (nope, no sedation), Atenolol (didn't stop the shakes), Imipramine, Doxepin, Risperdal


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#11 User is offline   Alpam 

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Posted 22 August 2009 - 02:06 AM

The only TCA that I have been on is Dothiepin (Dosulepin) which I found to be one of the more effective meds I have taken. It was good for Depression anxiety and insomnia due to its sedating effects. I took it before bed time in a single dose so I wasn't sedated during the day. It is a old drug and I believe one of the most dangerous in overdoses.

My chemist the other day stated that they only really see Dothiepin and Doxepin used in depression these days, the others are more prescribed for pain (but that was just what this chemist saw).

Good luck in your search.
dx: Depends on who you talk to, either "Severe anxiety problems" or "a personality disorder" with both causing major depression, insomnia, poor concentration, anxiety.
Current meds:
Nortriptyline 100mg , Dexamphetamine 50mg, Seroquel 450mg, Inderal 120mg, Sodium Valproate 400mg, Amisulpride 800mg.
Previous meds: Zoloft 200mg, Mirtazapine(shudder) 60mg, Cymbalta 120mg, Dothiepin 300mg
, Reboxetine 4mg, Citalopram 60mg, Zyprexa 15mg, Temazepam, Diazepam 20mg, Xanax 6mg, Clonazepam 6mg, Benztropine 2mg, Modafinil.

#12 User is offline   felnx 

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Posted 22 August 2009 - 04:16 PM

View PostTom, on 20 August 2009 - 12:44 PM, said:

I'm on doxepin. Seems to help somewhat with the depression but not so much with anxiety. It works better than imipramine, which I also tried. Be ready to be knocked out for few weeks on doxepin though. It has a really strong anti histamine effect. I'm on 200mgs.

-Tom Posted Image


I concur with the doxepin. It's my pdocs favourite TCA. It's starting to make a comeback in low dose for sleep and depression.



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Posted 10 January 2010 - 07:08 PM

I am on Imipramine for GAD/Depression. 125mg's per day taken in one dose when going to bed. Has worked well, lifted my mood, helped my sleeping enormously and siginificantly reduced my panic/anxiety (I still get anxious and I constantly worry but this drug seems to stop the transition of this into 'Panic').

Only problems personal to me alone) is bad cotton mouth for the first 4-6 months, constant craving for sweet/junk food, weight gain (not severe around 1 stone MAX)and for the first 6 months used to get a strange pain around prostate region after ejaculating. This has gone now. I will soon be tapering off and I am a little worried about this but I would recommend this drug to people with similar probs to be who want to (quite understandably) stay away from SSRI's and SNRI's.

#14 User is offline   GoldCoin 

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Posted 12 January 2010 - 08:53 AM

Nortriptyline (allegron) was the tryciclic prescribed to me.
It is not sedating at all, it used to be very early on but that stopped quickly.

I have had no weight gain and no other side effects.
I think it is working really well at keeping my depression at bay after ECT.
Past Diagnosis - Cluster A or B personality traits, Border Line Personality Disorder, Major Depressive Disorder, Cyclothymia, Psychosis NOS, Bi Polar.
Current Diagnosis - Schizoaffective Disorder

Past Medication- Lexepro, Effexor, Prozac, Diazepam, Mogodon, Temazepam, Sodium Valporate, Zyprexa, Ativan, Edronax, Lithium carbonate, clonazepam, imovane, lamictal, Zeldox, Seroquel, Thorazine
Current Medication - lamictal (100mg) Nortriptyline (150mg), clozapine (300mg).

#15 User is offline   Catnapper 

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Posted 15 January 2010 - 02:06 PM

I took Vivactil (protriptyline)for a year or two - it's been four or five years ago so I don't really remember the dosing details. It did work to pull me out of a nearly deadly depression, even though the side effects sucked (constipation and dry mouth). I tried to stop a month or so after I started (aided by the pdoc), but I was mood charting and it was clear my mood went back down. Then when I restarted it, the mood chart proved my mood was improving. So it definitely worked for me, and I got used to modifying my diet and fluid intake to compensate.

I'm not your doc and don't know your history, but if you've had more than a few episodes of major depression, you may want to talk to your pdoc about a mood stabilizer. I started on Lamictal about a year ago and feel better than I have in a long time. I've had five episodes of depression in my lifetime (some lasting over a year) and the pdoc has changed my diagnosis to BP II, even though I've never had a DSM-IV defined hypomania. I don't really care what it's called, but the mood stabilizer is the best drug for me so far. Good luck.
New Improved Diagnosis: Probably BP II (instead of MDD recurrent), or as the pdoc said, "There's clearly some sort of cycle going on." The more I think about it, the more I think he's right. I've started a mood stabilizer and feel better, so I have my fingers crossed I'll stay far away from the abyss.

RX: Generic versions of Lamictal 200 mg, Wellbutrin SR 300 mg, Ambien 10 mg, Gabapentin 900 mg (for hot flashes), lots of vitamins and fish oil tablets.

RX Graveyard: Prozac, Topomax, Zoloft, Vivactil, Adderall, Provigil

DX: Previously DXed with Major Depressive Disorder, Recurrent, Without Psychotic Symptoms; still enjoying Dysthymia and Binge Eating Disorder

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