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Anyone else here on Tricyclics


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I s anybody else currently taking TCAs I dont see these drug names show up here very often. This is reafirming my  thoughts  that I'm on a 25 year old drug that seems to be used more for pain relief that depression now a days. I also take 75mgs effexor down from 300mgs, which my doctor thought may have precipitated a suicide attempt. So she cut my effexor added wellburrtrin(couldnt stand it) so she out of the blue says how about amitriptyline or nortiptyline well I dont know so I says go for it. If u read my previous post I dont think this nortrptyline (I'm taking 50mgs) is really doing anything in combo with the effexor because I'm having some pretty heavey duty depression style rumanations recently. (Like cutting off one of my limbs with a saw just to get help) Should i be addament with pdoc about this and go on celexa or zoloft? Also this is kind of fucking nuts because just 2 weeks ago I got a phone call from my insuarnace company informing me I have been approved for 2 years of disability payments. You'd think I'd be happy than a pig in shit! But I feel Lost in space. My refuge is in the medicine cabinet 1-2 mgs of klonopin with a topping of seroquel.

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I s anybody else currently taking TCAs I dont see these drug names show up here very often.

<{POST_SNAPBACK}>

Desipramine (generic Norpramin), 25 mg 2/day,  backed up with 5mg "mixed

amphetamine salts"  (generic Adderall, IR) and caffeine.

The TCAs aren't prescribed as much because they can be dangerous in overdose.

MAOIs aren't prescribed as much because of potential interactions with some

foods as well as with many medications.

That's one of the problems with being actively suicidal - your doctor can't allow

you to have enough of a medication on-hand to off yourself. So if the safer

SSRIs and multiple reuptake inhibitors don't work, it's hard to justify going

full-bore with the TCAs, MAOIs, or Cymbalta (suicidal ideation is a side-effect).

One potential result - "undermedication"

Also, it's very hard to tell you what you should be asking your doctor about

without knowing how your previous meds failed.  Bipolar depression can be

sent into hypomania by an SSRI while some of the "treatment-resistant"

depressions are worsened. Wellbutrin can leave one person cranky, irritable,

and strung-out and another narcoleptic.  Both extremes are covered equally

well by "it didn't work" or "I couldn't handle it"...  It's why we frequently tell

people to write down what problems they are having before seeing their

doctor, so that s/he has a chance to know what is really going on.

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Yep, and as far as I can tell I'm the only person in a small city of 55,000 people who is taking Vivactil (protriptyline).  I say this because when I was in the hospital briefly for minor surgery they had to run to my drug store to get some!  And most regular docs have never heard of it.

I use 20 mg of it along with Wellbutrin and Topomax; the Topomax is an off-label usage as it's really an anti-seizure med.  The Vivactil unfortunately works o.k.  I say unfortunately because it makes my mouth dry and gives me constipation.  When I was prescribed it I was keeping a simple check-mark mood chart with the date and ratings of one to ten, one being suicidal and ten feeling great.  I took it for about two months and my mood picked up, asked to go off it because of side effects, and you could see my mood go right back down, so I went back on it again, and there was the evidence again in the mood chart that it worked, as much as I hated to admit it.

I have atypical depression which means I sleep and eat too much and so need meds that will get me going - there's no chance of triggering mania or making me hyper.  The SSRIs all turn me into a zombie, but Wellbutrin is my special friend, and Vivactil is an activating as opposed to sedating tricyclic which is why the pdoc chose it for me.  No one is sure at this point how much effect the Topomax is having, but I'm not stable enough that anyone wants to pull it and see what happens, either.

Don't ask me to quote my sources, but the tricyclics have been shown to have just as much effect on allieviating the symptoms of depression as the SSRIs and SSNIs have, but they have lots more side effects, and as nullOtrooper pointed out, it's lots easier to take an overdose.  Those are the main reasons Prozac et al became so popular.

If the tricyclics work for you and the side effects aren't overwhelming, there's nothing wrong with them, and being an older drug doesn't make them worse than the newer ones in terms of effectiveness.  The trouble is always figuring out which mix is right for you, and finding a pdoc that knows how to do that.  Good luck to you. 

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I've taken amitrityline, nortriptyline, desipramine, and one other I can't think of right now.

Aside from desipramine, which I used mainly to help me sleep, I've used the others as anti-depressants. I've never used only a TCA, but I took nortriptyline for a long time as we tried and failed several other drug trials. Nortriptyline also helped with the horrific-wake-up-screaming nightmares I used to have regularly.

It's not a bad idea to have your blood levels on nortriptyline checked once in a while. I was taking a moderate dose by the PDR, but we checked it along with a bunch of other tests and found that I was nearly twice the official maximum. This explained nicely my un-characteristic hostility and abrasiveness -- one of the side effects of exceeding the dose is "troublesome patient hostility." We reduce the nortriptyline and that effect went away. Eventually we gave up on it in favor of trying some other things more aggressively.

Fiona

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Don't ask me to quote my sources, but the tricyclics have been shown to have just as much effect on allieviating the symptoms of depression as the SSRIs and SSNIs have, but they have lots more side effects, and as nullOtrooper pointed out, it's lots easier to take an overdose.
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