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Low dose TCA for dysthymia started, some questions


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Hi,

I've started two weeks ago, a therapy for my dysthymia which my pdoc prescribed.

My symptoms are:

- early-morning awakening insomnia

- low energy and sleepness during the day

- loss of interest in everyday activity

- irritability

My pdoc prescribed a low dose TCA amitriptyline, started with 12.5 mg first week and gone to 25 mg second week.

I always got my dose around one hour before bedtime.

Sleep goes well, no more early morning awakening, increased vivid dream.

As a side effect, at start time and after upping the dose, I feel drowsy for all the morning, slight dry mouth. However side-effect with this dosage are quite tolerable.

I hope to feel more energetic and motivated.

However, I cannot find any study for low-dose TCA useful for dysthymia or melanchony. Does somebody has a pointer?

Some experience?

Have you tried some other med for mild depression / dystymia ?

bye

  Lord-dep

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Lord-dep -

I haven't seen any studies of TCAs in this context, but have seen a couple of things suggesting that standard treatments for Major Depressive Disorder can be ineffective in dealing with Dysthymia.  I recommend reading The Half-Empty Heart by Alan Downs, PhD., as a good, thorough look at Dysthymia, both its physical and cognitive causes and treatments.  I found it an eye-opener.

I wish I could advise you on an effective treatment, but my own dysthymia is refractive (treatment-resistant) so far.  Good luck with yours.

Cerberus

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I found a study here comparing amitriptyline to both placebo and adinazolam that did specify dosages (it's an abstract, so they don't have to). I got it from this search.

Here is a really long article that I found on this search for Pubmed articles with the words, "amitriptyline" and "dysthymia". I suggest you just hit Ctrl + F and then type in "amitriptyline," and click on "Find Next" as many times as you have to.

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I am a fan of combining Amitriptyline or Nortriptyline with Effexor or Zoloft or Lexapro. Ami & Nort tend to cover all the side effects produced by SSRI's & Low doseages of TCA's are relatively side effects free. The best time I had was 150mg of Effexor + 100mg of Amitriptyline. At the moment I am trying the SSRI's because Effexor pooped out on me somewhat & I wanted to give it a rest.

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Thanks for all the answers.

I hope my treatment is only temporary (one or two months).

Does anybody have success with temporary tratment without immediate relapse ?

Or do You think I'm going to get my meds all life long ?

And concening my lack of energy and drowsiness, do you think I have only to wait a few more days or I can combine a stimulant or some other med in the morning to get fully awake during the day ?

bye

  Lord-dep

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Guest libbie

Thanks for all the answers.

I hope my treatment is only temporary (one or two months).

Does anybody have success with temporary tratment without immediate relapse ?

Or do You think I'm going to get my meds all life long ?

And concening my lack of energy and drowsiness, do you think I have only to wait a few more days or I can combine a stimulant or some other med in the morning to get fully awake during the day ?

bye

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