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Re: help me find the right medication!

Posted by ed_uk on March 6, 2005, at 12:39:53

In reply to Re: help me find the right medication!, posted by ronser2000 on March 6, 2005, at 12:20:10

Hi,

I think you would like desipramine for your depression, it is generally easier to tolerate than imipramine. It might not be adequate for your anxiety though.

>blurred vision dizziness dry mouth, daytime fatigue, trouble concentrating, spaced out at times.

These side effects are milder with desipramine compared to imipramine. Imipramine is probably more effective for anxiety though.

>paroxetine-highest dose 50mg a day
fluoxetine-80mg a day but best response at 20mg a day but still side effects

Did paroxetine work at a low dose eg. 10-20mg/day? Did you stay on the low dose for 2-3 months before increasing, to see if the low dose was adequate. People often have a lot more side effects at high doses. Higher doses aren't generally much more effective, unless you have obsessive-compulsive disorder in which case high doses are usually needed.

Since you did best on the lowest dose of fluoxetine, did you ever try a lower dose eg. 5-10mg/day? Why did you increase the dose if you were doing well at 20mg?

In one clinical trial of 5mg fluoxetine in depression, 5mg was effective. In fact, there was a trend towards patients given 5mg doing slightly better than those given 20mg. After 6 weeks, patients given 5mg did just as well as patients treated with 40mg!

Ed.


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