Posted by yxibow on February 5, 2007, at 1:48:43
In reply to 20 years of imipramine, posted by wmd40 on February 4, 2007, at 21:13:06
>
> Hello Pyscho-Babblers,
>
> I've been told that this might be a good place to
> sing the blues about a life spent waiting to die,
> with the occasional tired and half-hearted attempt
> to hurry the process up.Life is for living -- its random, unpredictable, and yet amazing that all of our genetic parts manage to work together in any fashion whatsoever if you look at the human body as a system.
So, first of all -- and I know its easier said than done, with MDD, but this is also a place to find solace, and people who are passionate, and to not give up.
One may have their own religious views, but as an agnostic personally, at least on my good days, I can't just think of "getting through life". Sure, there are the bad spots, but finding anything that can possibly spark a positive view is a fantastic contrast to that idea.
>
> I've been taking imipramine (currently 300 mg per
> day) for about 20 years; I started just before the
> rage for Prozac got under way. I've had all the
> usual side effects: dry mouth, sedation,
> orthostatic hypotension, urinary hesitancy and
> the constant brain fog.TCAs aren't completely out of fashion, they're tried and true medicine.
> Because the side effects are so bad, I've tried
> many other drugs -- Prozac, Luvox, clomipramine,
> Remeron, Wellbutrin, Effexor, Zoloft, desipramine,
> moclobemide, Paxil, Cognitive Behavioural
> Therapy (the worst of the bunch), and lithium
> as an adjunct -- but nothing works as well as
> good old fashioned imipramine.
>
> I desperately miss what I think I remember as a
> happy unmedicated life before the onset of
> depression, but every time I've tried to wean
> myself off drugs, I've plunged into a miserable
> state, so I've pretty much given up on that.
I also miss the days before my current disorder which has eaten up 5 years of my life and especially the days of college when fairly substantial dysthymia and long distance calls were the worst things.
> I'm now beginning to wonder -- perhaps a bit late
> -- what the long term effects of life on
> imipramine might be. A web search suggests that
> I can expect to turn a purplish blue colour some
> time, but I can't find any other information.
> Does anybody out there know? I suppose that as
> a 20-year veteran, I probably know about as much
> as anybody else what to expect, but I'm hoping
> somebody else might know better.
If you've lived through 20 years of it, you are probably right that you know the effects of imipramine. I'm not sure about purplish blue colours but the only minor caveat about TCAs is that they have a small risk of Tardive Dyskinesia, lower than most neuroleptics, but higher than SSRIs. However I would definately say that 20 years is fairly tardive for any major effect like that to happen.
You may have found your best remedy but I wouldn't give up on the search for newer ones. There are also some AEDs that I see you haven't tried as augmentation, although generally the most common ones like Depakote probably have their greatest effect on BP.
I can't say I like the effects of Seroquel, which has some of the side effects of what you mentioned, but it along with other medications, I'm not sure the alternative is a good road to go down considering MDD.
Imipramine (which is actually desipramine in the body) has had 50+ years of use and probably couldn't count the patient-years that would add up to in generics as well. In general, though its not an exact science, we know that aggregate patient-years are a predictor of future predictions. So the thousands of patient-years essentially exceed a human lifetime. Its not as forgiving as an SSRI in overdose (please dont), but besides the previous mentioned possibility, sometimes the old ones are the good ones.-- tidings
poster:yxibow
thread:729805
URL: http://www.dr-bob.org/babble/20070201/msgs/729854.html