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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by anita on May 3, 2000, at 23:13:53
Hiya,
For those of you who have tried low-dose Vivactil (protriptyline), what were the side effects, other than increased energy? I'm concerned mainly about dry mouth and extreme anxiety. I'd be adding it to Zoloft, which helps with anxiety and suicidal ideation, but leaves me sedated and apathetic.
thank you,
anita
Posted by JohnL on May 4, 2000, at 3:16:33
In reply to Low-dose Vivactil side effects?, posted by anita on May 3, 2000, at 23:13:53
> Hiya,
>
> For those of you who have tried low-dose Vivactil (protriptyline), what were the side effects, other than increased energy? I'm concerned mainly about dry mouth and extreme anxiety. I'd be adding it to Zoloft, which helps with anxiety and suicidal ideation, but leaves me sedated and apathetic.
>
> thank you,
> anitaAnita,
It sounds to me like you already have a pretty good handle on what to expect. Dry mouth, mild constipation, and temporary initial anxiety are reasonable expectations I think. I experienced all of those on Vivactil myself. I kind of liked it after a couple weeks, but it made my tinnitus so loud I couldn't endure. I also had added it to Zoloft.One thing to keep in mind is that the Zoloft will interfere with the metabolism of Vivactil a little bit. What that means is that your low dose may actually be higher than you would think. The plasma level of Vivactil in your system will be increased somewhat in the presence of Zoloft. Not a lot, but some. A more drastic increase would be encountered if you were taking Prozac for example instead of Zoloft. So if side effects at first seem overly bothersome in any way, I wouldn't hesitate in getting the doctor's approval to start with an even lower dose than was first discussed.
On the bright side, a drug monograph on Vivactil I read says, "Suitable for the apathetic withdrawn depressed patient." Cool. I haven't seen that statement made in any other monographs of any other antidepressants.
JohnL
Posted by AndrewB on May 4, 2000, at 9:27:09
In reply to Low-dose Vivactil side effects?, posted by anita on May 3, 2000, at 23:13:53
Hi again Anita,
I was very interested in hearing about the side effects you had on amisulpride. I'd love to know more. By telling of your experinece, others taking amisulpride can better know what they are getting into. I hope you don't mind these questions. Are you still taking amisulpride? How does it help you. What is your diagnosis. Are there any other side effects? Where did you end up ordering it from.
Most importantly, if you are still interested, I have recently read about a straight forward way to take away your side effects.Best wishes,
AndrewB
Posted by anita on May 5, 2000, at 13:44:57
In reply to Amisulpride, posted by AndrewB on May 4, 2000, at 9:27:09
Thanks, John, for your input. I had terrible dry mouth on nortriptyline, and don't particularly want to deal with that again, but maybe at a really low dose, as you suggest, it won't be a problem.
Andrew, I think I've talked about my experience with amisulpride before, but I'll reiterate it, and maybe one of us can make a general post all about amisulpride from the input of everybody who has taken it so it will be helpful to others...
I took amisulpride for atypical depression, 12.5 or 25mg a day, for several weeks. Essentially it felt like Ritalin: increased energy, desire to get out of the house and do things and see friends, a brightening of mood, more regular sleep. It also increased my appetite and caused a suprising amount of weight gain in only a few weeks (10 lbs.), not entirely due to eating more.
I also got my period very late one month. It wasn't as anxiety-provoking as other stimulant meds I've tried. I took it with 100mg Lamictal. I did like it, but eventually it made me very irritable, as do all dopaminergic meds do for me for some reason, so I stopped taking it. I ordered it from a Swiss company I think, one that you had recommended to me.I am interested in how to alleviate the side effects -- anything about irritability?
ciao,
anita
> Hi again Anita,
>
> I was very interested in hearing about the side effects you had on amisulpride. I'd love to know more. By telling of your experinece, others taking amisulpride can better know what they are getting into. I hope you don't mind these questions. Are you still taking amisulpride? How does it help you. What is your diagnosis. Are there any other side effects? Where did you end up ordering it from.
> Most importantly, if you are still interested, I have recently read about a straight forward way to take away your side effects.
>
> Best wishes,
>
> AndrewB
Posted by AndrewB on May 5, 2000, at 17:23:26
In reply to Re: Amisulpride + Vivactal, posted by anita on May 5, 2000, at 13:44:57
Anita,
I’m sorry. I forgot what you had told me before about your amisulpride experience.
I agree with you that it would be a good idea to write a post summing up peoples' experiences with amisulpride. The problem is that feedback is real limited so far. I am filing peoples' responses and hopefully there will be enough feedback in a couple of months to write such a post.
The side effects of weight gain and altered menses can be eliminated by restoring normal prolactin levels. This can be accomplished by taking bromocriptine or Mirapex (pramipexole).
The irritability I don't think would be effected by changing the prolactin levels. That has something to do with over stimulation or excessive dopamine levels wouldn't you think? It is interesting that you got this effect with such a low dose. I've got a couple of suggestions as to how to avoid the irritability but they are really just shots in the dark.
One would be to pulse dose the amisulpride in order to give your body a break. Maybe one day on and one off or 5 on and 2 off.You also may want to try Mirapex. It is different from other dopaminergic medicines. For example, it has much greater affinity for the D3 receptor than amisulpride and, conversely, a smaller affinity for the D2 receptor than amisulpride. It has been speculated that it may be most effective for atypical depression and supposedly it is going to be studied for use with bipolars. There seems to be a continuing interest in it for use as an Antidepressant, alone or as an adjunct. The latest study on it just came out last month. But I've never tried it by itself and have heard only one other persons experience with it so I can’t really say too much about it. I'm going to try it by itself, that is, without amisulpride, in this upcoming week to see how strong its AD effect is. Anyway, I know you are looking for the right dopaminergic, maybe Mirapex is it.
Best wishes,
Andrew
Posted by Darby on May 5, 2000, at 22:29:08
In reply to Re: Amisulpride, Irritability, posted by AndrewB on May 5, 2000, at 17:23:26
Andrew:
You mentioned a new study on Mirapex/pramipexole that just came out. Can you tell me where it's published? What was the outcome of the study?
Thanks,
Darby
Posted by AndrewB on May 6, 2000, at 7:46:29
In reply to Andrew--What New Study?, posted by Darby on May 5, 2000, at 22:29:08
Darby,
The latest study about pramipexole and depression is entitled, "Pramipexole augmentation of a selective serotonin reuptake inhibitor in the treatment of depression." It is published in the Journal of Clinical Psychophamocology, April 2000. There is no citation yet for it in Medscape so I can't tell you the conclusions of the study.
AndrewB
This is the end of the thread.
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