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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 shelby on January 23, 2001, at 21:40:09
I am going to my psych. doctor on Monday and wanted to post this question in the hopes I will get some answers - hopefully.
My question is - is there another tricyclic that is similar to elavil in no problems with sleeping but that gets my away from the carbohydrate cravings. As I go up in dose (winter time) so too, do my cravings.
I have been on anti-depressents for 10 years approx. I started out and am currently on elavil. Over the years, I have tried to get off meds but crash within a week. I have also tried the SSRI's (Effexor, Paxil, Prozac, Serzone, Desyrel, Zoloft, Wellbutrin) with no great results (insomnia, agitation, aggressiveness, felt like a wall was around me). I have started at low doses and slowly working my way up. I have also given these drugs a good amount of time (6-8 weeks give or take a week). I have also tried St. John's Wort and trytophin. They did not work for depression either.
It seems like the older tricyclics work for me due to their "dirty blanket" abilities (not just targeting seretonin, norepinephrine or dopamine).
I have tried doxepin (even worse carbo cravings!), trimipramine, ludiomil (really scary side effect - felt like I was going to have a seizure). These three were taken along with elavil so the side effect profile would be exacerbated (sp?). I have also tried imipramine by itself years ago but had night sweats, bad dreams and insomnia.
I need a calming anti-depressent. Is there such a one that is similar to elavil? Sorry for the long post. I have read the archives also trying to find info that would pertain to me.
Thanks
Posted by SLS on January 23, 2001, at 22:00:25
In reply to Am near the end of my rope!, posted by shelby on January 23, 2001, at 21:40:09
> I am going to my psych. doctor on Monday and wanted to post this question in the hopes I will get some answers - hopefully.
>
> My question is - is there another tricyclic that is similar to elavil in no problems with sleeping but that gets my away from the carbohydrate cravings. As I go up in dose (winter time) so too, do my cravings.
>
> I have been on anti-depressents for 10 years approx. I started out and am currently on elavil. Over the years, I have tried to get off meds but crash within a week. I have also tried the SSRI's (Effexor, Paxil, Prozac, Serzone, Desyrel, Zoloft, Wellbutrin) with no great results (insomnia, agitation, aggressiveness, felt like a wall was around me). I have started at low doses and slowly working my way up. I have also given these drugs a good amount of time (6-8 weeks give or take a week). I have also tried St. John's Wort and trytophin. They did not work for depression either.
>
> It seems like the older tricyclics work for me due to their "dirty blanket" abilities (not just targeting seretonin, norepinephrine or dopamine).
>
> I have tried doxepin (even worse carbo cravings!), trimipramine, ludiomil (really scary side effect - felt like I was going to have a seizure). These three were taken along with elavil so the side effect profile would be exacerbated (sp?). I have also tried imipramine by itself years ago but had night sweats, bad dreams and insomnia.
>
> I need a calming anti-depressent. Is there such a one that is similar to elavil? Sorry for the long post. I have read the archives also trying to find info that would pertain to me.
>
> ThanksDear Shelby,
If you want to stick with tricyclics, you can try either desipramine or nortriptyline. Nortriptyline is the daughter molecule of Elavil, but has less of the H1 receptor effects known to produce increased appetite and weight gain. In my experience, desipramine actually helps reduce my appetite. Both of these drugs seem to fit the bill. If one does not work as well as you like, you can switch over to the other one. There seems to be a trend for people to respond better to one and not the other and vise versa. I am not sure if there is any merit to this idea, but if imipramine worked better than Elavil, try desipramine first. Desipramine is the daughter drug of imipramine. If the Elavil worked better than the imipramine, try the nortriptyline first. Again, I have no statistical information to support this notion.
Either of these drugs should have a calming effect if you are responding well to them as antidepressants. They are not as sedating, but can be calming as your depression remits and the anxiety along with it. You might feel a bit stimulated early on, perhaps with a temporary increase in anxiety, but it may be worth riding out this brief phase early in treatment.
Good luck. Tell me what you come up with.
- Scott
Posted by SalArmy4me on January 23, 2001, at 22:23:52
In reply to Am near the end of my rope!, posted by shelby on January 23, 2001, at 21:40:09
How about mirtazapine, a tetracyclic?
I started Remeron at 60 mg right away and had no side-effects. Here are the benefits of Remeron: --It can be used for all types of depression, anxiety, OCD, and insomnia. --It is convienient because it is taken only once at bedtime. --It may improve libido and sexual performance (its the only medication that improves mine). Dr. Bob Hsieung's fellow doctors recommend it for sexual dysfunction. --It has none of the anticholinergic effects of SSRIs. --It has gained recognition from psychiatrists in only four years of FDA approval. See the Organon website for further information.
Posted by ChrisK on January 24, 2001, at 5:58:32
In reply to Am near the end of my rope!, posted by shelby on January 23, 2001, at 21:40:09
My father was taking Elavil for most of his life and I found that when SSRI's never helped me that I also reacted to TCA's. My pdoc talked me into Nortriptyline and I really haven't had any problems with it.
If I have problems with carb cravings I think it comes from the Zyprexa I take.
> I am going to my psych. doctor on Monday and wanted to post this question in the hopes I will get some answers - hopefully.
>
> My question is - is there another tricyclic that is similar to elavil in no problems with sleeping but that gets my away from the carbohydrate cravings. As I go up in dose (winter time) so too, do my cravings.
>
> I have been on anti-depressents for 10 years approx. I started out and am currently on elavil. Over the years, I have tried to get off meds but crash within a week. I have also tried the SSRI's (Effexor, Paxil, Prozac, Serzone, Desyrel, Zoloft, Wellbutrin) with no great results (insomnia, agitation, aggressiveness, felt like a wall was around me). I have started at low doses and slowly working my way up. I have also given these drugs a good amount of time (6-8 weeks give or take a week). I have also tried St. John's Wort and trytophin. They did not work for depression either.
>
> It seems like the older tricyclics work for me due to their "dirty blanket" abilities (not just targeting seretonin, norepinephrine or dopamine).
>
> I have tried doxepin (even worse carbo cravings!), trimipramine, ludiomil (really scary side effect - felt like I was going to have a seizure). These three were taken along with elavil so the side effect profile would be exacerbated (sp?). I have also tried imipramine by itself years ago but had night sweats, bad dreams and insomnia.
>
> I need a calming anti-depressent. Is there such a one that is similar to elavil? Sorry for the long post. I have read the archives also trying to find info that would pertain to me.
>
> Thanks
Posted by Noa on January 24, 2001, at 12:06:14
In reply to Re: Am near the end of my rope!, posted by ChrisK on January 24, 2001, at 5:58:32
I wonder, too, if you would benefit from augmentation by light box therapy? Also, I recently started an exercise program and find that the carbo cravings I have had, due in large part to insulin resistance, have pretty much disappeared! Something to consider--I don't know if it would help with carbo cravings due to ADs.
Posted by Phil on January 24, 2001, at 20:55:56
In reply to Re: Am near the end of my rope!, posted by Noa on January 24, 2001, at 12:06:14
shelby, I'm back on Amitriptyline after trying just about everything else. I gave Remeron a long trial and at 60 mg it had few side effects and a few benefits. It just didn't get the job done. I'm ramping up on amitrip and hope it does the job as it has in the past.
I'll deal with the side effects because this beast has really been kicking my ass.
Posted by PatJ. on January 30, 2001, at 12:32:00
In reply to Am near the end of my rope!, posted by shelby on January 23, 2001, at 21:40:09
I know you got a lot of answers alreasy so I will just add that when you are at the end of your rope, tie a knot in it and hang on! :-) Pat
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