![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by 3 Beer Effect on December 23, 2001, at 9:27:13
I read that Sinequan (Doxepin) has both anti-anxiety and anti-depressant properties. Does anyone have experience with Sinequan- Is it more or less sedating than Remeron? Is the anti-anxiety effect as good as Klonopin or other benzodiazepines? What major side effects can I expect?
Are there other TCAs that might be better than sinequan for my condition- social phobia/anxiety/insomnia/major depression?
(I am not willing to take asendin {amoxapine} because of this risk of tardive diskeneysia).So far the only really effective anti-anxiety/anxiolytic/social phobia medicine is 3 twelve ounce beers! Nothing else I have tried even comes close. Do any of the TCAs cause the euphoric, sociable, happy & relaxed feeling of well-being that you get after drinking 3 beers? (I can't drink anymore because alcohol counteracts anti-depressants, & because you can't be drunk all of the time or you will run into major health problems). I wish they could come up with a non addictive, non-barbituate pill that replicates the 3 beer feeling, but I have yet to find it.
I think the MAOI Parnate would work well for my condition & I would have no trouble following the no tyramine diet but if the SSRIs & Effexor give me insomnia would Parnate cause insomnia/nervousness also? (I've read very few people can tolerate Nardil & that Nardil requires high doses to be effective so I wouldn't consider Nardil as an option.)
I cannot tolerate SSRIs & Effexor XR because of insomnia & nervousness. Remeron 45 mg made me sleep 17 hours per day & seemed to have no anti-anxiety or antidepressant properties for me. Klonopin (0.5 mg 2x per day) is the only medicine that has done anything good for me (besides alcohol), but most doctors seem to think benzodiazepines are the spawn of the devil (even though they hand out highly addictive high potency amphetamines to children like candy for ADD) so I am trying to find an alternative medication.
Posted by christophreJMC on December 23, 2001, at 10:43:54
In reply to Sinequan/TCAs for social phobia/anxiety depress. ?, posted by 3 Beer Effect on December 23, 2001, at 9:27:13
> I think the MAOI Parnate would work well for my condition & I would have no trouble following the no tyramine diet but if the SSRIs & Effexor give me insomnia would Parnate cause insomnia/nervousness also? (I've read very few people can tolerate Nardil & that Nardil requires high doses to be effective so I wouldn't consider Nardil as an option.)
Why can't people tolerate Nardil? (I had no side-effects from Nardil, but I'm not at all typical.) If you are worried about insomnia and nervousness, I think Nardil would be better suited to your needs.
It's kind of strange, when I was diagnosed with panic disorder doctors would shove massive amounts of benzodiazepines down my throat; but now when I ask for Klonopin for social anxiety, they change the subject to SSRIs. (MAOIs aren't the easiest drugs to get either.)
As far as I know, TCAs are pretty worthless for social anxiety; but if the sedating meds you've tried have helped, so might a TCA.
Christophre.
P.S. - If there were a drug that produced the "three beer effect," I don't think they'd let us have it.
Posted by spike4848 on December 23, 2001, at 17:02:29
In reply to Re: Sinequan/TCAs for social phobia/anxiety depress. ? » 3 Beer Effect, posted by christophreJMC on December 23, 2001, at 10:43:54
> > I think the MAOI Parnate would work well for my condition & I would have no trouble following the no tyramine diet but if the SSRIs & Effexor give me insomnia would Parnate cause insomnia/nervousness also? (I've read very few people can tolerate Nardil & that Nardil requires high doses to be effective so I wouldn't consider Nardil as an option.)
I feel your pain brother ..... I had a similar thought. My depression, panic and social anxiety has really only responded to nardil .... but then light bulb flash/idea .... how about a sedating tricyclic? So I tapered off nardil ..... sunk into my current deep depression .... and started elavil. No luck.
I do know my aunt had bad depression and insomnia and doxepin is working wonders for her.
I definately recommend Mr. Kreg Park's Web site www.socialfear.com. It has great information on the best treatment for s.p.
Keep us updated.
Spike
Posted by jay on December 23, 2001, at 17:04:48
In reply to Sinequan/TCAs for social phobia/anxiety depress. ?, posted by 3 Beer Effect on December 23, 2001, at 9:27:13
> I read that Sinequan (Doxepin) has both anti-anxiety and anti-depressant properties. Does anyone have experience with Sinequan- Is it more or less sedating than Remeron? Is the anti-anxiety effect as good as Klonopin or other benzodiazepines? What major side effects can I expect?
>
> Are there other TCAs that might be better than sinequan for my condition- social phobia/anxiety/insomnia/major depression?
> (I am not willing to take asendin {amoxapine} because of this risk of tardive diskeneysia).
>
> So far the only really effective anti-anxiety/anxiolytic/social phobia medicine is 3 twelve ounce beers! Nothing else I have tried even comes close. Do any of the TCAs cause the euphoric, sociable, happy & relaxed feeling of well-being that you get after drinking 3 beers? (I can't drink anymore because alcohol counteracts anti-depressants, & because you can't be drunk all of the time or you will run into major health problems). I wish they could come up with a non addictive, non-barbituate pill that replicates the 3 beer feeling, but I have yet to find it.
>
> I think the MAOI Parnate would work well for my condition & I would have no trouble following the no tyramine diet but if the SSRIs & Effexor give me insomnia would Parnate cause insomnia/nervousness also? (I've read very few people can tolerate Nardil & that Nardil requires high doses to be effective so I wouldn't consider Nardil as an option.)
>
> I cannot tolerate SSRIs & Effexor XR because of insomnia & nervousness. Remeron 45 mg made me sleep 17 hours per day & seemed to have no anti-anxiety or antidepressant properties for me. Klonopin (0.5 mg 2x per day) is the only medicine that has done anything good for me (besides alcohol), but most doctors seem to think benzodiazepines are the spawn of the devil (even though they hand out highly addictive high potency amphetamines to children like candy for ADD) so I am trying to find an alternative medication.Hi:
My Dad has been on doxepin for about 8 years now.(200mg's) He takes it for Depression, Anxiety, as well as Panic disorder. He also takes Lectopam (bromazepam..a benzo not available in the U.S... I don't know why. It's got a similar punch like Ativan, but lasts a bit longer.)He has done very, very well on this med. He now only has usual and 'normal' reations of depression and anxiety from time to time. He doesn't end up in bed for days.
He is on 200mg at bedtime. It has helped him massively, but I could barely stand the med. It reminds me of Remeron. But, the only thing is that it doesn't seem to cause the same amount of anxiety/anger as a side-effect.
I would suggest you start low and go slow if you start a TCA. I would say to possibly consider Imipramine, Nortriptyline, and both Clomipramine and Amitriptyline last. It may be best to try all, and make sure you give them each time to work..at an *effective* dose.
I would also highly suggest a benzo for atleast a few months into starting your new med. This will help with any side-effects, and be theraputic for your condition.
Good luck...it may really be worth a shot.
Jay
Posted by geno on December 23, 2001, at 18:50:43
In reply to Re: Sinequan/TCAs for social phobia/anxiety depress. ? » 3 Beer Effect, posted by christophreJMC on December 23, 2001, at 10:43:54
> > I think the MAOI Parnate would work well for my condition & I would have no trouble following the no tyramine diet but if the SSRIs & Effexor give me insomnia would Parnate cause insomnia/nervousness also? (I've read very few people can tolerate Nardil & that Nardil requires high doses to be effective so I wouldn't consider Nardil as an option.)
>
> Why can't people tolerate Nardil? (I had no side-effects from Nardil, but I'm not at all typical.) If you are worried about insomnia and nervousness, I think Nardil would be better suited to your needs.
>
> It's kind of strange, when I was diagnosed with panic disorder doctors would shove massive amounts of benzodiazepines down my throat; but now when I ask for Klonopin for social anxiety, they change the subject to SSRIs. (MAOIs aren't the easiest drugs to get either.)
>
> As far as I know, TCAs are pretty worthless for social anxiety; but if the sedating meds you've tried have helped, so might a TCA.
>
> Christophre.
>
> P.S. - If there were a drug that produced the "three beer effect," I don't think they'd let us hghb
Posted by Cmatt on December 25, 2001, at 2:14:29
In reply to Sinequan/TCAs for social phobia/anxiety depress. ?, posted by 3 Beer Effect on December 23, 2001, at 9:27:13
> I read that Sinequan (Doxepin) has both anti-anxiety and anti-depressant properties. Does anyone have experience with Sinequan- Is it more or less sedating than Remeron? Is the anti-anxiety effect as good as Klonopin or other benzodiazepines? What major side effects can I expect?
>
> Are there other TCAs that might be better than sinequan for my condition- social phobia/anxiety/insomnia/major depression?
> (I am not willing to take asendin {amoxapine} because of this risk of tardive diskeneysia).
>
==================================================
==================================================I have no idea how long or how often you have used the Klonopin, but I have used both TCA and benodiazepines, and although both have had some beneficial effect, for me a TCA benefit tends to persists as where after a while with either xanax or klonopin, the benzo benefit diminishes some what.
I don't think either type of medication is worthless, but antidepressants do tend to correct chemical imbalances.
If I were in your position and knowing what I know, I would first opt for a TCA with a very low dose of a benzo like klonopin for a few weeks, and then attempt to do without the Klonopin there after. Go slow with a TCA and let your body tell you what is happening.
For example, I learned that I could only handle
5mg. of Elavil twice a day to start with, and then in a few days 10mg. once a day...ect. For me, the only side effect from Elavil has been some constipation, and I have used it for about three years.
Elavil is about the most sedating of all the TCA, and likely has the most potent anti-anxiety effect, but each person responds differently, so only trial and error can find a potentially effective antidepressant for an individual.Regards,
Cmatt
Posted by spike4848 on December 25, 2001, at 21:13:02
In reply to Re: Sinequan/TCAs for social phobia/anxiety depress. ?, posted by Cmatt on December 25, 2001, at 2:14:29
Dear Cmatt,
What are you using elavil for .... Panic, depression, social phobia? What dose are you on of elavil?
Thanks,
Spike
> I have no idea how long or how often you have used the Klonopin, but I have used both TCA and benodiazepines, and although both have had some beneficial effect, for me a TCA benefit tends to persists as where after a while with either xanax or klonopin, the benzo benefit diminishes some what.
>
> I don't think either type of medication is worthless, but antidepressants do tend to correct chemical imbalances.
>
> If I were in your position and knowing what I know, I would first opt for a TCA with a very low dose of a benzo like klonopin for a few weeks, and then attempt to do without the Klonopin there after. Go slow with a TCA and let your body tell you what is happening.
>
> For example, I learned that I could only handle
> 5mg. of Elavil twice a day to start with, and then in a few days 10mg. once a day...ect. For me, the only side effect from Elavil has been some constipation, and I have used it for about three years.
>
>
> Elavil is about the most sedating of all the TCA, and likely has the most potent anti-anxiety effect, but each person responds differently, so only trial and error can find a potentially effective antidepressant for an individual.
>
> Regards,
> Cmatt
Posted by Cmatt on December 26, 2001, at 0:51:47
In reply to Cmatt? Elavil for?, posted by spike4848 on December 25, 2001, at 21:13:02
> Dear Cmatt,
>
> What are you using elavil for .... Panic, depression, social phobia? What dose are you on of elavil?
>
> Thanks,
>
> Spike
==================================================
Spike,I have used Elavil for a mixed generalized anxiety/ mild to moderate depressive disorder, with the anxiety being the prominant disorder.
I also use .5mg Xanax to .75mg Xanax per day.
Xanax has a double therapy punch. It helps keep the anxiety symptoms minimized as well as helping keep my inner ear disorder calmed down.I have used Elavil in the dosage range of
40mg-80mg. per day.I have nothing against the daily use of a benzodiazepine if need be, but if a person can do well just on an antidepressant, my opinion is that a person will be better of in the long run without chronic use of a benzodiazepine due to the dependency issue. I for one wish I could have done without a benzodiazepine, but I accept the regiment I'm using, and do the best I can.
Cmatt
Posted by Mitch on December 26, 2001, at 18:42:45
In reply to Sinequan/TCAs for social phobia/anxiety depress. ?, posted by 3 Beer Effect on December 23, 2001, at 9:27:13
> I read that Sinequan (Doxepin) has both anti-anxiety and anti-depressant properties. Does anyone have experience with Sinequan- Is it more or less sedating than Remeron? Is the anti-anxiety effect as good as Klonopin or other benzodiazepines? What major side effects can I expect?
I took the stuff for about three or four years (first antidepressant back in 1979). I think it is best for sleep and generalized anxiety. If you want a TCA to work similar, but with improved antidepressant effect I would go with amitriptyline (Elavil). I don't know if they still make this-but they made a combination med. that was amitripytline+chlordiazepoxide (Librium) combined together in various strengths. That might be something to consider-they are both very dirt cheap. As far as sfx go, expect a lot of dry mouth and "hang-over". I liked amitriptyline better than Remeron because I built up a tolerance to the sedation, whereas with Remeron the sedation never seemed to go away. The closest thing to "3 Beers" might be flurazepam which is used as a hypnotic and is very long-acting. Maybe, some flurazepam at bedtime (30mg) with 25mg of Elavil?
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.