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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Lia Mason on March 22, 2002, at 12:39:40
I'm trying to build up to a therapeutic imipramine dose but at 60 I'm already tired. As I need to go to 200, this is discouraging. My doc says if I soldier through--over months--it will eventually subside. Anyone have experience that speaks to this? I already failed on nortriptyline which made me totally lightheaded and woozy.
Thanks!
Lia
Posted by TSA West on March 22, 2002, at 13:46:54
In reply to Will tricyclic sedation wear off?, posted by Lia Mason on March 22, 2002, at 12:39:40
Maybe you can split the doses into three times daily: http://www.dr-bob.org/tips/split/Splitting-doses-to-diminis.html
Posted by OldSchool on March 22, 2002, at 16:13:34
In reply to Will tricyclic sedation wear off?, posted by Lia Mason on March 22, 2002, at 12:39:40
> I'm trying to build up to a therapeutic imipramine dose but at 60 I'm already tired. As I need to go to 200, this is discouraging. My doc says if I soldier through--over months--it will eventually subside. Anyone have experience that speaks to this? I already failed on nortriptyline which made me totally lightheaded and woozy.
>
> Thanks!
> Lia
Lia, usually TCAs are quite sedating. Tofranil is one of the most sedating antidepressants there is. Its from the anti-cholinergic side effects, thats a big part of it. I took Pamelor once for a few months and the sedation never went away. TCAs are just generally very sedating drugs, with the one exception of desipramine which some people like and claim is somewhat stimulating.If it were me, Id be opting for a modern class antidepressant. The modern class ADs generally have a much more tolerable side effect profile.
Old School
Posted by Waterlily on March 22, 2002, at 19:07:51
In reply to Will tricyclic sedation wear off?, posted by Lia Mason on March 22, 2002, at 12:39:40
I never had a big problem with sedation - what little I had at first subsided after a few weeks. Have you had a blood imipramine level drawn? I suspect what happened to me was a bit unusual, but it may also be the case with you - just something to think about: I was on 75 mg of imipramine and my blood level was in the high therapeutic range, nearing toxic levels (don't ask me what the number was, but this is what my doc told me). I stayed on imipramine for over a year and had blood levels monitered periodically. Each time the blood level came back 'high therapeutic'. Imipramine can be cardiotoxic at high levels, which is why my doc was monitering the level.
Posted by Janelle on March 23, 2002, at 20:46:39
In reply to Re: Will tricyclic sedation wear off?, posted by Waterlily on March 22, 2002, at 19:07:51
My experience is similar to that of Waterlily.
I was on amitriptyline (Elavil) for about a year. During the first few weeks it was very sedating and I got those anticholinergic side effects, but all of this WORE OFF and soon it felt like I wasn't even on a med at all. No side effects that I could *feel* from the TCA after a few weeks.
Posted by Denise528 on March 24, 2002, at 9:23:33
In reply to Re: Will tricyclic sedation wear off?, posted by Janelle on March 23, 2002, at 20:46:39
Hi,
I was on prothiaden for about 5 years. When I first started it it made me really drowsy in a nice way and then that wore off and I felt great for the first time in years.
Denise
Posted by polarbear206 on March 25, 2002, at 16:31:01
In reply to Re: Usually not, posted by OldSchool on March 22, 2002, at 16:13:34
> > I'm trying to build up to a therapeutic imipramine dose but at 60 I'm already tired. As I need to go to 200, this is discouraging. My doc says if I soldier through--over months--it will eventually subside. Anyone have experience that speaks to this? I already failed on nortriptyline which made me totally lightheaded and woozy.
> >
> > Thanks!
> > Lia
>
>
> Lia, usually TCAs are quite sedating. Tofranil is one of the most sedating antidepressants there is. Its from the anti-cholinergic side effects, thats a big part of it. I took Pamelor once for a few months and the sedation never went away. TCAs are just generally very sedating drugs, with the one exception of desipramine which some people like and claim is somewhat stimulating.
>
> If it were me, Id be opting for a modern class antidepressant. The modern class ADs generally have a much more tolerable side effect profile.
>
> Old School
Lia,
Elavil is the most sedating among the tricyclics. I also take imipramine. The sedation will wear off once you get used to the med and your body adjusts. This class of meds works the best for those with more severe "endogenous" depressions. It is very activating because it targets more then one neurotransmitter. The ssri's taken alone blunted my emotions. I feel more like my old self with the tricyclics. Good Luck.
Posted by Zo on March 25, 2002, at 17:12:19
In reply to Re: Usually not, posted by polarbear206 on March 25, 2002, at 16:31:01
That's great to hear!
I still agree with OldSchool, though. Only I'd also be inclined to sidestep the SSRIs, which have all been almost as bad as the TCAs, for me.
Um, what does that leave. Effexor, Wellbutrin, pstims, Zyprexa. . .lots of things.
Zo
This is the end of the thread.
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