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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by becksA on August 15, 2004, at 22:15:19
I've been dealing with anxiety a lot lately, and am taking Xanax XR for it...which has been helping a bit, although I feel i need more, because it is still there. However, my depression has gotten very bad...(I just moved from europe and have no friends...nobody to talk to...nobody to hang out with)..I've tried every single SSRI for anxiety/depression in the past so we've acknowledged that thats not going to help...is there another drug or type of drug that is considered usually helpful with depression?
Posted by Racer on August 15, 2004, at 23:08:06
In reply to Non-SSRI Depression relief?, posted by becksA on August 15, 2004, at 22:15:19
Yes, there are three major classes of antidepressants -- the SSRIs, the tricyclics, and the monoamine oxydase inhibitors. Then there are the newer drugs, like Wellbutrin and Effexor.
Generally speaking, all are about equally effective -- although that doesn't mean that all are equally effective for each person taking them. Some people respond better to one drug or class of drugs than to another. That's why finding a drug involves so much trial and error.
The tricyclics, or TCAs, are very effective for many people. They do have side effects for many people, but they are very effective drugs. The same is true for the monoamine oxydase inhibitors, or MAOIs. The biggest drawback to the MAOIs is that there are dietary restrictions that must be taken seriously, and which include many over the counter drugs, as well.
The SSRIs are the first line drugs these days, for a variety of reasons that really don't have a lot to do with their effectiveness. They're safer than the older drugs -- much lower risk in overdose, for example, and fewer side effects. Of course, as they've been used longer, more side effects have shown up, so that might not be such a selling point anymore.
If you read through this board, you'll see that there are a fair number of people here who sing the praises of the tried and true TCAs and MAOIs.
Good luck.
Posted by becksA on August 15, 2004, at 23:26:20
In reply to Re: Non-SSRI Depression relief?, posted by Racer on August 15, 2004, at 23:08:06
I am reluctant to try MAOI's because of the strict dietary requirements....I would first like to try the Tricyclics you speak of....what are some popular drugs in this class? How do they chemically work differently than SSRI's?
Thanks
Posted by HappyGirl on August 15, 2004, at 23:48:11
In reply to Non-SSRI Depression relief?, posted by becksA on August 15, 2004, at 22:15:19
Hi:
I have no tolerance on any of SSRIs, including Effexor. Then, my pdoc. rxed 'Serzone' first and then 'Trazodone.'In the beginning Serzone/Nefadozone regimen, I was put on 450 mg. - 600 mg. that is quite 'mass' dosage. Serzone offered me a great deal of 'relief' on both depression and Anxiety. Plus, I slept VERY well during the nights thanks to 'Serzone.' However, for some reason, I developed 'intense thirst' during my sleep, then now I'm on Trazodone. However, Trazodone makes me quite drowsy next day, then I've been on both Nefadozone and Trazodone. The former with my breakfast and the latter before going to the bed. This combo. Nefadozone 150 mg. and Trazodone 150 mg. along with Wellbutrin sr 200 mg. working VERY well on my depression and Anxiety.
H.G.
Posted by zeebop on August 16, 2004, at 6:31:02
In reply to Re: Non-SSRI Depression relief?, posted by becksA on August 15, 2004, at 23:26:20
> I am reluctant to try MAOI's because of the strict dietary requirements....I would first like to try the Tricyclics you speak of....what are some popular drugs in this class? How do they chemically work differently than SSRI's?
> Thanks
Excellent and famous TCA's :
1- Imipramine (Tofranil) : the oldest and the gold standard AD's : it has equal potency at 5HT/Ne reuptake inhibition : excellent for severe depression,GAD,Panic and ADD
2- Amitriptyline (Elavil/Tryptizoll/Saroten) :
same as above and strong 5HT2 Antagonism ,but much more sedative , so better for insomnia and anxiety and not good for ADD
3- Nortriptyline (pamelor) :
Potent NE inhibitor and 5ht2 Antagonist : also great for severe depression,anxiety,ADD,concentration,but less for anxiety and insomnia
4- Desipramine (Norpramin) :
Also NE inhibitor but weak 5ht2 antagonist : good for depression and ADD,but can cause some anxiety and insomnia
5- Maprotiline (Ludiomil) :
Also a very selective Ne inhibitor with anxiyolitic effects .
6- Clomipramine (Anafranil):
Very potent 5HT inhibitor with some NE inhibition ,so is more like an Effexor - type,and so is the odd one : good for OCD,depression,but sexual side effects and apathy similar to Effex + SSRIsWeight Gain is a problem with all AD's (Except Selegiline,Wellbutrin)...However WG is dose-related with TCA's,while SSRIs are not and continue with time..so much worse in the case of SSRis.
One note : if you don't like all the above,you can try Selegiline which is at 5-10mg is a MAO-B ,so does not have dietry resrictions and affects dopamine ,so is very good for depression,ADD,+ No Weight Gain .
All the best.
This is the end of the thread.
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