![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by theo on April 16, 2005, at 9:04:25
I'm lucky with most meds in that I usually just need a small dose.
What is the minimum effective dose of imipramine? I know most dosing sheets say 150-300mg but seems like I've read that many people get by with less than 150mg and get results with less side effects.
Posted by linkadge on April 16, 2005, at 11:05:33
In reply to Any success with low doses of imipramine?, posted by theo on April 16, 2005, at 9:04:25
I know a few people who do well on 75mg of imipramine.
Linkadge
Posted by ed_uk on April 16, 2005, at 16:07:09
In reply to Any success with low doses of imipramine?, posted by theo on April 16, 2005, at 9:04:25
Hi theo :-)
>What is the minimum effective dose of imipramine?
It's a myth that there's a minimum effective dose. The minimum effective dose is the minumum dose that works for YOU- it doesn't matter what dose other people require! Dosage requirements for imipramine are extremely variable. Sukarno only needed 25mg imipramine for panic disorder.
Kind regards,
Ed.
Posted by theo on April 16, 2005, at 16:31:43
In reply to Re: Any success with low doses of imipramine? » theo, posted by ed_uk on April 16, 2005, at 16:07:09
> Hi theo :-)
>
> >What is the minimum effective dose of imipramine?
>
> It's a myth that there's a minimum effective dose. The minimum effective dose is the minumum dose that works for YOU- it doesn't matter what dose other people require! Dosage requirements for imipramine are extremely variable. Sukarno only needed 25mg imipramine for panic disorder.
>
> Kind regards,
> Ed.Exactly my point. Many docs start you at the published minimum dose which can be way to much. I'm trying to get input on where to start should I try a TCA such as imipramine.
Posted by ed_uk on April 16, 2005, at 17:03:45
In reply to Re: Any success with low doses of imipramine? » ed_uk, posted by theo on April 16, 2005, at 16:31:43
Hi Theo :-)
>I'm trying to get input on where to start should I try a TCA such as imipramine.
TCAs are best started at a very low dose and then gradually increased as necessary. Imipramine can be started at 10mg/day. 10mg/day is unlikely to be effective as an antidepressant. Nevertheless, initiating treatment with a small dose can minimize side effects. The 10mg tablets are useful for titration.
Kind regards,
Ed.
Posted by theo on April 16, 2005, at 17:23:22
In reply to Re: Any success with low doses of imipramine? » theo, posted by ed_uk on April 16, 2005, at 17:03:45
Is there a big difference between say, imipramine and amitriptyline as fair as TCA side effects? Are they both similar in effectiveness for mild nagging depression and anxiety?
Posted by ed_uk on April 16, 2005, at 20:03:23
In reply to Re: Any success with low doses of imipramine? » ed_uk, posted by theo on April 16, 2005, at 17:23:22
Hi,
Amitriptyline causes considerably more drowsiness and sedation than imipramine. Amitriptyline also causes more anticholinergic side effects. They are likely to be similar in effectiveness.
Ed.
Posted by Dreyfus on April 17, 2005, at 15:40:22
In reply to Re: Any success with low doses of imipramine? » theo, posted by ed_uk on April 16, 2005, at 20:03:23
From around 1982 until 1988, I did pretty well on 25mg imipramine and 10mg valium per day. Two doctors were sure it was just psychosomatic and I really didn't need to take anything. One doctor was just an idiot and the other finally came around after reading a study that confirmed that many patients responded to small doses. Interestingly, 20 mg wouldn't cut it and 50mg or higher caused rampant anxiety.
In retrospect, I think I was right on the borderline of being depressed because I would have occasional "bad days" following early awakenings. At that dosage, however, I had normal emotions (not deadened), a normal sex life, and a variety of interests. I haven't been able to re-create over the intervening 16 years
Michael
Posted by theo on April 17, 2005, at 16:05:29
In reply to Re: Any success with low doses of imipramine?, posted by Dreyfus on April 17, 2005, at 15:40:22
> From around 1982 until 1988, I did pretty well on 25mg imipramine and 10mg valium per day. Two doctors were sure it was just psychosomatic and I really didn't need to take anything. One doctor was just an idiot and the other finally came around after reading a study that confirmed that many patients responded to small doses. Interestingly, 20 mg wouldn't cut it and 50mg or higher caused rampant anxiety.
>
> In retrospect, I think I was right on the borderline of being depressed because I would have occasional "bad days" following early awakenings. At that dosage, however, I had normal emotions (not deadened), a normal sex life, and a variety of interests. I haven't been able to re-create over the intervening 16 years
>
> Michael
So it's been 16 years since you have taken imipramine? Are you on any TCA's currently? Did you ever try amitriptyline?
Posted by Dreyfus on April 18, 2005, at 11:21:40
In reply to Re: Any success with low doses of imipramine? » Dreyfus, posted by theo on April 17, 2005, at 16:05:29
> > From around 1982 until 1988, I did pretty well on 25mg imipramine and 10mg valium per day. Two doctors were sure it was just psychosomatic and I really didn't need to take anything. One doctor was just an idiot and the other finally came around after reading a study that confirmed that many patients responded to small doses. Interestingly, 20 mg wouldn't cut it and 50mg or higher caused rampant anxiety.
> >
> > In retrospect, I think I was right on the borderline of being depressed because I would have occasional "bad days" following early awakenings. At that dosage, however, I had normal emotions (not deadened), a normal sex life, and a variety of interests. I haven't been able to re-create over the intervening 16 years
> >
> > Michael
>
>
> So it's been 16 years since you have taken imipramine? Are you on any TCA's currently? Did you ever try amitriptyline?
>
No, I haven't been on any TCA's since that time. When I started getting the super hyper-anxiety (kind of like a continous panic attack), my doctor tried me on amitriptyline, desipramine, and trazodone with the same result. It always started when I reached a therapeutic dose. At that point, we decided to try Parnate, which worked fast and well without the hyper-stimulation.I have been on Parnate for most of the past 16 years. I have also tried wellbrutrin, Prozac, Remoron, Serzone, and Nardil. All caused the same problem, except Nardil. Unfortunately, Nardil didn't work as well as Parnate for me. As an additional piece of information, I was put on Amitriptyline in 1977 (my first antidepressant) and had no problems tolerating at 75mg, which worked well for me. I took it for 3 years without any problems. Another interesting fact is I have no problem tolerating stimulants.
Michael
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.