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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 Christ_empowered on April 6, 2014, at 13:01:47
I was thinking (generic) celexa and some kinda once daily Bupropion. Ups the number of pills I'm taking (sad), but might give better results. Also, Tofranil is SEDATING, and I suspect it may be causing some degree of cognitive impairment. Also, the dry mouth sucks. And the dosing is strange, because I'm on meds that might increase levels of imipramine and/or metabolites (trileptal, 1200mgs/day). Also, there's the whole "TCAs cause mania" thing to consider :-(
I just don't care for sri drugs. They make me feel too apathetic. Prozac made me a little antsy and flattened out. Celexa helped with psychotic depression (or..whatever you call my issues at the time....), but then it proved to apathetic-making after about 6 months.
On the plus side, lots of the older sri drugs are now generic. On the downside, there's so many to choose from. I need help with agitation and energy; concentration and mood; mild-ish ocd-kinda sorta tendencies, plus a tendency towards psychotic depression.
Ugh. I specifically requested Tofranil, from a public health doc no less, so now I feel bad. I don't like wasting their time when they're clearly dealing with people who are much sicker and/or incapacitated than I am. Also, I'm looking at 4 drug limit on my disability :-(
Current meds: up to 300/Neurontin (max 3 doses of 100mgs each), 150 Tofranil, 30 Abilify, 1200 Trileptal. I also do Orthomolecular, and I recently increased my niacinamide to a minimum of 6 grams/day. Works great, but it potentiates the sedating effects of Neurontin and if I take Tofranil on top....I'm zombie-fied.
So...yeah...I was thinking drop the Neurontin (I rarely take it anyway; my OM line up includes 4-6 grams Taurine and 6+ grams niacinamide, so I've got some GABA-action going with supplements), drop the Tofranil, keep everything else, and whip up a 2 AD mix that'll perk me up a lil bit and also calm me down. Ugh. I wish they still made Dexamyl :-(
Thanks for all your help, everyone!
Posted by jono_in_adelaide on April 6, 2014, at 18:17:52
In reply to maybe something more modern than Tofranil?, posted by Christ_empowered on April 6, 2014, at 13:01:47
Drop the Tofranil, add an SSRi in the morning (which ever one has been kindest to you in the past) and nortriptyline 75mg at bedtime OR bupropion XL 300mg in the morning
Posted by LouisianaSportsman on April 6, 2014, at 21:59:40
In reply to Re: maybe something more modern than Tofranil?, posted by jono_in_adelaide on April 6, 2014, at 18:17:52
> Drop the Tofranil, add an SSRi in the morning (which ever one has been kindest to you in the past) and nortriptyline 75mg at bedtime OR bupropion XL 300mg in the morning
I'm thinking about nortriptyline 75mg. at bedtime along with my "true psych meds": Brintellix 20mg.; Lamictal 200mg.; Latuda 60mg.; Topamax XR 200mg.
Do you have any experience with it? I recently quit bupropion hydrobromide 522mg.
Posted by Phillipa on April 6, 2014, at 22:48:22
In reply to Re: maybe something more modern than Tofranil?, posted by LouisianaSportsman on April 6, 2014, at 21:59:40
Would luvox potentiate the other meds you are on as would hit the ocd and someone said that it could have some antipsycotic properties? Phillipa
Posted by Christ_empowered on April 6, 2014, at 23:23:04
In reply to Re: maybe something more modern than Tofranil?, posted by Phillipa on April 6, 2014, at 22:48:22
maybe i'll just drop tofranil for wellbutrin of some persuasion. All the drug interactions checkers say no-no to sri+bupropion. anyone know what's up with that?
Also...is Effexor more apathetic-making than Tofranil? Ugh. ADs are stoopiid.
Posted by phidippus on April 7, 2014, at 0:58:27
In reply to maybe something more modern than Tofranil?, posted by Christ_empowered on April 6, 2014, at 13:01:47
>I need help with agitation and energy; concentration and mood; mild-ish ocd-kinda sorta tendencies, plus a tendency towards psychotic depression.
I'd recommend Mirtazapine. It'll boost serotonin, norepenephrine and dopamine. Serotonin for the mood and agitation, norepenephrine for concentration and dopamine for energy.
Eric
Posted by herpills on April 7, 2014, at 19:41:36
In reply to maybe something more modern than Tofranil?, posted by Christ_empowered on April 6, 2014, at 13:01:47
I've been doing well with mirtazapine, so far I like it better than the SSRIs. Have you ever tried mirtazapine/Remeron?
Lamictal instead of Trileptal might be better for depression?
This is the end of the thread.
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