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Re: Low-dose Vivactil side effects?

Posted by JohnL on May 4, 2000, at 3:16:33

In reply to Low-dose Vivactil side effects?, posted by anita on May 3, 2000, at 23:13:53

> Hiya,
>
> For those of you who have tried low-dose Vivactil (protriptyline), what were the side effects, other than increased energy? I'm concerned mainly about dry mouth and extreme anxiety. I'd be adding it to Zoloft, which helps with anxiety and suicidal ideation, but leaves me sedated and apathetic.
>
> thank you,
> anita

Anita,
It sounds to me like you already have a pretty good handle on what to expect. Dry mouth, mild constipation, and temporary initial anxiety are reasonable expectations I think. I experienced all of those on Vivactil myself. I kind of liked it after a couple weeks, but it made my tinnitus so loud I couldn't endure. I also had added it to Zoloft.

One thing to keep in mind is that the Zoloft will interfere with the metabolism of Vivactil a little bit. What that means is that your low dose may actually be higher than you would think. The plasma level of Vivactil in your system will be increased somewhat in the presence of Zoloft. Not a lot, but some. A more drastic increase would be encountered if you were taking Prozac for example instead of Zoloft. So if side effects at first seem overly bothersome in any way, I wouldn't hesitate in getting the doctor's approval to start with an even lower dose than was first discussed.

On the bright side, a drug monograph on Vivactil I read says, "Suitable for the apathetic withdrawn depressed patient." Cool. I haven't seen that statement made in any other monographs of any other antidepressants.
JohnL


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