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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Maxime on July 13, 2004, at 19:28:26
Is there any TCA out there that is know for it's stimulating effect?
Parnate isn't doing the job. We added Adderall XR and I felt good for about a week.
I am wondering if it is time to go another route.
Maxime
Posted by linkadge on July 13, 2004, at 19:52:01
In reply to Stimulating TCA?, posted by Maxime on July 13, 2004, at 19:28:26
probably nortryptaline, or protryptaline. You could also try some straterra. Provilil might be safer to add to parnate.
Linkadge
Posted by KaraS on July 13, 2004, at 20:43:19
In reply to Re: Stimulating TCA?, posted by linkadge on July 13, 2004, at 19:52:01
Desipramine is very stimulating also. Nortriptyline was for me as well though oddly it is quite sedating for some others.
Posted by Ktemene on July 14, 2004, at 1:32:42
In reply to Stimulating TCA?, posted by Maxime on July 13, 2004, at 19:28:26
> Is there any TCA out there that is know for it's stimulating effect?
>
> Parnate isn't doing the job. We added Adderall XR and I felt good for about a week.
>
> I am wondering if it is time to go another route.
>
> MaximeWere you thinking of switching to a TCA or adding one to augment Parnate? The June 2002 Current Psychiatry article on MAOIs said that with the exception of clomipramine TCAs are generally safe with MAOIs. Some people have posted that they had good results using Parnate + desipramine. A combo like that might be worth discussing with your pdoc if you are willing to stay with Parnate. By the way, have you tried Adderall again since it pooped out? Sometimes the good effects return if you don't use Adderall every day. Did you try Provigil? Some people find it quite stimulating and it can (I think) be combined with Parnate with no problem.
Posted by rod on July 14, 2004, at 5:50:43
In reply to Stimulating TCA?, posted by Maxime on July 13, 2004, at 19:28:26
hi
I also think Desipramine is a good choice from the "TCAs". Nortriptyline might be too sedating.
Some people find Imipramine also very stimulating.
I think you just have top try out and see how you react...good luck
Roland
Posted by King Vultan on July 14, 2004, at 7:57:56
In reply to Stimulating TCA?, posted by Maxime on July 13, 2004, at 19:28:26
As the others have mentioned, desipramine would be a good choice. It is activating and along with nortriptyline, has the fewest side effects of the tricyclics. However, nortriptyline is generally considered to be at least moderately sedating; although, individual reactions can vary. Protriptyline (Vivactil) is even more stimulating than desipramine, but I found its anticholinergic effects to be intolerable, as many people apparently do. Too bad because it was a wonderful stimulant and effective antidepressant.
Todd
Posted by Maxime on July 14, 2004, at 20:17:28
In reply to Re: Stimulating TCA?, posted by King Vultan on July 14, 2004, at 7:57:56
What is anticholinergic mean?
Maxime
> As the others have mentioned, desipramine would be a good choice. It is activating and along with nortriptyline, has the fewest side effects of the tricyclics. However, nortriptyline is generally considered to be at least moderately sedating; although, individual reactions can vary. Protriptyline (Vivactil) is even more stimulating than desipramine, but I found its anticholinergic effects to be intolerable, as many people apparently do. Too bad because it was a wonderful stimulant and effective antidepressant.
>
> Todd
Posted by Maxime on July 14, 2004, at 20:23:24
In reply to Re: Stimulating TCA?, posted by Ktemene on July 14, 2004, at 1:32:42
> > Is there any TCA out there that is know for it's stimulating effect?
> >
> > Parnate isn't doing the job. We added Adderall XR and I felt good for about a week.
> >
> > I am wondering if it is time to go another route.
> >
> > Maxime
>
> Were you thinking of switching to a TCA or adding one to augment Parnate? The June 2002 Current Psychiatry article on MAOIs said that with the exception of clomipramine TCAs are generally safe with MAOIs. Some people have posted that they had good results using Parnate + desipramine. A combo like that might be worth discussing with your pdoc if you are willing to stay with Parnate. By the way, have you tried Adderall again since it pooped out? Sometimes the good effects return if you don't use Adderall every day. Did you try Provigil? Some people find it quite stimulating and it can (I think) be combined with Parnate with no problem.
>
I don't know what to do really. Whether I should add something to the Parnate or lose the Parnate altogether. I did go back on the Adderall and it does help keep me awake that is all it does and it is not working like it was the first week I was on it. I also get headaches and I suspect the med combo isn't helping. I hear people get really bad headaches will provigil. I want something that will lift my mood and not just make me more awake.I don't know what to do next.
Maxime
>
Posted by Maxime on July 14, 2004, at 20:24:33
In reply to Re: Stimulating TCA?, posted by rod on July 14, 2004, at 5:50:43
Thanks Rod, I need all the luck I can get. :)
Maxime
> hi
>
> I also think Desipramine is a good choice from the "TCAs". Nortriptyline might be too sedating.
> Some people find Imipramine also very stimulating.
> I think you just have top try out and see how you react...
>
> good luck
> Roland
Posted by King Vultan on July 15, 2004, at 7:57:54
In reply to Re: Stimulating TCA? -Todd, posted by Maxime on July 14, 2004, at 20:17:28
> What is anticholinergic mean?
>
> Maxime
>
Anticholinergic means it blocks acetylcholine receptors, which can generate these side effects:1) Dry mouth
2) Constipation
3) Urinary hesitation/retention
4) Tachycardia (fast heartbeat)
5) Blurry vision
6) (male) Erectile dysfunction
7) Decreased lacimation (dry eyes)
8) Cognitive and memory problems
9) Aggravation of glaucoma
10) Photophobia (intolerance of light)
11) Decreased sweatingOf these, I suffered from the first three on nortriptyline, the first four on desipramine, and the first six on protriptyline. I also had some cognitive issues on nortripytline but honestly don't know if it was due to the sedation of the drug or some type of anticholinergic effect. Keep in mind that blocking norepinephrine reuptake can also generate tachycardia, and this no doubt played some role in the tachycardia I experienced on desipramine and protriptyline.
Todd
Posted by King Vultan on July 15, 2004, at 9:13:06
In reply to Re: Stimulating TCA? -Todd, posted by Maxime on July 14, 2004, at 20:17:28
Actually, now that I think of it, I did not suffer urinary hesitation/retention on nortriptyline; this effect was blocked by nortriptyline's alpha-1 adrenergic blockade. However, that's a long and tedious story.
Todd
Posted by Sad Panda on July 15, 2004, at 19:16:34
In reply to Stimulating TCA?, posted by Maxime on July 13, 2004, at 19:28:26
Hi Maxime,
How much Parnate are you taking? You might just need more of it.
If you want to add a TCA I would choose Doxepin, Nortriptyline or Desipramine depending on how well you are sleeping.
Cheers,
Panda.
Posted by Maxime on July 15, 2004, at 21:05:03
In reply to Re: Stimulating TCA? » Maxime, posted by Sad Panda on July 15, 2004, at 19:16:34
80 mg of Parnate. I've tried to take more but it doesn't improve the depression.
Maxime
> Hi Maxime,
>
> How much Parnate are you taking? You might just need more of it.
>
> If you want to add a TCA I would choose Doxepin, Nortriptyline or Desipramine depending on how well you are sleeping.
>
> Cheers,
> Panda.
>
Posted by Sad Panda on July 16, 2004, at 0:21:13
In reply to Re: Stimulating TCA?, posted by Maxime on July 15, 2004, at 21:05:03
> 80 mg of Parnate. I've tried to take more but it doesn't improve the depression.
>
> Maxime
>
>
> > Hi Maxime,
> >
> > How much Parnate are you taking? You might just need more of it.
> >
> > If you want to add a TCA I would choose Doxepin, Nortriptyline or Desipramine depending on how well you are sleeping.
> >
> > Cheers,
> > Panda.
> >
>
>How high did you go & how long did you take it for? Parnate besides being a MAOI is also a stimulant. If you are use to the MAOI diet, I would try Selegiline too.
Cheers,
Panda.
This is the end of the thread.
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