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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Bob on March 5, 2009, at 23:57:33
Scott,
I may have missed it, but I was wondering how your switch to desipramine from nortriptyline was going. I remember you saying you were going to make the change because you felt you had gained too much weight on nortriptyline.
I am currently on nortriptyline and have gained a good amount of weight in 5-6 months.
Bob
Posted by SLS on March 6, 2009, at 6:30:52
In reply to Question for Scott (SLS), posted by Bob on March 5, 2009, at 23:57:33
Hi Bob.
> I may have missed it, but I was wondering how your switch to desipramine from nortriptyline was going. I remember you saying you were going to make the change because you felt you had gained too much weight on nortriptyline.
>
> I am currently on nortriptyline and have gained a good amount of weight in 5-6 months.
>
> BobI have not felt well since making the switch to desipramine, presumably because I have been well short of my therapeutic dosage, which seems to be 300mg. I was underdosed for over two months. My doctor finally consented for me to raise the dosage of desipramine to 300. That was eight days ago. I am beginning to feel better, but I had hoped that I would spring right up and feel great. No such luck. So, I need to be patient and keep my fingers crossed.
It seems that I must still struggle to take the weight off that I had put on while taking nortriptyline. I think the Abilify is working against me.
Where are you at with things?
- Scott
Posted by Bob on March 6, 2009, at 10:37:38
In reply to Re: Question for Scott (SLS) » Bob, posted by SLS on March 6, 2009, at 6:30:52
> Hi Bob.
>
> > I may have missed it, but I was wondering how your switch to desipramine from nortriptyline was going. I remember you saying you were going to make the change because you felt you had gained too much weight on nortriptyline.
> >
> > I am currently on nortriptyline and have gained a good amount of weight in 5-6 months.
> >
> > Bob
>
>
>
> I have not felt well since making the switch to desipramine, presumably because I have been well short of my therapeutic dosage, which seems to be 300mg. I was underdosed for over two months. My doctor finally consented for me to raise the dosage of desipramine to 300. That was eight days ago. I am beginning to feel better, but I had hoped that I would spring right up and feel great. No such luck. So, I need to be patient and keep my fingers crossed.
>
> It seems that I must still struggle to take the weight off that I had put on while taking nortriptyline. I think the Abilify is working against me.
>
> Where are you at with things?
>
>
> - Scott
Hey Scott,Sorry to hear you're having trouble with the new cocktail. I know at least some of your pain with that.
My situation is somewhat untenable, as usual. I'm still taking Nortriptyline, Citalopram and Pramipexole - all in minimum therapeutic doses. The Mirapex is causes bouts of daytime sleepiness which was not entirely unexpected, but still disappointing. I'm starting to gain mad weight which I would at least reflexively blame on the the Nortriptyline.
I'm reluctant to go up on any of the meds as I may get into an experimental study which would preclude playing with the meds. Nevertheless, I think about possible changes all the time, just as I always have. I figured I may want to try that Milnacipran (approved in the US as Savella) since it has the high norepinephrine to serotonin reuptake ratio, in which case I would discontinue both the Citalopram and Nortriptyline. Big change. Another idea is to try a different dopamine agonist, or possibly Abilify again, but the latter is sort of scary for me. Last go 'round it seemed to cause joint pain and agitation despite an extraordinarily low dose.
You mentioned that Abilfy might be part of your problem. How so?
Bob
Posted by SLS on March 6, 2009, at 14:18:36
In reply to Re: Question for Scott (SLS) » SLS, posted by Bob on March 6, 2009, at 10:37:38
> You mentioned that Abilfy might be part of your problem. How so?
I meant that the Abilify was making it difficult for me to lose the weight that I put on while taking nortriptyline.
Nothing is ever easy. Still, I don't take for granted that things can be, and have been, worse.
Hoping that you're doing okay...
- Scott
Posted by diego on March 6, 2009, at 16:49:35
In reply to Re: Question for Scott (SLS) » Bob, posted by SLS on March 6, 2009, at 14:18:36
Scott,
Don't mean to butt in, but wondered if you've ever augmented your Nardil (or is it Parnate) with either protriptyline or an amphetamine?
Before I tried MAOIs, Vivactyl was the best thing I tried.
I currently add a tiny amount (1.25 mg BID) Desoxyn to my Parnate and find it quite effective.
Diego (Seamus2)
Posted by Bob on March 6, 2009, at 20:48:17
In reply to Re: Question for Scott (SLS) » Bob, posted by SLS on March 6, 2009, at 14:18:36
> > You mentioned that Abilfy might be part of your problem. How so?
>
> I meant that the Abilify was making it difficult for me to lose the weight that I put on while taking nortriptyline.
>
> Nothing is ever easy. Still, I don't take for granted that things can be, and have been, worse.
>
> Hoping that you're doing okay...
>
>
> - Scott
I thought Abilify was supposed to be typically weight neutral.
Posted by SLS on March 7, 2009, at 6:01:43
In reply to Re: Question for Scott (SLS) » SLS, posted by Bob on March 6, 2009, at 20:48:17
> I thought Abilify was supposed to be typically weight neutral.
Me, too.
Apparantly, for me and some others, it produces moderate weight gain. It seems to sneak up on people.
- SCott
Posted by SLS on March 7, 2009, at 6:06:51
In reply to Re: Question for Scott (SLS), posted by diego on March 6, 2009, at 16:49:35
Hi Diego.
> Don't mean to butt in,
Are you kidding! You are very kind to want to offer suggestions for my healing.
> but wondered if you've ever augmented your Nardil (or is it Parnate) with either protriptyline or an amphetamine?
I have tried augmenting Parnate + desipramine with Dexedrine. I saw a few good days from it, then it fizzled out. Oddly, I never thought to try adding it to Nardil.
I did not react well to protriptyline. It made the depression significantly worse and was hell in terms of anticholinergic side effects.
Again, we see how differently we can all respond to the identical drug.
- Scott
Posted by diego on March 7, 2009, at 22:07:33
In reply to Re: Question for Scott (SLS) » diego, posted by SLS on March 7, 2009, at 6:06:51
Well, about the only other augment I can think of is reboxetine.
VERY potent NRI, so I'd be leery combining it with an MAOI. SEs are horrendous: your cremasters will go into a state of permanent contraction after a couple days (with no stimulation needed :p ) Also induces severe constipation. I found it quite activating after only a week, but had to stop due to the SEs.
Like you say, YMMV...
Best of luck.
This is the end of the thread.
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