Posted by zeugma on May 11, 2003, at 19:23:44
In reply to Do TCA's cause depersonalization (like Efexor)?, posted by Tiina on May 11, 2003, at 15:17:25
> Hi everybody!
> I'm really starting to hate Efexor. It's been the only drug that's made my depression go away but it's also made me depersonalized. I've just completely lost my sense of identity. In addition I'm really impatient and rude and don't feel alive and my sleep is disturbed etc. etc. I was wondering if tricyclics often cause depersonalization like the newer stuff seems to do? I would really like to get rid of this feeling. It's like since my feelings are not in the way I can talk about everything and anything which I couldn't do before because of shame and guilt etc. but talking about things like that doesn't get me anywhere! I guess neuroleptics are supposed to help with distorted conceptions and stuff so I don't need my anti-depressant to suppress me. So does anybody know if tricyclics work "more gently"?
> TiinaSSRI's seem to do a good job making people apathetic even as they become less depressed. Not necessarily an ideal tradeoff, especially in the long term, which is why I do not think SSRI's are the best option for chronic depression. Effexor is basically an SSRI that also becomes noradrenergic at higher doses, so it tends to cause the same problems as SSRI's with added complications. On the other hand it is generally a more effective antidepressant.
TCA's, on the other hand, are primarily noradrenergic drugs. Even the more serotonergetic ones like amitriptyline or clomipramine are metabolized to norepinephrine-selective compounds. Their actions, in fact, are so complex it's no wonder they don't flood the brain with one transmitter like SSRI's. Someone who has experienced newer noradrenergic drugs like Strattera or reboxetine could comment usefully on the contrast between norepinehrine- and serotonin- selective reuptake inhibitors. But there doesn't seem to be the apathy-inducing aspect to these drugs, either.
Also (thinking about the contrast between TCA's and Effexor) Effexor seems to be activating for most people and can disturb sleep. TCA's have a sedating effect which seems to balance the stimulating effect of norepinephrine reuptake inhibition. As others have said, there's something to be said for dirty drugs.
poster:zeugma
thread:225855
URL: http://www.dr-bob.org/babble/20030505/msgs/225917.html