Posted by Robert35 on May 28, 2006, at 16:16:14
In reply to Re: Cymbalta vs imipramine » Robert35, posted by circusboy on May 27, 2006, at 21:48:34
Hi Circusboy,
> .. Writing was especially excruciating, as was > any sort of task that required sustained
> attention (following recipes, pushing data
> around at work). My head was constantly buzzing > with incoherent half-thoughts as well, and I was > perpetually anxious.The way you describe it is even more familiar than I put it in my earlier post... now you guess what does that mean ;) ?
> My psychiatrist prescribed Ritalin
> (methylphenidate), which helped *tremendously*. > If you decide to stick with Prozac, I strongly
> recommend a stimulant (doctor willing, of
> course).
>I didn't do much reading on stimulants and ADD drugs till now (because I suspect they are not easily prescribed anywhere (and Dutch doctors have a reputation to keep to prescribe as little as possible) but I guess it works by augmenting Prozac with a DA (and possibly a nor-epinephrine ) action ?
My plan is to try nortryptiline first (against pain) together with the Prozac and see what it will do (with or without P.); I will do some further reading and keep this in mind (thanks for mentioning!).
If I can convince my pain doc that it is working against pain he is willing to prescribe I guess (he almost solely works with meds).
(I am not seeing a pdoc now.)> However, I don't think you should stick with
> Prozac. Early this year I tapered off Prozac
> (for, as it turns out, probably specious
> reasons: I blamed the drug for sexual issues
> when it was probably just anxiety in a new
> relationship) and on to, as it were,
> desipramine. Over the course of several weeks
> my anxiety almost disappeared and my
> concentration improved dramatically. I was
> amazed. Unfortunately, it turned out I couldn't > sleep on a theraputic (for me: ~50mg) dose of
> desipramine and had to stop. I tried
> nortriptyline next. Couldn't tolerate that,
> either: I slept very well and my mood was
> starting to improve, but it caused some serious > memory and cognitive disturbances.
>
> I quit antidepressants altogether, and just
> stuck with Ritalin at 25-30mg/day. *The anxeity > and cognitive problems I had on Prozac did not
> return!* I truly thought it was the desipramine > conferring all those benefits, but it turns out a > lot of it came just from *stopping Prozac*.
>
> Now, I'm not anti-Prozac. In fact, it was one
> of only two SSRIs that actually worked for me
> (the other was sertraline), and I thought I'd be > on it for the rest of my life. It had helped me > quite a bit in the past. My guess is that
> Prozac, over the long term, supresses
> dopamanergic neurotransmission and causes
> anxeity through direct agonism at the 5HT2C
> receptor, as well as by simply increasing
> extracellular serotonin. (Please correct and/or > add to my hypothesis if you've got any ideas). > This would at least help explain the cognitive
> issues.This would be such a nice solution (just one easy tolerable med.) but is there no habituation to Ritalin (or can it poop out) ?
>
> What were/are the primary symptoms of your depression? Not that the dots are easily connected, but it's at least a place to start.
>
> -cbActually I started a.d's 14 years ago because of excruciating pain I have since 17 years.
I also experienced lots of trouble going to sleep, waking up, trouble concentrating and being easily irritated, not being able to get ahead in my life (I had to make some choices and each attempt failed).
I have had a two depressive episodes in my teens, which were not treated so it is a mixted picture (so to speak).
I have to leave it at this (getting late here), thanks again for your input,
best regards,Robert
poster:Robert35
thread:646652
URL: http://www.dr-bob.org/babble/20060525/msgs/649810.html