Posted by bleauberry on January 29, 2008, at 19:56:28
In reply to Anyone experience urinary problems on Desipramine?, posted by greywolf on January 28, 2008, at 19:47:50
I had bad urinary problems on desipramine, reboxetine, or milnacipran. All 3 have one thing in common...heavy increase of norepinephrine.
I don't think nortriptyline is as strong on norepinephrine because it gave me only a little problem. The others were severe.
I came here seeking help on the topic. Recently someone else told me they were taking reboxetine, they had the same urinary problems (hesitancy, stoppage) as me on milnacipran, and that the problem was cured with flomax. The explanation was that the increased norepinephrine stimulates the alpha-1 receptors causing the problems, and flomax is an alpha-1 blocker. Flomax relaxes the muscles in the bladder and prostate. It is usually prescribed for enlarged prostate.
That person used 4mg flomax which is a normal common dose. It is also available in 2mg which might be enough to do the trick.
I was also told the problem might be the anticholinergic effects. I don't think mine were, because nortriptyline has strong anticholinergic effects and did not do that to me. If the problem was anticholinergic, there was a drug suggested that is pro-cholinergic to counter it. I'm not sure but I think it was Baclofen?
The alpha-1/Flomax thing makes the most sense to me.
Whether the alpha-1 receptors would adjust on their own over time or not, I do not know. In 2 weeks of milnacipran I showed no sign of adjusting. Maybe 2 or 4 months maybe, maybe never, I really don't know. If you like desipramine or want to give it a fair trial you will probably need something like flomax to get that far.
poster:bleauberry
thread:809430
URL: http://www.dr-bob.org/babble/20080124/msgs/809627.html