Posted by Racer on May 15, 2008, at 14:57:46
In reply to Re: Changing medication, posted by Hobbyhawk on May 15, 2008, at 13:38:58
> Lofepramine is desipramine and my GP says they don't really prescribe it any more, because it is old-fashioned (probably something to do with cost in reality). Whether that is true for nortiptyline as well, I don't know.
It will be true of nortriptyline as well, I can virtually guarantee it.
There are several reasons why TCAs are used less frequently these days. One is that they are more dangerous in overdose than newer medications. That's just the nature of the beast -- when you're discussing medications for depression, you have to keep in mind the danger of suicide associated with depression.
Another reason, though, has to do with what we're discussing here: side effects. The TCAs as a whole tend to have more frequent and more burdensome side effects than do the newer medications. Statistically -- and a lot of people will disagree with me on this, but I'm talking statistics, not individuals -- statistically all the antidepressants are about equally effective. That means that the choice for which medication to use for any individual patient is often based on side effect profile. For many people who walk into their GP's office for a prescription, the side effects associated with the older antidepressants won't be tolerable. Those of us here tend to be more willing to tolerate some of those side effects, in order to get relief which the newer medications simply do not provide.
That's a long way of saying, "It might be worth trying another TCA, but they do have more side effects than the newer meds."
>
> I realise that these drugs all have side effects but some are so bad that they prevent me even having the limited life I have now.Oh, I hear you. I have the same issue, and battle a lot with myself over my decision not to take certain medications which might actually reduce my mood-related distress. My experience of those drugs, though, is that I was too apathetic and flat to feel any real distress -- and that just isn't good enough for me anymore. So, instead, I take medications that keep me marginally functional, I work in therapy on ways to improve my functioning -- and feel a hell of a lot of despair about my future.
It's a hard balance, and it's not a pleasant place to be. I very much hope that something I've offered helps you find an effective compromise for your situation.
poster:Racer
thread:829240
URL: http://www.dr-bob.org/babble/20080510/msgs/829263.html