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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by denise1966 on October 14, 2005, at 6:59:55
Hi,
Is it really going to be another 5 to 10 years before they bring out a new class of drugs for depression.
I'm starting to feel crap again and need to have something to hang on to.
Please tell me it won't be that long somebody.
Thanks....Denise
Posted by SLS on October 14, 2005, at 11:05:03
In reply to Need something to hope for., posted by denise1966 on October 14, 2005, at 6:59:55
Hi Denise.
I don't think there is anything radically different that is due to appear this year. The Emsam patch is due to come out next year, I believe. It is a new transdermal delivery system for an old drug, selegiline (deprenyl, Eldepryl). Selegiline is a MAOI that is selective at low dosages for the MAO-B enyzme and used previously for Parkinsons Disease. People who have tried Emsam have said that it works for depression better than the oral preparation. I don't know what dosages are used. Perhaps they are high enough to allow for MAO-A to be inhibited too.
Agomelatine is an interesting drug that should appear in Europe within a year. It is a melatonin receptor agonist and an antagonist at 5-HT2c receptors. This is quite different from anything else being marketed.
Gepirone might yet make it to market as the drug company has submitted new data to the FDA. It is a cousin of Buspar and is said to have antidepressant properties. Like Buspar, it is a 5-HT1a partial agonist.
You can find other submissions at:
http://www.neurotransmitter.net/newdrugs.html
Phase III drugs are considered imminent, but can still take 2 years to come through.
I guess a good question to ask yourself is, which existing drugs are new to you?
Have you tried both Nardil and/or Parnate? Have you combined either drug with another antidepressant like desipramine or Wellbutrin?
Have you tried adding lithium or thyroid?
Have you tried adding an anticonvulsant mood stabilizer? Which ones?
- Scott
Posted by denise1966 on October 14, 2005, at 14:11:50
In reply to Re: Need something to hope for. » denise1966, posted by SLS on October 14, 2005, at 11:05:03
Hi Scott,
Thanks for the suggestions. I would consider selegeline patch but my experience with Nardil has put me off a bit.
Also, I must say that I suffer from agitated unipolar depression not bipolar so the mood stablers don't really work for me as I don't need to be stabalised I need to be lifted.
I am impatient when it comes to drugs as I like to feel something happening at least after I take the first dose. Anyway, here is a list of the drugs I have tried as of 24 years of age.
By the way, when are you going to try out Mifeprestone, I keep hoping you will.
Age 24 – 28
Prothiaden, Lowest dose
Response – Worked very quickly (not placebo), no side effects except initially very drowsy, but the positive effects started almost straight away (This was not a placebo effect), felt better than I had in years, more energetic, relaxed, improved sleep. Started enjoying life again.
Age 29 – 32.
Seroxat (20mg) and later Sertraline (50mg)
Response – Again worked really quickly, side effects were stomach upset and initial loss of appetite and diarreah slightly wired at first, legs slightly weak. But again felt the positive effects within about 4 days, so although slightly wired felt the depression lift.
Age 32
Came off medication.
Depression started again aged 35 (2001)
Since then:-
Seroxat (Paxil) 20mg – approx 4 weeks
Response – Suicidal. Severe agitation, felt awful, felt like I was outside myself, initially pacing up and down. No lifting of depression.Remeron (Mirtazapine) 15mg – Approx 4 weeks.
Response – Suicidal. As above, but this time with an appetite and better sleep. Very agitated at times. No lifting of depression.Prothaiden (Pushed dose right up to max dose) and added Prozac. (Over a month)
Response – after pushing the dose of prothaiden and prozac to max, had a seizure.Prozac and lithium (Over 1 month)
No response.
April 20th to June 25th 2002
100mg of Effexor.
Response – Not so agitated, eat more and sleep more but still depressed.
June 25th to August 19th
50mg Sertraline (Zooloft) plus 50Mg Lamictal.
Response – Not so agitated but still feel depressed.
June 14th to to November 14th November
50 mg of Lamictal.
Response – No side effects. No response that I am aware of. Crying more.
14th November to 29th November
100 mg of Lamictal.
Response – As above.
29th November to 13 December
150 mg of Lamictal
Response – As above.
13th December to around February 2003
200 mg of Lamictal.
Response – As above.
Worse always around the time of my period.
Also tried tegretol for a short period of time - didn't feel like I was taking anything.
February 2003
Tried (Nardil) phenelzine for about a month. Felt like I was in a trance on it.
March 2003
40mg of Seroxat after about 4 days on it felt my depression start to lift a bit, started going out again, socialising and performing better at work. Even went on holiday to Goa.
December 2004 - Current Day
Seroxat 40mg - Starting to get breakthrough anxiety, numbness, apathy, lack of motivation and stop wanting to go out again.
Tried Nardil again in between taking Seroxat and was in a trance like state again.
Have tried taking Wellbutrin just for a couple of days but didn't feel anything.
Have also tried Buspar for a few days which made me feel very apathetic.
I'm going to ask the Psychiatrist when I see him to let me try thyroid hormones but as I'm from the UK I think that highly unlikely.
I'm not very optimistic about seeing this new psychiatrist on the NHS because when I rang to find out why I'd not heard anything about an appointment I was told by his secretary that he'd referred me back to my Doctor saying I should see a Psychiatric Nurse instead.
Anyway, after going on at the secretary she told me that he's now "willing" to see me on monday at 14:00pm so it sounds as though he doesn't even want to see me in the first place!
Kind Regards.....Denise
Posted by ed_uk on October 14, 2005, at 15:47:42
In reply to Re: Need something to hope for., posted by denise1966 on October 14, 2005, at 14:11:50
Hi Denise,
I'm not sure you need to worry about whether there are any new ADs in development just yet. There are so many established ADs you haven't tried.
I wouldn't recommend trying another SSRI. I think you should try some more tricyclics.
~ed x
Posted by SLS on October 14, 2005, at 16:05:41
In reply to Re: Need something to hope for., posted by denise1966 on October 14, 2005, at 14:11:50
Hi Denise.
I'm currently visiting a friend in Minnesota, so I really don't know what's going on with mifepristone. I would have tried it a month ago had the FDA granted my doctor permission to dispense it. I think there is a misunderstanding as to what is actually required. It's been a bit of a mess, but I still look forward to trying mifepristone. It might come to my having to use a different doctor whose participation can be overseen by an institutional review board. This normally means that the doctor must be affiliated with a university or perhaps be on the staff of a hospital that has one set up.
What I may do in the meantime is try taking dexamethasone for a few days. There is some precedence for doing this for people who are hypercortisolemic.
As for you, my best advice is to avoid evaluating drugs based on how you react to them during the first week. With as many drugs as you have tried, it is becomes imperative to give each treatment an adequate trial. I would return to Wellbutrin if I were you as long as you tolerated it well for the short time you took it. 300mg is practically mandatory. Wellbutrin makes for a good adjunct to other drugs if nothing else.
I would recommend starting at very low dosages of any drug and increase it very gradually so as to minimize startup side effects. These side effects seem to discourage you from continuing with treatment when they might in the end be of little consequence. You have not allowed yourself to work up to therapeutic dosages on quite a few drugs. You have also aborted treatment too early on most of them. You will very likely have to go back and retry these drugs.
You have so many options, I don't know where to start!
PERMUTATIONS. One would like to reduce the number of permutations to try by adding together as many drugs as is safe.
It might make sense to give nortriptyline 75mg a try immediately. If necessary, add Wellbutrin 300mg. If necessary, add Effexor 150-300mg. If necessary, add lithium 300-600mg. This will cover quite a bit and save a lot of time.
Don't discard mood-stabilizers or neuroleptics as adjuncts. You don't have to be bipolar or psychotic to benefit from these drugs. I would at some point try to establish lithium at dosages between 300-600mg. If you feel dysphoric or experience a flat affect after two weeks, you can cross it off your list. If not, you can continue taking it as you move through drug trials. Parnate + lithium / Lamictal can be a potent combination. You can even take Wellbutrin, nortriptyline, or desipramine in combination with Parnate. This is, of course, an aggressive treatment that most doctors will refuse to administer.
I think you should consider building a treatment around either an MAOI or Wellbutrin. The advantage to using the MAOI is that it probably has the best chance of getting you well. The disadvantage is that you cannot introduce drugs that inhibit the reuptake of serotonin with it. On the other hand, almost anything will mix safely with Wellbutrin.
Besides Lamictal, try and find a mood-stabilizer that agrees with you. Depakote and Trileptal are good choices. So now, you are taking Wellbutrin, lithium, and Trileptal. You are tolerating the combination well, but are not gaining an adequate antidepressant response. Now you start adding in your second antidepressant. Effexor would be my first choice. You still need to try Zoloft 200mg, so that might be next. If that doesn't work, I would keep all the drugs in place and add a third antidepressant - a tricyclic. I think nortriptyline at a dosage of 75mg would be best.
If you are experiencing absolutely no benefit, I would suggest discontinuing the antidepressants, retain the lithium and mood stabilizers, and add an MAOI.
You know, there are people who are biologically bipolar who never experience mania. Many people whom display depression only are of course treated as unipolar. It is only when these people fail multiple antidepressant treatments does it then dawn on the physician that he might be dealing with an unusual bipolar presentation and subsequently treat the patient successfully by adding mood stabilizers.
Are you bipolar or unipolar? Who cares? If you pretend that you are bipolar, you will have a better chance of getting well. You may have to revisit Wellbutrin, Prozac, Zoloft, Seroxat, and Remeron for lack of adequate trials (inadequate dosages and inadequate trial periods).
This has not been a well-composed post. It is more of a ramble so that you could gain some insight into previous treatment failures and future treatment successes.
- Scott
Posted by UgottaHaveHope on October 14, 2005, at 18:49:32
In reply to Need something to hope for., posted by denise1966 on October 14, 2005, at 6:59:55
Have you tried the MAOIs? Have you tried every SSRI? Have you tried natural herbs? Have you gone to see a pdoc? Have you worked on your thoughts?
Please, please, don't ever give up hope. There are new drugs or new forms ofd current drugs (the XRs) coming out every few months. Within five years, docs hope to be able to get a blood sample and be able to tell you exactly what drug will lift you from your depression.
Just know that there are ppl ion here that have been far worse off than you and they have gotten better. You have a desire to get better because you are posting. It doesn't happen overnight. It takes time. There are people in here that care for you and want to help. Please keep posting.
Posted by Tom Twilight on October 15, 2005, at 5:02:27
In reply to Re: Need something to hope for., posted by denise1966 on October 14, 2005, at 14:11:50
Hey Denise
I'm sorry your having such a rough time
I for one am very grateful for the help you have given me, and want you to get well!
As Ed says there are lots of drugs (and combinations of drugs) that you could try, and you haven't, as yet.
You probably need to be on at least two drugs, one for anxiety one for depression.
You don't seem to have responded spectacularly to SSRIs of MAOIs, so tryciclics might be a good idea.
For depression you could try something like Lofepramine, I haven't tried it, but a lot of people seem to respond well. You could take Zyprexa or Seroquell for anxiety with the Lofepramine.For me a combination of Mirtazapine and Effexor worked extremely well for depression, although it didn't help anxiety.
Maybe you could try this combination with a third drug for anxietyI'm currently taking 50mgs of Marplan/Isocarboxazid, which is working well for anxiety and depression.
Marplan supposedly has less side effect than Nardil, and is less sedating. I certainly find it quite benign in terms of side effects, although I've never tried Nardil.Lastly you could try Clomipramine, the most Serotogenic of the Tryciclics.
It has lots of side effects, but I found it very effective for anxiety, and reasonably effective for depression.
It works so well for anxiety that it would hopefully elmininate the need for two medications.
You have to increase the dose slowly however, to get your body to ajust to the side effects.
Posted by ravenstorm on October 18, 2005, at 9:21:58
In reply to Re: Need something to hope for., posted by Tom Twilight on October 15, 2005, at 5:02:27
Denise, have you tried doxepin? Would that be similar to the other TCA you were on that worked so well the first time?
I tried to start a topic about the two TCA's but no one has responded to it.
Posted by denise1966 on October 19, 2005, at 3:51:17
In reply to Re: Need something to hope for. » denise1966, posted by SLS on October 14, 2005, at 11:05:03
Hi Scott,
Thanks for this info. Yes, I have tried Lithium, had quite a flat affect from it.
Tried Nardil and didn't like it, although it relaxed me, it put me in a trance like state.
I'm going to try and persuade my new psychiatrist to let me try adding a thyroid hormone.
So we'll see how that goes.
Thanks again.
Denise
Posted by denise1966 on October 19, 2005, at 3:54:00
In reply to Re: Need something to hope for. » denise1966, posted by ed_uk on October 14, 2005, at 15:47:42
Hi Ed,
hmmmm, well I took prothiaden (dothiapin) which is a tricyclic at 300mg to no avail and that one used to work really well for me at 75mg years ago.
So I'm sort of finished with tricyclics but who knows maybe I'll give another one a try later down the line.
Have you any experience taking tricyclics yourself?
Denise
Posted by denise1966 on October 19, 2005, at 4:04:58
In reply to Re: never GIVE UP, posted by UgottaHaveHope on October 14, 2005, at 18:49:32
Hi,
Yes I've tried Nardil and a few SSRIs and tricyclics and Mirtazapine and Effexor and others.
Thanks for your encouragement though, I know what your saying its just that sometimes it gets so fustrating.
I want something that works and works quickly, I don't want to waste another day to depression.
Thanks again and I won't give up.
Denise
Posted by denise1966 on October 19, 2005, at 4:13:33
In reply to Re: Need something to hope for., posted by Tom Twilight on October 15, 2005, at 5:02:27
Hi Tom,
Thanks for those suggestions :-)
I have tried prothiaden (which is a tricyclic) but I'll bear the clomipramine in mind later down the line if I don't find anything else.
Haven't heard of lofepramine but I'll look it up.
I have thought of Effexor and Mirtazapine, what doses did you have to take to get a response and why did you stop it, because of the anxiety?
Denise
Posted by denise1966 on October 19, 2005, at 4:28:54
In reply to Re: Need something to hope for., posted by ravenstorm on October 18, 2005, at 9:21:58
Hi Ravenstorm,
I think Dothiepin = Prothiaden and Doxepin = Sinequan, they're both similiar I think.
Prothiaden did really help me years ago but not this time round. I've never tried any other tricyclics so can't really compare.
Kind Regards....Denise
Posted by denise1966 on October 19, 2005, at 4:44:37
In reply to Re: Need something to hope for. » denise1966, posted by SLS on October 14, 2005, at 16:05:41
Hi Scott,
Thanks for the ramble :-) I hope you get to try mifepristone soon in the meantime good luck with the Dexamethasone.
Thanks for your advice but I'm not prepared to stick out 6 weeks of a drug only to find it doesn't work and then switch to another. In my experience when drugs have worked they've worked within a couple of weeks at least.
When I first ever took prothiaden it worked within a couple of days, same with Seroxat. Two years ago when I went straight onto a higher dose of Seroxat it started to work within about 4 days although not as well.
I def don't want to start any doses on a low dose as it takes too much time and I still get side affects, I'd rather start high and take Zyprexa for the side affects as I feel that nowadays I need higher doses.
I think you're right in saying that I may need to go back and retry other drugs but rather than giving them a longer try, I need to increase the start up dose. That's my gut feeling anyway.
I might give Wellbutrin another try at 300mg but If I do I'll only give it a week. Thing is I hope I don't get a seizure or pass out on it as I did once with high dose of prothiaden and Sertraline.
Mood Stablizers really don't do a thing for me, I took quite a high dose of lamictal and lithium for a long time and felt pretty much nothing on them.
I will always keep neuroleptics in mind as Zyprexa has helped me so much in the past but I like to keep it as my "rainy day" "savings in the bank" drug.
Anyway, thanks again for the post and I hope you get some response from dexamethasone when you take it.
I wish they did trials of mifepristone for unipolar here in the UK but I've already enquired and they don't.
Kind Regards....Denise
> Hi Denise.
>
> I'm currently visiting a friend in Minnesota, so I really don't know what's going on with mifepristone. I would have tried it a month ago had the FDA granted my doctor permission to dispense it. I think there is a misunderstanding as to what is actually required. It's been a bit of a mess, but I still look forward to trying mifepristone. It might come to my having to use a different doctor whose participation can be overseen by an institutional review board. This normally means that the doctor must be affiliated with a university or perhaps be on the staff of a hospital that has one set up.
>
> What I may do in the meantime is try taking dexamethasone for a few days. There is some precedence for doing this for people who are hypercortisolemic.
>
> As for you, my best advice is to avoid evaluating drugs based on how you react to them during the first week. With as many drugs as you have tried, it is becomes imperative to give each treatment an adequate trial. I would return to Wellbutrin if I were you as long as you tolerated it well for the short time you took it. 300mg is practically mandatory. Wellbutrin makes for a good adjunct to other drugs if nothing else.
>
> I would recommend starting at very low dosages of any drug and increase it very gradually so as to minimize startup side effects. These side effects seem to discourage you from continuing with treatment when they might in the end be of little consequence. You have not allowed yourself to work up to therapeutic dosages on quite a few drugs. You have also aborted treatment too early on most of them. You will very likely have to go back and retry these drugs.
>
> You have so many options, I don't know where to start!
>
> PERMUTATIONS. One would like to reduce the number of permutations to try by adding together as many drugs as is safe.
>
> It might make sense to give nortriptyline 75mg a try immediately. If necessary, add Wellbutrin 300mg. If necessary, add Effexor 150-300mg. If necessary, add lithium 300-600mg. This will cover quite a bit and save a lot of time.
>
> Don't discard mood-stabilizers or neuroleptics as adjuncts. You don't have to be bipolar or psychotic to benefit from these drugs. I would at some point try to establish lithium at dosages between 300-600mg. If you feel dysphoric or experience a flat affect after two weeks, you can cross it off your list. If not, you can continue taking it as you move through drug trials. Parnate + lithium / Lamictal can be a potent combination. You can even take Wellbutrin, nortriptyline, or desipramine in combination with Parnate. This is, of course, an aggressive treatment that most doctors will refuse to administer.
>
> I think you should consider building a treatment around either an MAOI or Wellbutrin. The advantage to using the MAOI is that it probably has the best chance of getting you well. The disadvantage is that you cannot introduce drugs that inhibit the reuptake of serotonin with it. On the other hand, almost anything will mix safely with Wellbutrin.
>
> Besides Lamictal, try and find a mood-stabilizer that agrees with you. Depakote and Trileptal are good choices. So now, you are taking Wellbutrin, lithium, and Trileptal. You are tolerating the combination well, but are not gaining an adequate antidepressant response. Now you start adding in your second antidepressant. Effexor would be my first choice. You still need to try Zoloft 200mg, so that might be next. If that doesn't work, I would keep all the drugs in place and add a third antidepressant - a tricyclic. I think nortriptyline at a dosage of 75mg would be best.
>
> If you are experiencing absolutely no benefit, I would suggest discontinuing the antidepressants, retain the lithium and mood stabilizers, and add an MAOI.
>
> You know, there are people who are biologically bipolar who never experience mania. Many people whom display depression only are of course treated as unipolar. It is only when these people fail multiple antidepressant treatments does it then dawn on the physician that he might be dealing with an unusual bipolar presentation and subsequently treat the patient successfully by adding mood stabilizers.
>
> Are you bipolar or unipolar? Who cares? If you pretend that you are bipolar, you will have a better chance of getting well. You may have to revisit Wellbutrin, Prozac, Zoloft, Seroxat, and Remeron for lack of adequate trials (inadequate dosages and inadequate trial periods).
>
> This has not been a well-composed post. It is more of a ramble so that you could gain some insight into previous treatment failures and future treatment successes.
>
>
> - Scott
Posted by SLS on October 19, 2005, at 7:56:25
In reply to Re: To SLS, posted by denise1966 on October 19, 2005, at 3:51:17
> Tried Nardil and didn't like it, although it relaxed me, it put me in a trance like state.
It did the same thing to me for a couple of weeks before it began to work.
- Scott
Posted by Pfinstegg on October 19, 2005, at 8:20:03
In reply to Re: To SLS » denise1966, posted by SLS on October 19, 2005, at 7:56:25
I think looking into Cytomel is a great idea. I take tiny amounts of it three times a day. It has such a short half-life that you do tend to feel a lift and then a let-down, but this is hardly noticeable when you take it three times a day. My endo was aiming to bring my TSH level down to around 0.5, which he said is optimal for depression- and an important adjunct in treating it. I'm presently 0.38. You do need to take all the preventive measures for osteoporosis when you do this - even if you are young- i.e. Calcium, Magnesium, Vitamin D, occasional bone scans- and Fosamax or Actonel if you begin to develop even a tiny amount. I think it's really helpful. I also find Wellbutrin helpful- 37,5 mg. three times a day of the regular formulation- it's got a short half life unless you take the sr (that gave me hypertension, which is why I'm doing it this way). I think it helps a lot, too. One thing- you have saqid that it's very hard for you to wait 6-8 weeks to see if an AD works. Cytomel and Wellbutrin work within a half hour of taking them, so you'll know right away!
All the best to you..
pfin
Posted by SLS on October 19, 2005, at 9:03:23
In reply to To SLS, posted by denise1966 on October 19, 2005, at 4:44:37
> Thanks for your advice but I'm not prepared to stick out 6 weeks of a drug only to find it doesn't work and then switch to another.
I'm afraid that this is the nature of the beast.
Without a crystal ball or some other assurance that you will always respond to all drugs in the future the way you had to a few in the past, I'm afraid that 4-8 week trials are indicated as the only sure way to properly evaluate the efficacy of a drug and what the persistent side effects will be.
> In my experience when drugs have worked they've worked within a couple of weeks at least.
This had been my experience also up until I experienced my only true remission. At this time, I would say that it took a minimum of 3 weeks to begin to notice a subtle improvement and another 6-8 weeks to reach a state of remission. Despite this, I was only willing to give drugs 2-3 weeks each to work subsequently after I relapsed. This was illogical. However, my impatience and the pretentious and mistaken notion that I had figured out my own biological constitution and response pattern impelled me to continue with 2-3 week trials, despite encouragement by my doctors to extend them to 6 weeks.
> When I first ever took prothiaden it worked within a couple of days, same with Seroxat. Two years ago when I went straight onto a higher dose of Seroxat it started to work within about 4 days although not as well.
It might be true for you that every drug that you will go on to respond to shows evidence of therapeutic effect within 2 weeks. I have no real way of knowing. The deal is this: with each drug that you try, fewer and fewer remain as alternatives. The fewer that remain as alternatives, the more compelled you will be to give each drug more time to work. The closer you get to exhausting the remaining drug alternatives, the more you will be compelled to go back and retry some of them for an extended period of time at higher dosages. It is possible that you will need spend only another 2 weeks in a state of depression to get well with the next drug chosen. On the other hand, it is possible that you are skipping over drugs that would take 4 weeks to be effective, and you would never know which ones. If this is true, it might take you years before you get around to trying them again for the 4-6 week trials they require.
If you decide to go with it, I would recommend that you give Wellbutrin at least 6 weeks. I would also recommend that you give any one dosage a minimum of 3 weeks to evaluate for efficacy and side effects. I try to use this as a guideline for any antidepressant I try.
You might want to titrate Wellbutrin to 300mg over the course of two weeks to obviate startup side effects like anxiety, irritability, cognitive fogginess, or even dysphoria. You would then complete another 3 weeks at 300mg and be prepared to evaluate your progress during week 5. If there is ANY improvement, you could then justify another 3 weeks.
My guess is that you are resistent to these suggestions and the therapeutic logic behind them. You might even be defensive and angry at me right now. However, I feel strongly enough about this so as to implore you to give Wellbutrin a truly adequate trial.
It looks like I'll be trying dexamethasone in a few days. Thanks for the kind words of encouragement.
:-)
- Scott
Posted by ed_uk on October 19, 2005, at 13:31:43
In reply to Re: To Ed, posted by denise1966 on October 19, 2005, at 3:54:00
Hi Denise,
What side effects did you have from Prothiaden?
>Have you any experience taking tricyclics yourself?
Yes, I've taken dothiepin, amitriptyline and lofepramine (Gamanil).
~Ed xx
Posted by ravenstorm on October 20, 2005, at 11:55:24
In reply to Re: To Ed » denise1966, posted by ed_uk on October 19, 2005, at 13:31:43
What is the difference between prothiaden and doxepin?
Posted by ed_uk on October 20, 2005, at 14:14:13
In reply to Re: To Ed, posted by ravenstorm on October 20, 2005, at 11:55:24
Hi R,
Dothiepin (Prothiaden) and doxepin (Sinequan) are both sedating tricyclic antidepressants. Doxepin is a more potent antihistamine than dothiepin, and tends to be more sedating.
For a long time, dothiepin was the most widely prescribed antidepressant in the UK. Dothiepin is not marketed in the US.
The new international name for dothiepin is dosulepin.
Chemically, dothiepin, amitriptyline (Elavil) and doxepin differ by one atom only.
Kind regards
~ed
Posted by ravenstorm on October 20, 2005, at 17:29:03
In reply to Re: To Ed » ravenstorm, posted by ed_uk on October 20, 2005, at 14:14:13
Ed thanks so much. Do you think amitryptilline is more or less sedating than dothiepin?
I was looking up on Scott's table of psychiatric drugs and it didn't even show a histamine block for dothiepin which is what confused me.
Do all the TCA's lower your blood pressure?
Posted by ed_uk on October 21, 2005, at 14:07:08
In reply to Re: To Ed, posted by ravenstorm on October 20, 2005, at 17:29:03
Hi R,
>Do you think amitryptilline is more or less sedating than dothiepin?
I find them similar.
>Do all the TCA's lower your blood pressure?
They all can do. Nortriptyline is less likely to lower BP than any of the other TCAs.
Kind regards
~Ed
This is the end of the thread.
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