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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by TriedEveryDrug on August 2, 2008, at 18:28:45
I used to take despiramine for ADD, inattentive-type.
It worked remarkably well. Unbelievably so.
But it also made me very anxious, especially socially anxious. And angry. I'd have a really short fuse.
Anyway, ssris always helped me w/ anxiety and social issues, but there is a 2d6 interaction between ssris and desipramine (ssris inhibit 2d6, which breaks down desipramine).
I did try paxil and desipramine once together - wow, it knocked me out for 3 days. Couldn't get out of bed.
I also did try lyrica w/ despiramine - made me dopey and counteracted anything the desip did. And constipated!
Anyway, has any other antidepressant been successfully combined with desipramine? I can't really take the side-effects, even at the lowest doses. Which sucks because it works so well :(
Thanks!!
Posted by Crotale on August 4, 2008, at 0:00:52
In reply to Despiramine for ADD-can anything be combined w/it?, posted by TriedEveryDrug on August 2, 2008, at 18:28:45
> Anyway, ssris always helped me w/ anxiety and social issues, but there is a 2d6 interaction between ssris and desipramine (ssris inhibit 2d6, which breaks down desipramine).
The SSRIs, Zoloft, Celexa, and Lexapro don't inhibit CYP2D6 to as great an extent as do Prozac, Paxil, and Luvox. It's possible to use the combination, preferably with one of the SSRIs that have less of an effect on this enzyme. You should only do this under your doctor's supervision, of course; you would lower your dose of desipramine, and then get your serum level tested and gradually raise the dose, continuing to monitor your desipramine levels.
You might want to get your serum desipramine level checked anyway, as some people are poor metabolizers due to a genetic mutation.
> Anyway, has any other antidepressant been successfully combined with desipramine? I can't really take the side-effects, even at the lowest doses. Which sucks because it works so well :(
MAOIs such as Nardil and Parnate can be used in combination with desipramine, since it has hardly any effect on serotonin uptake.
A number of antidepressants can be used with caution in combination with desipramine, provided desipramine serum levels are monitored.
There are also other medications that might help you besides traditional antidepressants.
-Crotale
Posted by TriedEveryDrug on August 4, 2008, at 0:19:42
In reply to Re: Despiramine for ADD-can anything be combined w, posted by Crotale on August 4, 2008, at 0:00:52
> The SSRIs, Zoloft, Celexa, and Lexapro don't inhibit CYP2D6 to as great an extent as do Prozac, Paxil, and Luvox. It's possible to use the combination, preferably with one of the SSRIs that have less of an effect on this enzyme. You should only do this under your doctor's supervision, of course; you would lower your dose of desipramine, and then get your serum level tested and gradually raise the dose, continuing to monitor your desipramine levels.
>
> You might want to get your serum desipramine level checked anyway, as some people are poor metabolizers due to a genetic mutation.
>
> MAOIs such as Nardil and Parnate can be used in combination with desipramine, since it has hardly any effect on serotonin uptake.
>
> A number of antidepressants can be used with caution in combination with desipramine, provided desipramine serum levels are monitored.
>
> There are also other medications that might help you besides traditional antidepressants.
>
> -CrotaleThanks for the info. I'll talk to my doctor about these ssris and the maois.
I've tried everything for ADD - most of the stimulants, effexor, cymbalta, strattera, other TCAs, Emsam, etc. The only thing that works is desipramine. I do want to try guanfacine too, some people are claiming it has a cognitive effect.
Posted by Crotale on August 7, 2008, at 23:30:03
In reply to Re: Despiramine for ADD-can anything be combined w » Crotale, posted by TriedEveryDrug on August 4, 2008, at 0:19:42
Which stimulants have you tried? There are quite a few of them out there.
Many people find the MAOI Parnate to have a stimulant effect. It doesn't have amphetamine metabolites but it chemically resembles amphetamine.
I've heard of the use of guanfacine and clonadine (another alpha2-agonist) for ADD. I'm not clear as to how effective they are but they have been in use for some time.
Good luck,
-Crotale
This is the end of the thread.
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