Posted by KarenRB53 on January 18, 2009, at 8:43:36
In reply to Re: To Scott - Nortriptyline Not Good For Atypical » KarenRB53, posted by SLS on January 18, 2009, at 6:05:24
> Oh, crap, Karen. I never saw your post. I don't visit this board very often.
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> > I've been looking for posts on Imipramine and found yours. I've been diagnosed with Atypical depression with Major Depression episodes. Prozac worked well for 10 yrs on and off (mostly on) but pdoc wants me to try something else and has suggested Imipramine. Any advice appreciated.
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> Imipramine was synthesized in 1957 and first marketed in 1959. It was the very first tricyclic antidepressant. For many years, it remained the "gold standard" by which all other antidepressants were compared. It is a very effective drug. If you were responsive to Prozac, I think imipramine is a worthy choice to give a short trial of 4-6 weeks. In my estimation, one cannot consider their trial with imipramine adequate unless a dosage of 200mg is reached. Imipramine inhibits the reuptake of both norepinephrine (NE) and serotonin (5-HT) as does the major active metabolite of Prozac, so this might be your doctor's rationale for its choice. If it is, your doctor is smarter than the average bear. If you are currently taking Prozac, you might want to try ADDING desipramine first. Desipramine is the active metabolite of imipramine. It potently inhibits the reuptake of NE. Although it does not inhibit the reuptake of 5-HT at all, this is precisely what makes it complementary to Prozac.
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> Imipramine carries with it a moderate load for anticholinergic side effects (dry mouth, constipation, sweating, heart palpitations, accelerated heart-rate, blurred-vision, and difficulties initiating urination). Of course, these are not always problematic. It depends on the individual. However, I found that these side effects lessened with continued use. Desipramine, on the other hand, carries no anticholinergic burden. Side effects are reduced compared to imipramine, although accelerated heart-rate is noticeable. A resting rate of 90-110 can be expected. However, the heart doesn't have to pump as hard, so it is not such a terrible thing. Oh. Weight gain is often more of a problem with imipramine than it is with desipramine.
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> - Scott
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>Thanks so much for responding Scott. I did try the Imipramine but broke out in hives so my pdoc took me off. I then went back on Prozac because the depression was pretty bad but have since tapered off again and now he has me trying Lexapro (Cipralex in Canada). Its only my 5th day at 2.5mg. I do have heart palpitations but not too bad Whats your opinion of this med compared to Prozac? I appreciate any advice you can give.
poster:KarenRB53
thread:829828
URL: http://www.dr-bob.org/babble/neuro/20080706/msgs/874708.html