![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by 3 Beer Effect on April 28, 2002, at 4:00:12
I was looking for experiences/info & side effects on the tricyclics Vivactil (protriptyline) & Norpramin (Desipramine) but can't even find the full prescribing info on these two old drugs even on the websites of the companies that make them.
I've never taken a tricyclic before so am not too familiar with them. Are the side effects similar to taking the anti-histamine Benadryl or are they much worse? Are tricyclics toxic to your liver & the rest of your body, especially if you take them long term? How stimulating is the Vivactil (Protriptyline) in comparison to Dexedrine, Adderall or Ritalin? Is Desipramine stimulating or sedating?I am getting fairly frustrated with anti-depressants. The only medications that seem to work as anti-depressants for me are stimulating ones. I am currently taking Lamcital 175 mg, but even Caffeine seems like it lifts my depression more than the Lamictal. Dexedrine works well for both my depression & ADD but it only lasts about 4 hours. Ritalin also works but has a bad irritable rebound when it wears off.
Duloxetine might work but it looks like it is going to be awhile until it comes out since it is still going through trials.
I couldn't tolerate Effexor XR. I probably can't take Wellbutrin SR because about a year & a half ago I had three drug induced seizures from an accidental overdose of the muscle relaxer Soma.
The MAOI Parnate sounds like a great stimulant but the dietary restriction/hypertensive crisis thing is kind of scary- lots of stuff has cheese in it & you might not even know it if you ate at a restaurant- pasta etc.
Are Vivactil (Protriptyline) & Desipramine useful for inattentive ADD & apathetic/ don't feel like doing anything or leaving the house Severe Depression? I've tried most of the newer anti-depressants which don't seem to work for me & tricyclics are supposed to work better for severe depression or non-responders. Perhaps I need a norepinephrine boost since ADD stimulants like Dexedrine & Ritalin work well for my depression.
I guess I could always try Concerta but I don't think the 56 mg would be enough of a boost since it provides only 12 mg immediately and the other 44 mg is spread out over 8-11 hours. I did well on Ritalin but only on 20 mg bid- Concerta is only supposed to equal 15 mg bid.
Posted by dennison on April 28, 2002, at 4:57:40
In reply to Vivactil/Protriptyline or Desipramine experiences?, posted by 3 Beer Effect on April 28, 2002, at 4:00:12
Hi 3 Beer Effect - took vivactil yrs ago would give it a thumbs up. It worked within a day. Side-effects noticed some temp dizziness upon standing and some mild sweating initially. Was approx. time effexor cameout so pdoc said let's give effexor a whirl lol, paraphrasing there..... -Effexor worked for 5 days- was great- then it bit dust never worked again regardless of inc. in dose. Makes you wonder hmmm vivactil half life extremely long --few days--well (((vivactil + effexor))), effect the first five days could have resulted from the ""overlap"" of the 2!!! ....................................................................................................Taken parnate for several yrs. --I don't believe it's very stimulatory or if it is it is very shortlived, but it works fast, no side-effects like nausea, nervousness or the general typical startup scenario. No cognitive blunting as many or I'd say almost all antidepressants seem to cause. Drawback--lowerred bloodpressure, which might be a significant problem or just a minor nuissance......................................................................................The psychostimulant option you mention seems a viable option and many times that's about the only option for augmentation that really brings around significant improvement without adding on a host of additional drugs with all their side-effects to content with.
Posted by Phil on April 28, 2002, at 8:03:55
In reply to Vivactil/Protriptyline or Desipramine experiences?, posted by 3 Beer Effect on April 28, 2002, at 4:00:12
I took Vivactil 20 years ago and it gave me the, how can I say this, jerks. I handed a lady my business card on a sales call. My arm jerked and I knocked several things off of her desk!! So, I don't have an answer there.
Desipramine didn't do anything for me a couple of years ago. Amitriptyline is the parent(?) drug of Nortriptyline and Desipramine. It worked real well for me but a lot of people can't take the side effects. If you have trouble finding info, go to www.rxlist.com.
It does say for Amitrip. that the dose should not exceed 150mg a day unless you were hospitalized. I took it 5 years at 250mg a day.
All my blood work, liver panel, etc. is good. If you have any heart condition, TCA's are not a good choice.
Posted by Ritch on April 28, 2002, at 14:49:20
In reply to Vivactil/Protriptyline or Desipramine experiences?, posted by 3 Beer Effect on April 28, 2002, at 4:00:12
> Are Vivactil (Protriptyline) & Desipramine useful for inattentive ADD & apathetic/ don't feel like doing anything or leaving the house Severe Depression? I've tried most of the newer anti-depressants which don't seem to work for me & tricyclics are supposed to work better for severe depression or non-responders. Perhaps I need a norepinephrine boost since ADD stimulants like Dexedrine & Ritalin work well for my depression.
I haven't tried protrip., but I have been on desipramine before and it worked better for my ADHD (focus-part anyways) than dexedrine. The only thing that worked better than desipramine(for focus) was Adderall. I just get hammered really bad by the anticholinergic side effects (like staring at something clear across the room and watching it slowly come into focus over several seconds). It also elevated my heart rate more than stimulants did. But, wow! I could really stay on track with complex work-related stuff, and it is definitely energizing (after a couple of weeks of course)
Mitch
Posted by fachad on April 28, 2002, at 19:03:29
In reply to Vivactil/Protriptyline or Desipramine experiences?, posted by 3 Beer Effect on April 28, 2002, at 4:00:12
If you have never taken TCAs before, start with desipramine rather than protriptyline. Desipramine is more potent at NE reuptake inhibition, and has much less potent anticholinergic properties.
For me desipramine was neither sedating nor activating. I did have terrible anti-cholinergic side effects, chiefly dry mouth and constipation. It also gave me sexual side effects, so I gave up after about 3 weeks.
Protriptyline is way more anticholinergic than desipramine, it is almost as anticholinergic as amitriptyline, so I would expect the dry mouth and constipation to be even worse than the desipramine.
Also, I think protriptyline is still under patient as Vicactal, so depending on your insurance, it may be big $$, whereas generic desipramine is cheap.
BTW, amitriptyline is the parent drug of nortriptyline and imipramine is the parent drug of desipramine.
> I was looking for experiences/info & side effects on the tricyclics Vivactil (protriptyline) & Norpramin (Desipramine) but can't even find the full prescribing info on these two old drugs even on the websites of the companies that make them.
> I've never taken a tricyclic before so am not too familiar with them. Are the side effects similar to taking the anti-histamine Benadryl or are they much worse? Are tricyclics toxic to your liver & the rest of your body, especially if you take them long term? How stimulating is the Vivactil (Protriptyline) in comparison to Dexedrine, Adderall or Ritalin? Is Desipramine stimulating or sedating?
>
> I am getting fairly frustrated with anti-depressants. The only medications that seem to work as anti-depressants for me are stimulating ones. I am currently taking Lamcital 175 mg, but even Caffeine seems like it lifts my depression more than the Lamictal. Dexedrine works well for both my depression & ADD but it only lasts about 4 hours. Ritalin also works but has a bad irritable rebound when it wears off.
>
> Duloxetine might work but it looks like it is going to be awhile until it comes out since it is still going through trials.
>
> I couldn't tolerate Effexor XR. I probably can't take Wellbutrin SR because about a year & a half ago I had three drug induced seizures from an accidental overdose of the muscle relaxer Soma.
>
> The MAOI Parnate sounds like a great stimulant but the dietary restriction/hypertensive crisis thing is kind of scary- lots of stuff has cheese in it & you might not even know it if you ate at a restaurant- pasta etc.
>
> Are Vivactil (Protriptyline) & Desipramine useful for inattentive ADD & apathetic/ don't feel like doing anything or leaving the house Severe Depression? I've tried most of the newer anti-depressants which don't seem to work for me & tricyclics are supposed to work better for severe depression or non-responders. Perhaps I need a norepinephrine boost since ADD stimulants like Dexedrine & Ritalin work well for my depression.
>
> I guess I could always try Concerta but I don't think the 56 mg would be enough of a boost since it provides only 12 mg immediately and the other 44 mg is spread out over 8-11 hours. I did well on Ritalin but only on 20 mg bid- Concerta is only supposed to equal 15 mg bid.
Posted by cmcdougall on April 29, 2002, at 13:44:25
In reply to Vivactil/Protriptyline or Desipramine experiences?, posted by 3 Beer Effect on April 28, 2002, at 4:00:12
Hi 3 Beers,
Your symptoms sound just like mine - a massive case of the "blahs".
When Celexa just wasn't doing enough, my pdoc augmented w/ desipramine. I also take Adderal for ADD and to help w/ motivation.
I currently take:
40mg Celexa
25mg 2xday desipramine
20mg 3xday AdderalThe desipramine really helps. I noticed a difference within a day or two. Once I accidentally took a double dose (50mg at once) and it was quite stimulating. I have toyed w/ the idea of giving up the Celexa and taking only the desipramine and Adderal. However, the thought of SSRI withdrawal keeps me from trying it.
Love and luck,
Carly
Posted by Leighwit on April 30, 2002, at 17:51:49
In reply to Vivactil/Protriptyline or Desipramine experiences?, posted by 3 Beer Effect on April 28, 2002, at 4:00:12
The only thing I could add 3 Beer is that I took Norpramin approx five years ago, and it worked rather well. In fact, I'm planning to try it again as I'm having trouble with Wellbutrin. Back to my point: after a few months, I switched Pdocs and he changed the script to desiprimine (generic) because he said there was no difference. In my experience, there was a definite difference and I stopped the desiprimine because it wasn't effective. I never did give the Norpramin a chance to ramp-up properly.
FWIW,
Laurie
Posted by Raga on May 1, 2002, at 11:10:11
In reply to Re: Vivactil/Protriptyline or Desipramine experiences?, posted by Leighwit on April 30, 2002, at 17:51:49
Desipramine is by far the best AD I've tried.
Works fairly well for my inattentive ADD, excellent concentration, excellent energy level, but doesn't seem to be touching my procrastination -- perhaps that part is all habit. I find it stimulating, with no drowsiness, few other side effects (like I only notice my throat a bit dry when I wake in the morning). However, two problems: faster heartbeat, much of the time spent in the 90's peaking just over 100. My PDoc is concerned. The other problem is I also have anxiety problems, and desipramine is making it worse. But I am also on risperdal, and if I take some of that during the day instead of before bed, it seems to cover the anxiety.Anyway, I highly recommend desipramine.
Personally I can't wait till reboxetine and especially tomoxetine come out; they should be similar, I think, with less side effects.-Raga
Posted by Leighwit on May 1, 2002, at 16:36:38
In reply to Re: Vivactil/Protriptyline or Desipramine experiences?, posted by Raga on May 1, 2002, at 11:10:11
My PDoc is concerned. The other problem is I also have anxiety problems, and desipramine is making it worse. But I am also on risperdal, and if I take some of that during the day instead of before bed, it seems to cover the anxiety.
>
> Anyway, I highly recommend desipramine.
> Personally I can't wait till reboxetine and especially tomoxetine come out; they should be similar, I think, with less side effects.
>
> -RagaI had anxiety issues with desiprimine also, Raga ~ but I had not experienced a problem with the brand Norpramin. You might ask your Pdoc what he/she thinks about that.
As for Reboxetine, I took it (it can be gotten here if your Pdoc orders through a teaching hospital in the UK ~ at least that's how mine got it) and I found the side effects in terms of anxiety and nervousness along with gastro-intestinal distress rather debilitating. I put Effexor and Reboxetine in the same "never again" category for myself ~ but as we always say, YMMV ~
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.