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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by wmd40 on February 4, 2007, at 21:13:06
Hello Pyscho-Babblers,I've been told that this might be a good place to
sing the blues about a life spent waiting to die,
with the occasional tired and half-hearted attempt
to hurry the process up.I've been taking imipramine (currently 300 mg per
day) for about 20 years; I started just before the
rage for Prozac got under way. I've had all the
usual side effects: dry mouth, sedation,
orthostatic hypotension, urinary hesitancy and
the constant brain fog.Because the side effects are so bad, I've tried
many other drugs -- Prozac, Luvox, clomipramine,
Remeron, Wellbutrin, Effexor, Zoloft, desipramine,
moclobemide, Paxil, Cognitive Behavioural
Therapy (the worst of the bunch), and lithium
as an adjunct -- but nothing works as well as
good old fashioned imipramine.I desperately miss what I think I remember as a
happy unmedicated life before the onset of
depression, but every time I've tried to wean
myself off drugs, I've plunged into a miserable
state, so I've pretty much given up on that.I'm now beginning to wonder -- perhaps a bit late
-- what the long term effects of life on
imipramine might be. A web search suggests that
I can expect to turn a purplish blue colour some
time, but I can't find any other information.
Does anybody out there know? I suppose that as
a 20-year veteran, I probably know about as much
as anybody else what to expect, but I'm hoping
somebody else might know better.--
wmd40
Posted by yxibow on February 5, 2007, at 1:48:43
In reply to 20 years of imipramine, posted by wmd40 on February 4, 2007, at 21:13:06
>
> Hello Pyscho-Babblers,
>
> I've been told that this might be a good place to
> sing the blues about a life spent waiting to die,
> with the occasional tired and half-hearted attempt
> to hurry the process up.Life is for living -- its random, unpredictable, and yet amazing that all of our genetic parts manage to work together in any fashion whatsoever if you look at the human body as a system.
So, first of all -- and I know its easier said than done, with MDD, but this is also a place to find solace, and people who are passionate, and to not give up.
One may have their own religious views, but as an agnostic personally, at least on my good days, I can't just think of "getting through life". Sure, there are the bad spots, but finding anything that can possibly spark a positive view is a fantastic contrast to that idea.
>
> I've been taking imipramine (currently 300 mg per
> day) for about 20 years; I started just before the
> rage for Prozac got under way. I've had all the
> usual side effects: dry mouth, sedation,
> orthostatic hypotension, urinary hesitancy and
> the constant brain fog.TCAs aren't completely out of fashion, they're tried and true medicine.
> Because the side effects are so bad, I've tried
> many other drugs -- Prozac, Luvox, clomipramine,
> Remeron, Wellbutrin, Effexor, Zoloft, desipramine,
> moclobemide, Paxil, Cognitive Behavioural
> Therapy (the worst of the bunch), and lithium
> as an adjunct -- but nothing works as well as
> good old fashioned imipramine.
>
> I desperately miss what I think I remember as a
> happy unmedicated life before the onset of
> depression, but every time I've tried to wean
> myself off drugs, I've plunged into a miserable
> state, so I've pretty much given up on that.
I also miss the days before my current disorder which has eaten up 5 years of my life and especially the days of college when fairly substantial dysthymia and long distance calls were the worst things.
> I'm now beginning to wonder -- perhaps a bit late
> -- what the long term effects of life on
> imipramine might be. A web search suggests that
> I can expect to turn a purplish blue colour some
> time, but I can't find any other information.
> Does anybody out there know? I suppose that as
> a 20-year veteran, I probably know about as much
> as anybody else what to expect, but I'm hoping
> somebody else might know better.
If you've lived through 20 years of it, you are probably right that you know the effects of imipramine. I'm not sure about purplish blue colours but the only minor caveat about TCAs is that they have a small risk of Tardive Dyskinesia, lower than most neuroleptics, but higher than SSRIs. However I would definately say that 20 years is fairly tardive for any major effect like that to happen.
You may have found your best remedy but I wouldn't give up on the search for newer ones. There are also some AEDs that I see you haven't tried as augmentation, although generally the most common ones like Depakote probably have their greatest effect on BP.
I can't say I like the effects of Seroquel, which has some of the side effects of what you mentioned, but it along with other medications, I'm not sure the alternative is a good road to go down considering MDD.
Imipramine (which is actually desipramine in the body) has had 50+ years of use and probably couldn't count the patient-years that would add up to in generics as well. In general, though its not an exact science, we know that aggregate patient-years are a predictor of future predictions. So the thousands of patient-years essentially exceed a human lifetime. Its not as forgiving as an SSRI in overdose (please dont), but besides the previous mentioned possibility, sometimes the old ones are the good ones.-- tidings
Posted by yxibow on February 5, 2007, at 1:57:25
In reply to 20 years of imipramine, posted by wmd40 on February 4, 2007, at 21:13:06
Oh, and welcome, by the way. :)
Posted by Declan on February 5, 2007, at 3:07:40
In reply to 20 years of imipramine, posted by wmd40 on February 4, 2007, at 21:13:06
You are likely to know as much about imiprimine as anyone.
But I have to say that anyone who can say CBT is 'the worst of the bunch' has style.
Posted by polarbear206 on February 5, 2007, at 9:53:19
In reply to 20 years of imipramine, posted by wmd40 on February 4, 2007, at 21:13:06
>
> Hello Pyscho-Babblers,
>
> I've been told that this might be a good place to
> sing the blues about a life spent waiting to die,
> with the occasional tired and half-hearted attempt
> to hurry the process up.
>
> I've been taking imipramine (currently 300 mg per
> day) for about 20 years; I started just before the
> rage for Prozac got under way. I've had all the
> usual side effects: dry mouth, sedation,
> orthostatic hypotension, urinary hesitancy and
> the constant brain fog.
>
> Because the side effects are so bad, I've tried
> many other drugs -- Prozac, Luvox, clomipramine,
> Remeron, Wellbutrin, Effexor, Zoloft, desipramine,
> moclobemide, Paxil, Cognitive Behavioural
> Therapy (the worst of the bunch), and lithium
> as an adjunct -- but nothing works as well as
> good old fashioned imipramine.
>
> I desperately miss what I think I remember as a
> happy unmedicated life before the onset of
> depression, but every time I've tried to wean
> myself off drugs, I've plunged into a miserable
> state, so I've pretty much given up on that.
>
> I'm now beginning to wonder -- perhaps a bit late
> -- what the long term effects of life on
> imipramine might be. A web search suggests that
> I can expect to turn a purplish blue colour some
> time, but I can't find any other information.
> Does anybody out there know? I suppose that as
> a 20-year veteran, I probably know about as much
> as anybody else what to expect, but I'm hoping
> somebody else might know better.
>
> --
> wmd40I was started on Imipramine around the same time as you, right before prozac came on the market. Imipramine has a good track record for those who experience more severe melancholic depressions. Since it has been on the market all these years, I have not come across anyone having what you describe as change in skin color. I work in the mental health field and have worked with elderly patients who have been on it for years. While the side effects can be quite bothersome, esp. at your high dosage, I am questioning your brain fog symptoms? Is this a constant problem, or just intermittent? Do you have mood swings or changes in energy levels? I had severe PPD, and was placed on Imipramine with an immediate response in 2 days. I ended up with an underlying bipolar disorder. Many people get a good response with using 2 antideprssants from different drug classes. Combining an SSRI or a SNRI with a TCA. I had a good success with Effexor/Imipramine and Lamictal. Due to my soft bipolar symptoms, I went off Imipramine and increased to a higher dose of Effexor. Imipramine has been an "old faithful" for many people who have tried other AD's.
Polarbear
Posted by Phillipa on February 5, 2007, at 11:16:49
In reply to Re: 20 years of imipramine, posted by polarbear206 on February 5, 2007, at 9:53:19
How come I seem to do better on low or no doses of antidepressants? I was given permission to play with my luvox and the lower it seems the better. I don't understand. Love Phillipa
Posted by wmd40 on February 5, 2007, at 21:31:44
In reply to Re: 20 years of imipramine, posted by polarbear206 on February 5, 2007, at 9:53:19
> I was started on Imipramine around the same time as you, right before prozac came on the market. Imipramine has a good track record for those who experience more severe melancholic depressions.
That's me, and when I stick with the high doses, I can be almost chirpy for hours at a time.
> Since it has been on the market all these years, I have not come across anyone having what you describe as change in skin color.
Neither have I. Sorry if I gave the impression that I was purplish blue myself. It's just that that was the one and only side effect that showed up when I googled for "long term use of imipramine". I'm actually something closer to
a greyish pink. :-)> I work in the mental health field and have worked with elderly patients who have been on it for years. While the side effects can be quite bothersome, esp. at your high dosage, I am questioning your brain fog symptoms? Is this a constant problem, or just intermittent? Do you have mood swings or changes in energy levels?
The "brain fog" is fairly constant, but perhaps its not the perfect expression. What I mean, I guess, is that I have great difficulty concentrating, and my mind drifts in the middle of a conversation so that there are long pauses while I struggle to bring my tongue back to order.
> I had severe PPD, and was placed on Imipramine with an immediate response in 2 days. I ended up with an underlying bipolar disorder. Many people get a good response with using 2 antideprssants from different drug classes. Combining an SSRI or a SNRI with a TCA. I had a good success with Effexor/Imipramine and Lamictal. Due to my soft bipolar symptoms, I went off Imipramine and increased to a higher dose of Effexor. Imipramine has been an "old faithful" for many people who have tried other AD's.
I also tried imipramine with Effexor for a while, and it wasn't bad, but really not any better than the imipramine alone, so I dropped the Effexor.
For the last couple of years, I've been taking clonazepam as well -- 3 mg per day. I think it helps somewhat, since anxiety seems to be a fellow traveller with depression in my case.
No mood swings, though. I'm a hard-core unipolar.
Thanks for your comments.
> Polarbear
--
wmd40
Posted by wmd40 on February 6, 2007, at 6:46:14
In reply to Re: 20 years of imipramine » wmd40, posted by yxibow on February 5, 2007, at 1:48:43
> Life is for living -- its random, unpredictable, and yet amazing that all of our genetic parts manage to work together in any fashion whatsoever if you look at the human body as a system.I know! It's so exquisitely evil, isn't it? If Satan were out sick with the flu and I had to fill in for a couple of days, I don't think I could dream up anything more horrible than life; not just human life, but the whole panoply of creation. Every creature is endowed by its creator with a primordial urge to live and keep on living as long as possible; and just in case a creature catches on to the game, it's also endowed with a drive to reproduce -- not a conscious drive, of course; just an urge to have sex, and the Grand Design takes it from there, so we're guaranteed to be overcrowded and unhappy and eventually somebody's lunch.
But perhaps that's not what you meant. :-)
> So, first of all -- and I know its easier said than done, with MDD, but this is also a place to find solace, and people who are passionate, and to not give up.
Solace is always worth finding, and I really do struggle not to give up.
> If you've lived through 20 years of it, you are probably right that you know the effects of imipramine. I'm not sure about purplish blue colours but the only minor caveat about TCAs is that they have a small risk of Tardive Dyskinesia, lower than most neuroleptics, but higher than SSRIs. However I would definately say that 20 years is fairly tardive for any major effect like that to happen.That's a relief! I think tardive dyskinesia would pretty much put me past my limits.
> Imipramine (which is actually desipramine in the body) has had 50+ years of use and probably couldn't count the patient-years that would add up to in generics as well. In general, though its not an exact science, we know that aggregate patient-years are a predictor of future predictions. So the thousands of patient-years essentially exceed a human lifetime. Its not as forgiving as an SSRI in overdose (please dont), but besides the previous mentioned possibility, sometimes the old ones are the good ones.Thanks. That's reassuring. I guess I should count my blessings. I could be a guinea pig for one of the newer drugs that have no history of long term use at all.
--
wmd40
Posted by ed_uk on February 6, 2007, at 15:23:32
In reply to Re: 20 years of imipramine, posted by wmd40 on February 6, 2007, at 6:46:14
Skin discoloration is mainly associated with chlorpromazine. I've not heard of it being caused by imipramine.
Ed
Posted by Declan on February 7, 2007, at 19:04:48
In reply to Re: 20 years of imipramine, posted by wmd40 on February 6, 2007, at 6:46:14
I know! It's so exquisitely evil, isn't it? If Satan were out sick with the flu and I had to fill in for a couple of days, I don't think I could dream up anything more horrible than life; not just human life, but the whole panoply of creation. Every creature is endowed by its creator with a primordial urge to live and keep on living as long as possible; and just in case a creature catches on to the game, it's also endowed with a drive to reproduce -- not a conscious drive, of course; just an urge to have sex, and the Grand Design takes it from there, so we're guaranteed to be overcrowded and unhappy and eventually somebody's lunch.
Posted by Declan on February 7, 2007, at 19:07:20
In reply to Wow. I'm impressed. » wmd40, posted by Declan on February 7, 2007, at 19:04:48
The best I can say to that is that is often very beautiful.
That sounds really lame.
Posted by cmorhoun on May 11, 2007, at 9:23:11
In reply to 20 years of imipramine, posted by wmd40 on February 4, 2007, at 21:13:06
You might try a stimulant like adderall or concerta. Many people who don't get any relief from ADs of any kind find releif from stimulants. They are a bit tricky because they loose their initial umph but if you don't chase the high that they often intially provide they can help. They are the only thing to help me so far.
>
> Hello Pyscho-Babblers,
>
> I've been told that this might be a good place to
> sing the blues about a life spent waiting to die,
> with the occasional tired and half-hearted attempt
> to hurry the process up.
>
> I've been taking imipramine (currently 300 mg per
> day) for about 20 years; I started just before the
> rage for Prozac got under way. I've had all the
> usual side effects: dry mouth, sedation,
> orthostatic hypotension, urinary hesitancy and
> the constant brain fog.
>
> Because the side effects are so bad, I've tried
> many other drugs -- Prozac, Luvox, clomipramine,
> Remeron, Wellbutrin, Effexor, Zoloft, desipramine,
> moclobemide, Paxil, Cognitive Behavioural
> Therapy (the worst of the bunch), and lithium
> as an adjunct -- but nothing works as well as
> good old fashioned imipramine.
>
> I desperately miss what I think I remember as a
> happy unmedicated life before the onset of
> depression, but every time I've tried to wean
> myself off drugs, I've plunged into a miserable
> state, so I've pretty much given up on that.
>
> I'm now beginning to wonder -- perhaps a bit late
> -- what the long term effects of life on
> imipramine might be. A web search suggests that
> I can expect to turn a purplish blue colour some
> time, but I can't find any other information.
> Does anybody out there know? I suppose that as
> a 20-year veteran, I probably know about as much
> as anybody else what to expect, but I'm hoping
> somebody else might know better.
>
> --
> wmd40
Posted by sukarno on May 22, 2007, at 8:34:57
In reply to Re: Wow. I'm impressed., posted by Declan on February 7, 2007, at 19:07:20
I was on imipramine (only 25mg at bedtime) and found that it worked wonders for my panic attacks and depression. I ended up having a lot of cardiac side effects after using it for a few weeks, so my doctor switched me to nortriptyline (Pamelor), which had less cardiac side effects and no brain fog. My grades were 4.0 at one point when I was on nortriptyline. I felt full of motivation (it works more on norepinephrine than imipramine does as imipramine primarily targets serotonin) and it still blocked my panic attacks pretty well. When I finally quit nortriptyline, my grades dropped to less than 2.0. I just couldn't concentrate well and was full of anxiety and panic attacks.
The only negative reports I've read are that TCAs can speed up the process of atherosclerosis. I read that in a book at the library (the book was published in the early 1980s) and there are some studies showing an association between long-term TCA use and atherosclerosis. I don't know if this is proven or not though.
However, I wouldn't worry about it as your LDL and homocysteine levels and things like smoking, high blood pressure and sedentary lifestyle would be a better determination of risk and untreated depression certainly increases the risk of heart disease too.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
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