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Dr. Bob is Robert Hsiung, MD,
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Posted by Ben on September 28, 2011, at 8:48:30
Which one is better concerning weight gain.
Posted by SLS on September 28, 2011, at 9:17:03
In reply to Amitriptylin vs. Doxepin and weight, posted by Ben on September 28, 2011, at 8:48:30
> Which one is better concerning weight gain.
Probably neither. They both suck. I have not been on doxepin, so I cannot give you any useful feedback regarding a comparison with amitriptyline.
If anxiety is a problem, you might want to take a closer look at doxepin.
- Scott
Posted by jono_in_adelaide on September 28, 2011, at 19:14:04
In reply to Re: Amitriptylin vs. Doxepin and weight » Ben, posted by SLS on September 28, 2011, at 9:17:03
Are you using them for sleep or as an antidepressant?
If you need a tricyclic antidepresant fir depression, try nortriptyline first.
If you're using them for sleep, then doxepin and amitriptyline are both equaly bad, the sedative effect is closely linked to the weight gain, so while 25mg of of doxepin is equal to 50mg of amitriptyline for sedation, its also about equal in weight gain.
If using it for sleep, Seroquel might be a better option, as it has a shorter half life, so by the time you wake up, the appetite stimulating effect has largely worn off, and you dont eat in your sleep.
Posted by linkadge on September 28, 2011, at 20:16:57
In reply to Re: Amitriptylin vs. Doxepin and weight, posted by jono_in_adelaide on September 28, 2011, at 19:14:04
I would (personally) think that doxapin might cause less weight gain for the following reason:
The weight gain is linked to both the h1 antagonism and the 5-ht2c antagonism, however, I believe more so due to the latter effect.
Doxapin is a more potent antihistamine than amitriptyline. It has a higher ration of h1 antagonism to 5-ht2c antagonism. The sleep inducing effect is probably more related to the h1 antagonism. So, with doxapin, you probably get more sedation at lower doses, meaning less potent 5-ht2c angtaonism therfore less weight gain?
Who knows though, but I personally think that doxapin was a more effective drug than amitriptyline.
Linkadge
Posted by Ben on September 29, 2011, at 6:55:44
In reply to Re: Amitriptylin vs. Doxepin and weight, posted by linkadge on September 28, 2011, at 20:16:57
> I would (personally) think that doxapin might cause less weight gain for the following reason:
>
> The weight gain is linked to both the h1 antagonism and the 5-ht2c antagonism, however, I believe more so due to the latter effect.
>
> Doxapin is a more potent antihistamine than amitriptyline. It has a higher ration of h1 antagonism to 5-ht2c antagonism. The sleep inducing effect is probably more related to the h1 antagonism. So, with doxapin, you probably get more sedation at lower doses, meaning less potent 5-ht2c angtaonism therfore less weight gain?
>
> Who knows though, but I personally think that doxapin was a more effective drug than amitriptyline.
>
> Linkadge
>
>Thanks for your response. In the meantime I found a book (ISBN 3-540-66847-0) where Amitriptylin causes more weight gain than Doxepin. Anyway I think that depends on the individual.
>
>
Posted by zatar on September 30, 2011, at 12:35:24
In reply to Amitriptylin vs. Doxepin and weight, posted by Ben on September 28, 2011, at 8:48:30
> Which one is better concerning weight gain.
I agree that neither is good. But have you tried a low dose of doxepin? I was on 10mg for sleep and it worked to keep me asleep (though I still was fatigued, due to CFS and Fibromyalgia; don't get good quality delta sleep). Appetite was hearty on 10mg doxepin, though this may be due to a dysregulated HPA axis and not so much the doxepin. It's better to anticipate the weight gain and take measure to mitigate it through calorie counting, support, exercise, and learning to fill up on vegetables/fiber before meals.
I may go back to 10mg doxepin for sleep as low dose mirtazapine is not working as I hoped. Very tired on it and the appetite issue. Lock the pantry doors at dinnertime, folks! LOL. We'll see in the coming weeks.
-Zatar
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