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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by TriedEveryDrug on June 5, 2009, at 11:38:11
I'm trying to figure out why desipramine works for my ADD-inattentive symptoms. Other common treatments (stims, atomoxetine) do not work for me. On desipramine I go from a spacey, uncomprehending dolt to a sharp, aware, comprehending non-dolt that can solve even difficult mathematical problems. It also makes me an anxious, depressed, social-avoidant irritable basket case
I've read places that some authorities speculate ADD-I is an entirely different affliction than ADD-H or ADD-combined. I somewhat agree with this - I think my problems have something to do with short-term memory. My memory has always been terrible, and recently an MRI found a lesion (possibly from a fetal stroke) in a portion of my brain (forgot where exactly).
Anyway. There is a nice little chart on wikipedia showing the Kd values for desipramine (and other TCAs)
http://en.wikipedia.org/wiki/Tricyclic_antidepressant#ComparisonYes, desipramine blocks the reuptake of NE transport quite a bit, but I'm questioning whether this is why it works for me (since atomoxetine didn't work at all), or maybe this is only part of the story.
I've dug around but I can't find much more info on desipramine. Are there other receptors that it blocks or is an agonist for?
(digging around I see desipramine is an agonist for sigma 1&2 - not sure if this means anything)
Or am I over-thinking this and desipramine's effects are entirely from its NET inhibition?
Thanks.
Posted by SLS on June 5, 2009, at 17:42:35
In reply to Receptors that desipramine affect + ADD-I, posted by TriedEveryDrug on June 5, 2009, at 11:38:11
Hi.
Imipramine had been used in the 1980s for adult ADD. It might have enough 5-HT inhibition to mitigate the dysphoria and anxiety you are experiencing. Of course, imipramine is converted extensively in the body into desipramine.
What I would do in place of switching from desipramine to another drug would be to combine it with things that target the dysphoria and anxiety. It would be interesting to run an experiment and try taking Zyprexa for a few days to see if both the dysphoria and anxiety resolve. If they do, at least you know that such a thing is possible and that you can begin to look for a substitute.
You should post your question on the Medication board too. Linkadge is usually good at knowing the receptors that are affected by different drugs.
By the way, it seems that desipramine and Strattera actually produce an increase in the concentrations in diffuse interstitial dopamine. Under normal circumstances the NET is responsible for clearing this residual dopamine as it occurs in the frontal cortical regions. I'm sure you can figure out the rest.
- Scott
Posted by desolationrower on June 7, 2009, at 15:40:40
In reply to Re: Receptors that desipramine affect + ADD-I » TriedEveryDrug, posted by SLS on June 5, 2009, at 17:42:35
its a 5ht3 antagonist too
i might add a bit of prozac or soemthing instead of switching to imipramine
-d/r
Posted by SLS on June 7, 2009, at 15:45:00
In reply to Re: Receptors that desipramine affect + ADD-I, posted by desolationrower on June 7, 2009, at 15:40:40
> its a 5ht3 antagonist too
>
> i might add a bit of prozac or soemthing instead of switching to imipramine
The Prozac sounds good to me.
- Scott
Posted by TriedEveryDrug on June 7, 2009, at 19:08:55
In reply to Re: Receptors that desipramine affect + ADD-I, posted by desolationrower on June 7, 2009, at 15:40:40
I'll see if I can score some from my doc.
That is the one SSRI I have never tried. I have seen papers on prozac and desipramine combinations.
Thanks
Posted by bladewalker on June 14, 2009, at 18:50:59
In reply to Re: Receptors that desipramine affect + ADD-I » desolationrower, posted by TriedEveryDrug on June 7, 2009, at 19:08:55
hi there,
Prozac+desipramine is good combination by itself but might be litle bit anxity triggering, especialy when starting prozac. If you add PINDOLOL(Visken) prozac will start working faster,supposedly little bit better and anxiety is supressed due its betablocking activity= beautiful combo.
I am currently using 10mg prozac+5mg pindolol bid+ 50mg desipramine with great results.good luck bladewalker
This is the end of the thread.
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