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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Lia Mason on July 10, 2002, at 11:22:53
Hi,
I'm currently taking imipramine... partly for depression, but mostly for pain control. I have a vaginal pain condition called vulvodynia.
Here's my twofold question. It has been suggested to me that I might have better pain control on desipramine because it targets norepinephrine which is thought to be implicated in pain. Is this true? Also, I took nortriptyline and had to stop because of sedation. My doctor (a gynecologist, not a pdoc) says that my side effect response to nortriptyline is a good predictor of how I would handle desipramine. That is, sedated on one, sedated on the other. This doesn't make a whole lot of sense to me. Anyone have a clue?
Thank you so much!
Lia
Posted by Shawn. T. on July 10, 2002, at 17:56:12
In reply to Need help with tricyclics question!, posted by Lia Mason on July 10, 2002, at 11:22:53
Desipramine is the active "in vivo" metabolite of imipramine. All of these drugs make you drowsy because of anticholinergic effects. Maybe someone familiar with both drugs can explain some subjective differences between them.
Posted by oracle on July 10, 2002, at 23:55:33
In reply to Re: Need help with tricyclics question!, posted by Shawn. T. on July 10, 2002, at 17:56:12
How long did you stay on this med before you decided
the sedation was too much ? For me it took weeks
for the sedation to go away. The first week was intense
but if i was to just judge things by the first 2 weeks
I would have never realized it would get managable.Hint: Start with micro doses, build up very, very slowly.
TCA's are very long lasting (a month +) so if you take too much
at first you could be out for several days !
Taking the meds a few hours before bedtime (instead of at)
helps also.Another hint: Micro dose is usually part of the smallest dose
manufactured.
Posted by Vanessa on July 12, 2002, at 23:00:00
In reply to Re: Need help with tricyclics question!, posted by oracle on July 10, 2002, at 23:55:33
> How long did you stay on this med before you decided
> the sedation was too much ? For me it took weeks
> for the sedation to go away. The first week was intense
> but if i was to just judge things by the first 2 weeks
> I would have never realized it would get managable.
>
> Hint: Start with micro doses, build up very, very slowly.
> TCA's are very long lasting (a month +) so if you take too much
> at first you could be out for several days !
> Taking the meds a few hours before bedtime (instead of at)
> helps also.
>
> Another hint: Micro dose is usually part of the smallest dose
> manufactured.Lis: I am no expert on tricyclics, but I have taken three of them. Amitriptyline and despipramine both knocked me out -- even after a month of taking them. I was sleeping l8 hours a day, and became even more depressed by the extreme lethargy they produced in me. It did not help to reduce the dose; they wiped me out on any dose. Taking them at bedtime didn't help; I still was very sedated the next day. However, the good news is that I did find a tricyclic that has produced no sedation at all. It's called Vivactil (protriptyline), and it has been mildly energizing instead of sedating, from the first day I took it. This reaction is apparently not nique to me; Vivactil is often described as "the energizing tricyclic." I don't know if it's used for pain, but you might ask your doctor about it.
This is the end of the thread.
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