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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by john berk on July 29, 2005, at 22:08:49
hey everyone.
i am taking prozac at the moment, [3 years prior to this moment i might add,] and i find i'm not getting the relief i once got, say 1 year ago.i was thinking of weaning off prozac and trying tofranil, my friend is doing the same with anafranil, and i was wondering if anyone has had a good reaction to tofranil usage!! i know it is much more cost-effective, and possibly has less sexual side-effects. i have moderate ocd and depression!! any feedback is much appreciated!
have a good night all..john btw, if i have asked this question prior, please excuse, reasurrance is part of my ocd "thing"!! thank you!!!
Posted by med_empowered on July 30, 2005, at 2:06:06
In reply to positive results with tofranil??, posted by john berk on July 29, 2005, at 22:08:49
hey! Yeah, I took Tofranil-PM is low/mid-range dose (150mgs). Tofranil-PM is kind of a rip-off...it costs pretty much the same as name-brand new antidepressants, and it doesn't work any better than old school Tofranil. Apparently, even generic Tofranil can usually be taken once a day with pretty good results. Anyway, I took it with a kind of high adderall dose (60mgs) which isnt done too often...the combo seemed to "jumpstart" the antidepressant effect and minimize the weight loss (although I did still have some weight loss). I did reasonably well on it until full-dose (60mgs) Cymbalta was added to "boost" the effect; the combo also "boosted" my blood-pressure to astronomic heights, so I opted to withdraw the Tofranil and keep the Cymbalta. Overall, I think the Tofranil was good for the more severe part of the depressive phase (I have bipolar disorder, so its a little unusual that I took a TCA; however, I get *really* bad depressive episodes, so it seemed like the thing to do). The Cymbalta maintained the effect with fewer side-effects, although there was a definite poop out. Overall...I'd say its good, but the side effects can be kind of rough, so watch out for that, and minimize the number of additional meds you take with it. If you respond well but do have side effects, you may be able to lower the dose for maintenance (kind of like with an MAOI) or switch off to something kind of similar, but with fewer side effects (cymbalta or effexor would be the top picks here I suppose). In terms of cost effectiveness...it is (in generic form) MUCH cheaper than anything available in brand name, but there are hidden costs associated with it--additional doctors visits, dosage adjustments, sometimes blood tests, additional medications to manage side effects-- that can bump the costs up to pretty much the same, possibly more than your average SSRI or newer meds like Effexor. If you have ANY suicidal tendencies please avoid this med since it can and will kill you when taken in sufficient quanitity...if you have hypomanic tendencies or have had a problem with psychosis, your doc may refuse to prescribe it or prescribe other medications along with it (mood-stabilizer, neuroleptic) to prevent any serious problems from developing. If you have OCD, I think you may be better served by going with Anafranil--similar side effect profile, but with more proven efficacy for OCD. Pamelor is also one to consider--its more energizing, so daytime sedation would be less of a problem.
Posted by john berk on July 30, 2005, at 15:41:04
In reply to Re: positive results with tofranil??, posted by med_empowered on July 30, 2005, at 2:06:06
Hi, thanks so much, you gave me much food for thought on tofranil, plus some excellent information i can pass on to my not so enlightened pdoc!! i'm not suicidal, but thanks for the warning on overdose, i know you have to be pretty careful with tca's! i have heard alot about anafranil, but i'm not sure i could take the energy-zap i here it induces, i'm usually pretty active!! thank you again med_empowerded!!!
This is the end of the thread.
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