![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by SheilaC on October 28, 2007, at 11:00:19
I have been taking Despiramine for about a week. I can't sleep because it makes me hot and sweaty all night. Needless to say, I don't know if its helping my mood becuase I haven't been sleeping.
I got off the Emsam patch because I thought it was causing muscle tension - plus it wasn't totatly getting rid of the depression.
Mood stabilizers (even Lamictil) make me depressed - I guess that's why I need an AD. BUT - the SSRIs, which make me pretty darn happy (almost manic) bother my bladder something awful.
I could go back to Emsam and add Abiify. When I took Abilify it helped me sleep - increased my sex drive, but also increased my hunger and water retention. Maybe 2mg. of Abilify will augment Emsam and help me. I also noticed when I took Abilify by itself (along with Xanax) that I was weepy in the morning - more emotional.
I know I need meds. Without meds I self medicate with alcohol and caffine and I get suicidal. I can't be that way. I know I need help. It's just finding the right combo of meds.
I thought about taking a small dose of Prozac (it doesn't bother my bladder as much as the other SSRIs) and add Abilify. But that may not be good either.
I feel like I'm pretty limited in my choices of drugs and doc just get frustrated with me.
Being BPII - I probably need to stay away from Prozac.
How long do I have to wait after taking Despiramine before I can go back to Emsam and Abilify?
I would just take Abilify - but it isn't enought either.
Posted by Phillipa on October 28, 2007, at 12:09:27
In reply to At a loss - need something..., posted by SheilaC on October 28, 2007, at 11:00:19
Not sure but if EMSAM was working I would go back to it. By the way what mg patch and how long were you on it? As far as the washout period. Since I don't know with TCA's I will not answer don't want to hurt you. Phillipa
Posted by Racer on October 28, 2007, at 13:09:51
In reply to At a loss - need something..., posted by SheilaC on October 28, 2007, at 11:00:19
You haven't been on desipramine very long, and it's quite possible the sleep disturbances will pass. Even if they don't pass, there are other options to improve sleep. If you don't give desipramine a chance to work, you'll never know if it would have helped you or not. I know it's a pain in the patootie to wait for a medication to show its stuff, but considering your history with medications, it's probably worth sticking it out. You might talk to your doctor about the sleep issues, and get something to help you through.
What time of day are you taking it? If you take it at night, it might be worth trying it in the morning.
Washout is likely to be two weeks, but your doctor will know better than anyone here.
As for going back to EMSAM, if it wasn't working for you, why? There are other options, besides SSRIs, EMSAM, and TCAs. I know you've tried a lot of them, but there are still options out there you probably haven't tried yet. You mention Lamictal as a mood stabilizer, but not which others you've tried. How long did you give EMSAM to work? It seems as though it wasn't that long ago you were still taking it, did you give it a good enough washout period before starting desipramine?
I don't know what other questions to ask, so I'll shut up now.
Posted by bleauberry on October 28, 2007, at 15:47:02
In reply to At a loss - need something..., posted by SheilaC on October 28, 2007, at 11:00:19
Since SSRIs work for you, would it make sense to stay with them? There must be some way to work on the bladder issues? I mean, what takes a higher priority, your mental sanity or a bladder inconvenience?
Maybe your doctor can prescribe something for whatever the bladder issues are.
Some people have done this and you could maybe consider it. That is, take a very low dose SSRI along with low dose tryptophan or 5htp. I know one girl who had side effect issues and poopout on higher doses of SSRIs, but had profound improvement with just 5mg prozac + 25mg 5htp (equivilant of 250mg tryptophan).
The trick would be to avoid B vitamins when you take 5htp, or otherwise it will convert to serotonin in your body more than in your brain and likely cause the same bladder probs as SSRIs. The trick is to get the serotonin boosted in the brain but not so much in the body. SSRIs will boost it everywhere. Without B vitamins, 5htp will mostly convert to serotonin in the brain. There are enough B's in food additives and a normal diet to supply all you need to convert it in the brain. Any extra will convert in the body before it even makes it to the brain.
Supposedly. All theory. For me though, true. I take 5htp without vitamins and I can feel it strongly without any bodily side effects. However, with B vitamins, that same 5htp causes sexual side effects worse than SSRIS.
Back to the original topic...you have already found something that suggests you are on target. Why venture away from that to try who knows how many other nasty drugs? Just fine tune what you know works, which seems to be serotonin.
Posted by Phillipa on October 28, 2007, at 21:11:58
In reply to Re: At a loss - need something..., posted by bleauberry on October 28, 2007, at 15:47:02
Sheila do you have interstitial cystitis? Very painful but fixable. Phillipa
Posted by Maxime on October 29, 2007, at 14:39:16
In reply to At a loss - need something..., posted by SheilaC on October 28, 2007, at 11:00:19
I agree with Racer.
And you should take desipramine in the morning as it is an activating med.
Hope you find relief soon.
Maxime
Posted by Astounder on November 2, 2007, at 0:40:58
In reply to At a loss - need something..., posted by SheilaC on October 28, 2007, at 11:00:19
> I have been taking Despiramine for about a week. I can't sleep because it makes me hot and sweaty all night. Needless to say, I don't know if its helping my mood becuase I haven't been sleeping.
>
> I got off the Emsam patch because I thought it was causing muscle tension - plus it wasn't totatly getting rid of the depression.
>
> Mood stabilizers (even Lamictil) make me depressed - I guess that's why I need an AD. BUT - the SSRIs, which make me pretty darn happy (almost manic) bother my bladder something awful.
>
> I could go back to Emsam and add Abiify. When I took Abilify it helped me sleep - increased my sex drive, but also increased my hunger and water retention. Maybe 2mg. of Abilify will augment Emsam and help me. I also noticed when I took Abilify by itself (along with Xanax) that I was weepy in the morning - more emotional.
>
> I know I need meds. Without meds I self medicate with alcohol and caffine and I get suicidal. I can't be that way. I know I need help. It's just finding the right combo of meds.
>
> I thought about taking a small dose of Prozac (it doesn't bother my bladder as much as the other SSRIs) and add Abilify. But that may not be good either.
>
> I feel like I'm pretty limited in my choices of drugs and doc just get frustrated with me.
>
> Being BPII - I probably need to stay away from Prozac.
>
> How long do I have to wait after taking Despiramine before I can go back to Emsam and Abilify?
>
> I would just take Abilify - but it isn't enought either.
>
>There's no need for a washout period, you can go back to EMSAM & Abilify immediately: MAOIs do not interact negatively with desipramine, no matter what the PI sheet says. Switching back quickly would be especially important since you mentioned suicidality when you're not on anything.
If the sweating the main problem with desipramine, you can try switching to protriptyline, which is mostly the same, just highly anticholinergic (which would reduce sweating).
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.