Posted by Elizabeth on November 6, 2001, at 15:52:55
In reply to T.C.A. Drug Use REM rebound from low dose? » Elizabeth, posted by jay on November 6, 2001, at 4:28:50
> I was wondering if you have any info or comments about the possibility that taking too low of a dose of a TCA can cause REM rebound?
It's interesting that you should ask. REM rebound is a possible withdrawal symptom with TCAs (and MAOIs), but my experience on TCAs has been different. I generally tend to have vivid dreams and move a lot during REM sleep (i.e., REM sleep behavior disorder). Desipramine, amoxapine, and some of the atypical antipsychotics have exacerbated this, at both low/moderate and high doses.
I'm not sure if it's a rebound effect you're getting or what might be going on. The kind of rebound you describe can happen with short- or intermediate-acting barbiturates, but I don't think I've ever heard about it with antidepressants. You might think about taking a different TCA with more anticholinergic activity. Perhaps even adding a little bit of amitriptyline at bedtime (say, 25-50 mg) would help without making the side effects much worse.
It might be relevant to note that I experienced complete REM sleep suppression with MAOIs, but when I added amoxapine or atypical antipsychotics, the vivid dreams would come back. (I also tried adding nortriptyline to Marplan, but I don't recall any effect on my dreams, or rather, my lack of dreams.)
> I am curious, because I seem to respond best to meds that deeply and quicly suppress REM.
I suggest MAOIs, then! < g >
> That is why I believe I respond to Effexor XR so well, is because a Medline search shows that it almost completely suppreses REM by the second or third night of use.
That's interesting. I'd always assumed it had roughly the same effect on REM sleep as SSRIs -- decreasing the percentage of sleep that includes REMs, but increasing REM density during periods of REM sleep. A lot of people do seem to have vivid dreams on Effexor, as with SSRIs.
-elizabeth
poster:Elizabeth
thread:82743
URL: http://www.dr-bob.org/babble/20011104/msgs/83366.html