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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by UgottaHaveHope on February 3, 2007, at 1:39:58
Scott, right now I am on week four of an Emsam trial. Emsam definitely gives me a little boost of extra energy, but I am not sure if that is a good thing with anxiety as my primary issue.
Have you taken Emsam? If so, what did you notice as the difference between Emsam and Nardil? If you didn't take it, what would predict is the difference? I know you know these meds, and could predict.
I once asked my doc about taking Imipramine. He's very aggressive with drugs, but said he didn't want to give me that one because it can cause heart problems. Are those other TCAs you mentioned safe to take?
Thanks for all of your help!
Posted by SLS on February 3, 2007, at 6:27:38
In reply to SLS, r u here?, posted by UgottaHaveHope on February 3, 2007, at 1:39:58
Hi UGHH.
> Scott, right now I am on week four of an Emsam trial. Emsam definitely gives me a little boost of extra energy,
Most people report this phenomenon, but more often than not, don't seem to glean a true antidepressant response.
> but I am not sure if that is a good thing with anxiety as my primary issue.
Interestingly, many people have seen an anxiolytic effect early in treatment with Emsam. However, I am not sure how long it persists.
> Have you taken Emsam?
Yes. But for less than a week. I thought it was producing dysphoria. However, it could very well have been the after-effects of being on Lyrica.
If so, what did you notice as the difference between Emsam and Nardil?
Unfortunately, I really can't answer that question.
If you didn't take it, what would predict is the difference? I know you know these meds, and could predict.
I think Nardil would produce a greater and more persistent anxiolytic effect for GAD and social anxiety with or without panic attacks. I also think that it is a more potent antidepressant.
> I once asked my doc about taking Imipramine. He's very aggressive with drugs, but said he didn't want to give me that one because it can cause heart problems.
Personally, I think there is too much drama associated with antidepressants these days. Imipramine used to be the gold standard of antidepressants, and cardiac function was almost never an issue.
> Are those other TCAs you mentioned safe to take?
But, yes, the two TCAs that represent the best margin of safety are nortriptyline and desipramine, and possibly trimipramine. I am aware of one case of a possible serotonin syndrome associated with the combination of Nardil + imipramine. Me. So, I am reluctant to recommend this treatment to anyone else. Nardil + nortriptyline seems to be safe so far.
> Thanks for all of your help!No problem!
Take care.
- Scott
Posted by UgottaHaveHope on February 4, 2007, at 1:48:54
In reply to Re: SLS, r u here?, posted by SLS on February 3, 2007, at 6:27:38
I was curious why you were a supporter of taking a TCA with a MAOI? Did a MAOI alone not do the trick? Thanks, Michael
Posted by SLS on February 4, 2007, at 11:20:26
In reply to Re: Why the TCA with MAOI, Scott? » SLS, posted by UgottaHaveHope on February 4, 2007, at 1:48:54
> I was curious why you were a supporter of taking a TCA with a MAOI? Did a MAOI alone not do the trick? Thanks, Michael
For me, the combination has a history of producing the best chance of working. Nothing else seems to.
- Scott
Posted by UgottaHaveHope on February 4, 2007, at 12:44:55
In reply to Re: Why the TCA with MAOI, Scott?, posted by SLS on February 4, 2007, at 11:20:26
Have you noticed a difference between the new Nardil and the old Nardil? In the end, it is just as effective, or close? Thanks, Michael
This is the end of the thread.
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