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SEANML
16-12-20, 12:08
Doctor is wondering if maybe amitrip would be a better option. My concerns are the positive RA factor and ana. Has anyone had this issue with the medication? My biggest fear in life is autoimmune and cancer.
Sorry if I have been a little crazy lately guys and women. You have all been of great help.
Its that drug or another one I am not familiar with imipramine.

panic_down_under
16-12-20, 13:11
Doctor is wondering if maybe amitrip would be a better option. My concerns are the positive RA factor and ana. Has anyone had this issue with the medication? My biggest fear in life is autoimmune and cancer.

Amitriptyline wouldn't be the most prescribed pain med for rheumatoid arthritis if there was a significant risk. Nor is there much evidence that it causes, or exacerbates cancer. If you go looking for reasons not to take a med you will almost always find at least one online. The best option is to avoid checking up on meds, especially with HA. An anxious mind it very capable of creating the full range of severe side-effects if given half a chance.

BTW-anxiety and depression are themselves arguably symptoms of an autoimmune disorder.


Its that drug or another one I am not familiar with imipramine.

Imipramine is a more potent TCA than amitriptyline. It was the AD that pulled me out of my first panic spiral. I had few problems with it even though I was always on very higher doses, mostly 300mg and 350mg for some months. Few doctors would prescribe doses that high these days, but the bloke that developed it took up to 1,000 mg for a while during the initial safety testing (back in those days the drug company chemists were also the guinea pigs).

Either med would be a good choice, but given the HA, I suggest amitriptyline as it generally causes slightly fewer initial side-effects. You could switch to imipramine later if amitriptyline proved inadequate.

SEANML
16-12-20, 14:16
I am trying to get out of the ha worry of amitrip. I took it years ago on low doses and it was nice. Only reason I like imipramine is that there is no "ana" or "RF" wich ever med I do choose it will be for my mental problems but also to help me sleep (it will be used to replace mirtazapine) which was an amazing drug but the eating is way out of hand lol.

Thanks for talking with me and helping me decide. I am still not sure wich is best (imipramine or ami). All I know if I hope they will be sedative like mirtazapine was. I need to loose the weight I gained from mirtazapine as well (also on olanzapine lol )

*Also I have memory issues (due to a head trauma) so I need to make sure the new meds do not alter my memory. Havent asked or looked into that. Just kinda started panic on the Rheumatoid and ana bit lol.
*Never knew it was prescribed for rheumatoid. And thankfully I havent seen any cancer risk for the 2 drugs. I saw a risk for a separate drug he had offered though.
**Also what is this dementia risk I heard about for amitriptiline? Is imipramine the same for that risk? I already have memory issues lol

panic_down_under
17-12-20, 07:04
I am trying to get out of the ha worry of amitrip. I took it years ago on low doses and it was nice.

There is no reason it should be any different at the higher doses for anxiety.


Only reason I like imipramine is that there is no "ana" or "RF"

Why are antinuclear antibody and rheumatoid factor such a concern for you?


wich ever med I do choose it will be for my mental problems but also to help me sleep (it will be used to replace mirtazapine) which was an amazing drug but the eating is way out of hand lol.

Mirtazapine is more a very sedating antihistamine than antidepressant. It is a more potent antihistamine than most of the meds marketed as antihistamines. It is the inhibition of histamine receptors which mostly causes sedation. Amitriptyline blocks histamine receptors to a lesser degree so probably won't be as sedating, but that also means it is also less likely to trigger the powerful carbohydrate cravings that mirtazapine does. Imipramine is usually significantly less sedating that amitriptyline.


Thanks for talking with me and helping me decide. I am still not sure wich is best imipramine or ami. All I know if I hope they will be sedative like mirtazapine was. I need to loose the weight I gained from mirtazapine as well (also on olanzapine lol

Unfortunately, there is no way of knowing which will be the more effective med for you other than by trying them.


*Also I have memory issues (due to a head trauma) so I need to make sure the new meds do not alter my memory. Havent asked or looked into that.

You probably have memory issues because of the anxiety too. Anxiety and depression are the emotional symptoms of atrophy (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045/) of the twin hippocampal regions of the brain caused by high brain stress hormone levels killing hippocampal cells and inhibiting the growth of new ones. ADs work by stimulating the growth (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025168) of hippocampal neurons. It is the new cells and the connections they form which produce the therapeutic response. Btw - therapy works (https://doi.org/10.1016/j.biopsych.2013.05.017) the same way. The hippocampi are critical (https://www.cell.com/current-biology/references/S0960-9822(02)70778-1) to the conversion of short-term to long-term memory.


Just kinda started panic on the Rheumatoid and ana bit lol.

What have you been reading?


*Never knew it was prescribed for rheumatoid.

To be clear, amitriptyline isn't prescribed to treat rheumatroid arthritis, but to alleviate the pain it causes. It is prescribed for many other conditions which produce neuropathic (nerve) pain, including fibromyalgia, diabetes and some cancers.


And thankfully I havent seen any cancer risk for the 2 drugs.

There are cancer risks in just about everything. One of the leading causes is anxiety/stress. Indeed, anxiety/stress is the leading cause of premature death overall because it often sets in train the circumstances which produce the main diseases of humanity so doing nothing about HA is itself not risk free.

To be blunt, none of us get out of this alive. Imho, quality of life is far more important than longevity. To quote one of my inspirations, Hunter S. Thompson:


"Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming "Wow! What a ride!"


Also what is this dementia risk I heard about for amitriptiline?

I assume what you've heard relates to meds that block acetylcholine receptors which according to a recent study increases the risk of dementia. It is always a good idea to treat a single study finding with scepticism as they don't always survive scrutiny and that may be even wiser for this study as there is considerable evidence pointing to TCAs either having no added risk, or significantly reducing dementia risk [1]. Anxiety/depression is itself a major risk factor for dementia.

Fwiw, I've been on very high doses of TCAs almost continually since early 1987. So far my brain hasn't turned to mush and most mornings I can still remember my name. On the days this alludes me it isn't because of dementia!! :winks:


Is imipramine the same for that risk? I already have memory issues lol

Amitriptyline is a more potent acetylcholine blocker than imipramine.



[1]
Bartels C, Belz M, Vogelgsang J, et al. (2020)
To Be Continued? Long-Term Treatment Effects of Antidepressant Drug Classes and Individual Antidepressants on the Risk of Developing Dementia: A German Case-Control Study.
J Clin Psychiatry. 2020 Aug 25;81(5):19m13205 [Abstract (https://doi.org/10.4088/jcp.19m13205)]

Leng Y, Diem SJ, Stone KL, Yaffe K. (2018)
Antidepressant Use and Cognitive Outcomes in Very Old Women.
J Gerontol A Biol Sci Med Sci. 2018 Sep 11;73(10):1390-1395 [Abstract (https://doi.org/10.1093/gerona/glx226)]

Lee CW, Lin CL, Lin PY, et al. (2017)
Antidepressants and risk of dementia in migraine patients: A population-based case-control study.
Prog Neuropsychopharmacol Biol Psychiatry. 2017 Jul 3;77:83-89 [Abstract (https://doi.org/10.1016/j.pnpbp.2017.04.006)]

Lee CW, Lin CL, Sung FC, et al. (2016)
Antidepressant treatment and risk of dementia: a population-based, retrospective case-control study.
J Clin Psychiatry. 2016 Jan;77(1):117-22 [Abstract (https://doi.org/10.4088/jcp.14m09580)]

Kessing LV, Forman JL, Andersen PK. (2007)
Do continued antidepressants protect against dementia in patients with severe depressive disorder?
Int Clin Psychopharmacol. 2011 Nov;26(6):316-22 [Abstract (https://doi.org/10.1097/yic.0b013e32834ace0f)]

SEANML
17-12-20, 19:29
I panic about ana and rheumatoid arthritis because they are just a big fear. I dont want a auto immune. Especially rheumatoid. I already am positive for ana and rheumatoid factor. Did the test last year with no follow ups required.
In your opinion which one is more sedating?
A part of me thinks imipramine might be better due to my panic of rheumatoid and auto immune. I was on ami for 2 weeks last year, got off it when I tested positive.
Ami was nice and euphoric and got rid of my fibro pain. Is imaprimine similar? Thanks for the chat, you are going to help me to decide. You are mellowing me out with your great responses and facts.

My memory is faulty from a traumatic brain injury coma 10 years back. So I have hard times talking. I hope you understand me well.
I just need a good sedative, and if it kills my pains and depression as an add on wicked! Lol. So from your opinion dementia is a low risk possibly with tcas. Hows your hair? I read it can cause hair loss too.

More concerned about auto immune. I'd take ami if it wasn't for the auto immune and rheumatoid. That's a nasty disease And treatments kill your immune system (so cancer can happen in theory)

I get all the side effects from a drugs.com site

panic_down_under
18-12-20, 08:09
I panic about ana and rheumatoid arthritis because they are just a big fear. I dont want a auto immune. Especially rheumatoid. I already am positive for ana and rheumatoid factor. Did the test last year with no follow ups required.

Which suggests your GP doesn't think the test results were significant. A single test positive doesn't necessarily mean you're at risk. You might have been positive for any number of reasons.


In your opinion which one is more sedating?

Amitriptyline is a far more potent blocker of histamine H1 receptors than imipramine so is likely to be considerably more sedating, however, as with all things antidepressant, YMMV. It all comes down to how the meds mesh with your individual biology.


A part of me thinks imipramine might be better due to my panic of rheumatoid and auto immune. I was on ami for 2 weeks last year, got off it when I tested positive.

Who's idea was that, you or your GP's?


Ami was nice and euphoric and got rid of my fibro pain. Is imaprimine similar?

Neither should be producing euphoria. You just may have been feeling extra good because the pain had eased/stopped.


I just need a good sedative, and if it kills my pains and depression as an add on wicked! Lol. So from your opinion dementia is a low risk possibly with tcas. Hows your hair? I read it can cause hair loss too.

The evidence shows that TCAs may reduce the dementia risk. No hair loss so far and I'm over 70 yo. Just about any med can trigger hair loss, but anxiety/stress is probably a greater risk.


More concerned about auto immune. I'd take ami if it wasn't for the auto immune and rheumatoid. That's a nasty disease And treatments kill your immune system (so cancer can happen in theory)

I get all the side effects from a drugs.com site

Just because something is listed as a potential side-effect doesn't mean the med is thought to cause it. Side-effects lists are based on reports during the trials of the med and detail everything reported irrespective of whether the maker believes it was caused by the med. This is why some contagious diseases are listed as a potential side-effect of some SSRIs. If this were true then it would mean our understanding of infectious disease was seriously flawed.

I've managed to track down the case which seems to have been responsible for ANA being on the side-effects list (PDF, page 14 (https://www.arrowpharma.com.au/wp-content/uploads/1970/01/Rithmik_PI.pdf)):



Immunological

Positive antinuclear antibodies and elevated immunoglobulin levels were noted in one patient with amiodarone induced pulmonary fibrosis.

As you can see it doesn't claim amitriptyline was the cause, but states what was likely responsible as elevated antibodies, including ANA are common (https://emedicine.medscape.com/article/301226-workup) with pulmonary (lung) fibrosis, as is PRF. Also note that unlike Drug.com it doesn't list PRF as a side-effect.

There is only one study in the medical literature involving amitriptyline and positive antinuclear antibodies (https://pubmed.ncbi.nlm.nih.gov/19918441/) and another listing both the AD and positive rheumatoid factor (https://pubmed.ncbi.nlm.nih.gov/20066424/). Neither claims amitriptyline as the cause, in the PRF case amitriptyline was prescribed as one of the treatments!

If amitriptyline was a risk factor then it wouldn't be one of the most prescribed pain meds for autoimmune disorders. You are stressing about nothing. My advice, stop looking up side-effects and trust your GP knows what he/she is doing. They are likely to know much more about what you can and cannot take than Drugs.com.

SEANML
18-12-20, 15:29
Hair loss scares me. I was thinning previously so I'm growing my hair out. I read tcas are toxic to hair.

You are being a great help in my decision. Ana and auto immune is scary. Dr said amitriptyline cause I used it before
He suggested imaprimine and anafril as alternatives.

panic_down_under
19-12-20, 00:50
Hair loss scares me. I was thinning previously so I'm growing my hair out. I read tcas are toxic to hair.

Temporary hair loss is an uncommon side-effect of most ADs (and many other meds). The TCAs are no more likely to cause it than the other classes. The hair will usually grow back when the ADs is discontinued so in the unlikely event this becomes a problem for you switching to another AD, including even another TCA, should resolve it.

As I wrote previously, if you go looking for reasons not to take a med you will inevitably find them online. You need to decide which is worse for you, living with anxiety or putting up with some, usually short-term, side-effects. Plus, this is not a zero sum situation, anxiety/stress itself carries considerable serious health risks.


Ana and auto immune is scary.

Then isn't it fortunate that not only do the ADs suggested by your GP not cause autoimmune issues, but may actually reduce the risk of you developing them?


Dr said amitriptyline cause I used it before
He suggested imaprimine and anafril as alternatives.

Any of them would be a good choice. Personally, I'd lean toward Anafranil (clomipramine), because it has a superior OCD track record (HA is on the OCD spectrum). However, given you've taken amitriptyline before that would probably be the better option for you psychologically.

If you decide to have a go then discuss and get the okay from your GP to start on a low dose, half a 25mg tablet for the first week, then 25mg for the next, ramping it up 25mg at weekly intervals until you reach the initial target dose, usually 75mg for amitriptyline and imipramine, 100mg for clomipramine. You may need to go higher later to achieve optimum results.

SEANML
19-12-20, 12:26
Anafril is a no because I had saw a side effect I did not want to risk. I will stop looking things up. But it has a risk of onocological. A cancer on drugs.com I am trying to get comfy with risking amitriptyline. I do have OCD and anxiety. Anafril is just a no go even though it's a small rare risk. Breast fibrodenosis I think was the cancer risk. I just have to think hard. Hair loss, ana, rheumatoid are scary but you are giving me some positive advice on everything . Thx again my friend. Also a good point on the ana and maybe being prevented with tcas thanks again you are truly helping me out here

panic_down_under
19-12-20, 23:29
Anafril is a no because I had saw a side effect I did not want to risk. But it has a risk of onocological. A cancer on drugs.com I am trying to get comfy with risking amitriptyline. I do have OCD and anxiety. Anafril is just a no go even though it's a small rare risk. Breast fibrodenosis I think was the cancer risk.

Sigh! :sad: Breast fibroadenoma is a benign, non cancerous tumour, i.e. fibrose lumps that form in breast tissue which are fairly common in females aged 30+, but very, very rare in males. Are you female? If so, do you take oral contraception? They are far more likely to cause such lumps.


I will stop looking things up.

That would be very wise because your efforts to date are not helping you. You don't seem to have the knowledge to evaluate what you're reading and just needlessly scaring yourself.


I just have to think hard.

No, stop thinking because overthinking everything seems to be stopping you from getting treated. Time to do. If not meds then therapy. But do something. As per my last post, doing nothing is by far the worst of the options available to you.


Hair loss, ana, rheumatoid are scary but you are giving me some positive advice on everything .

The only one that may impact you is hair loss and even this would only be a temporary side-effect.

SEANML
20-12-20, 11:50
Is anafril sedating? Have you ever used it? I was tempted for that one only cause there was no hair loss. The cancer thing only bothered me. Thx again. So they all cause massive hunger? Thats why I'm going off mirtazipine, also on olanzapine. I'm a male. If I do get hair loss from any of them I wonder if it can go away/calm down after a few weeks of treatment. I will admit I am very confused on what one to pick. I either get hair loss/ana/rheumatoid or cancer. There is none with side effects I like. Mirtazapine only caused massive eating and no other problems :( I wish they weren't so negative in side effects. Are you sure the ana/rheumatoid factor isnt a risk of getting the autoimmune. I know you answered it before but I just want to double check with your opinions. Thank you for being so patient with me, I do not want to tire you.

A part of my wants amitriptyline but I just dont know. Another part of me wants anafril or imaprimine. And then my last part doesn't want any because of those side effects we have spoken about.Ocd and anxiety are horrible combos to have as a disorder :( To sleep I take 30mg mirtazapine, 25mg olanzapine, 100 mg trazadone and 10 mg melatonin.

So whatever pick is going to have to be potent as my mirtazapine is. (I think mirtazapine is where the hunger issues are coming from, I keep sleep eating due to the cravings lol. meaning I wake up to eat a shit ton of foods and pass back out lol.)I still dont sleep well. Hard to fall asleep and then the eating wakes me up Not sure if its olanzapine or mirtazapine causing it lol. All I know is a cup of nuts dosed in olive oil usually stops the late night eating.

He gave me the option (either switching mirtazapine to 1 or those 3. Or going from olanzapine to ziprasdone. He says there is no way to know which is causing the hunger until we change 1 med and see) ziprasadone was not as scary for side effects lool. But my theory is its mirtazapine doing the hunger but who knows.

If I start to annoy just let me know.This discussion has been helpful.Closer to picking lol

panic_down_under
21-12-20, 10:00
Is anafril sedating? Have you ever used it? I was tempted for that one only cause there was no hair loss. The cancer thing only bothered me.

No, I haven't tried clomipramine and it is likely to be less sedating than amitrityline.


So they all cause massive hunger? Thats why I'm going off mirtazipine, also on olanzapine.

Both mirtazapine and olanzapine trigger carbohydrate cravings, especially the mirtazapine. Some on it will literally eat sugar out of of the bag by the spoonful while on it. Amatriptyline can also trigger carb cravings, not quite as bad as mirtazapine, but still to some extent, imipramine and clomipramine usually much less so.


I'm a male.

Congratulations. You almost certainly won't get breast fibroadenoma, which is not cancerous, because male's lack the fibro-glandular tissue in their breasts in which it grows. The exceptions are the rare males who have gynecomastia, a hormonal imbalance with high levels of oestrogen, or are undergoing oestrogen therapy for gender reassignment, or as part of the treatment for prostrate cancer. So unless you need to be wearing a C cup bra you're chances of developing fibroadenoma from taking clomipramine are roughly the same as you being able to fly to the Moon by flapping your arms.


If I do get hair loss from any of them I wonder if it can go away/calm down after a few weeks of treatment.

In the unlikely event this occurs it will continue as long as you take the med and will resolve only when you stop. If it happens switching to either amitriptyline or imipramine should fix the problem.


I will admit I am very confused on what one to pick. I either get hair loss/ana/rheumatoid or cancer There is none with side effects I like.

No! The only one of those that could be a risk is temporary hair loss. You are less likely to get ANA, or rheumatoid than if you didn't take amitriptyline, and it is almost impossible for you to get fibroadenoma, which is not cancer, from clomipramine. You are worrying about nothing.


Mirtazapine only caused massive eating and no other problems :( I wish they weren't so negative in side effects. Are you sure the ana/rheumatoid factor isnt a risk of getting the autoimmune. I know you answered it before but I just want to double check with your opinions.

Yes. That is what studies show.


A part of my wants amitriptyline but I just dont know. Another part of me wants anafril or imaprimine. And then my last part doesn't want any because of those side effects we have spoken about.Ocd and anxiety are horrible combos to have as a disorder :( To sleep I take 30mg mirtazapine, 25mg olanzapine, 100 mg trazadone and 10 mg melatonin.

Why such a high dose of trazodone? It is more sedating at lower doses.


He gave me the option (either switching mirtazapine to 1 or those 3. Or going from olanzapine to ziprasdone. He says there is no way to know which is causing the hunger until we change 1 med and see) ziprasadone was not as scary for side effects lool. But my theory is its mirtazapine doing the hunger but who knows.

It is almost certainly the mirtazapine and your GP should know that. As for ziprasidone that is not a long-term solution as tolerance builds quickly. I think all you need is a TCA, pick one out of a hat if you can't decide which, and if insomnia continues to be a problem replace all the other meds you're on with promazine. They use that to sedate horses for surgery! And if you have never been assessed at a sleep clinic then ask your GP to refer you to one.

SEANML
21-12-20, 11:23
I take 100mg trazadone for sleep (was 200) I am almost comfortable with saying that the only 1 of the 3 that will work is amitrip. (Due to the fact that it would be the only sedating one) Going on the others I feel is a waste of side effects due to the fact that they do not sedate.

I went to a sleep clinic I use a sleep apnea machine and he thinks I goto bed at the wrong time for my circadian. rhythm.

I am close to picking amitrip I just have to accept some how that it wont cause the ana/rheumatoid and hair loss is a gamble.(you get it or you dont) and you kept your hair. Did you use amitrip ever? Not sure if I asked. You say the hunger wont be as bad as mirtazapine so that is attractive.

The other part of me wants to but my dr to give me other solutions for sleep ( the dr prescribing these meds is a sleep dr/but was a phychiatrist.)

*promazine is a no lol I googled it sadly :( Cancer endometrial adenocarcinoma (https://www.drugs.com/cg/endometrial-cancer.html) I will try harder to not google but its hard. But yes I need to figure it out and I feel without mirtaz I will not sleep unless its amitrip. Id rather stay on mirtazapine but sleep eating is linked to alot of health problems too (but such an easy side effect with me other then weight gain) Id rather be fat before I go bald.

panic_down_under
21-12-20, 12:17
promazine is a no lol I googled it sadly :( Cancer endometrial adenocarcinoma

You have a womb? Endometrial adenocarcinoma is cancer of the lining of the womb, the endometrium.


I will try harder to not google but its hard.

You don't have the knowledge to evaluate what you are reading, so all you're doing is scaring yourself needlessly.

SEANML
21-12-20, 13:19
I am seeing this now. That i cannot interpret things online.

What tca did you use to solve your problems? Do you have ocd/anxiety? Sorry if this is too personal
Have you ever taken promazine? The side effects are favorable for me (tempted to ask my dr for that instead) Just not sure if that is a safe option. But not sure if it exists in canada lol.
Argh I want to turn off this worry about hair loss/ana/rhematoid amitrip I took before for a few weeks before I started worrying.Where did you see that it may prevent them?What I read is that antidepressants effect the immune system (but they are still no sure how)https://www.sciencedaily.com/releases/2006/01/060119230939.htm

Also is there a big difference between the sedation in amitrip and the other too anafril and imaprimine? A part of me thinks I should just take imaprimine because there is no immune system "issues" but im afraid I wont sleep ever lol. I really want to take amitrip but that immune thing is really turning me off.

I just realized I am going in circles argh sorry. I will try to stop the broken record as I put it

panic_down_under
22-12-20, 11:00
I take 100mg trazadone for sleep (was 200)

Trazodone is most sedating at 25-50mg and, ime, the highest dose at which it is still reasonably effective as a sleep aid is 75mg. Above that most don't find it effective. How long were you on 200mg and did it seem to help with anxiety when you were taking that much?


What tca did you use to solve your problems? Do you have ocd/anxiety?

It took imipramine for panic disorder for about 8 years and have been on another TCA, dosulepin, since 1995. It isn't available in Canada.


Also is there a big difference between the sedation in amitrip and the other too anafril and imaprimine?

On paper, yes. Amitriptyline is a significantly more potent histamine receptor blocker than clomipramine and imipramine.


A part of me thinks I should just take imaprimine because there is no immune system "issues"

There aren't any with amitriptyline either. You need to get over that nonsense.

SEANML
22-12-20, 11:04
I never noticed anything with trazadone, it just is a minor sleep aid (with little effects) I went down to 100 because I was told in emergency that higher doses dont sedate.

So are you saying if I take 50mg I may sleep better?

Was hoping imaprimine was a sedative, I was more comfy to try that one. And you having all your hair and not auto immunes is reassuring :P

I wish there was other meds, and i wish mirtazapine wasn't such a hungry drug.

panic_down_under
22-12-20, 11:34
So are you saying if I take 50mg I may sleep better?

It is likely to be more sedating than 100mg is. Whether it will make a huge difference will only be determined by trying it, but okay it with your doctor first.


Was hoping imaprimine was a sedative, I was more comfy to try that one. And you having all your hair and not auto immunes is reassuring :P

Anxiety/depression is itself arguably an autoimmune disease. One that nukes brain cells in the two hippocampal regions of the brain. ADs work by reversing the cell loss. There is also evidence (https://www.managedhealthcareexecutive.com/view/mental-health-condition-linked-autoimmune-disease) that anxiety/depression increases the risk of other autoimmune disorders such as lupus and that antidepressants may lower (https://www.webmd.com/balance/stress-management/news/20180619/severe-stress-may-send-immune-system-into-overdrive) that risk.

As I said earlier in this thread, doing nothing is probably the worst of your options.

SEANML
22-12-20, 13:04
So what you are trying to say is take amitrip or something because living the way I am currently is not a healthy option. And in the long run without the medication I will cause more harm than the med itself.? Just trying to make sure I understand.

And you truly think the worst side effect I may get is hair loss none of this auto immune stuff? I know when I took ami before I just never knew the side effects. All I know is my pains were not as bad.

Still rather take imaprimine but you say it wont sedate much grrrr also gained a fair amount of weight on mirtaz. I heard amitrip will cause weight gain. More reason to do imaprimine. But once again I need something for sleep, Not sure if I should ask the dr for more ideas. I already have angered him with how picky I am.

panic_down_under
23-12-20, 12:03
So what you are trying to say is take amitrip or something because living the way I am currently is not a healthy option.

Yes. Exactly.


And in the long run without the medication I will cause more harm than the med itself.? Just trying to make sure I understand.

Quite likely. Stress is the leading cause of premature death because it sets in train the maladies that take us out including heart disease and cancers. The sooner it is bought under control the better. It doesn't have to be medication. Therapy can be very effective too.


And you truly think the worst side effect I may get is hair loss none of this auto immune stuff?

In the unlikely event there is hair loss it would be temporary. If it happens then switching to another TCA will probably resolve it. As for the "auto immune stuff" the evidence doesn't show that amitriptyline adversely impacts the immune system, just the opposite.


I know when I took ami before I just never knew the side effects. All I know is my pains were not as bad.

Ignorance is bliss. Stay away from Dr Google. It is almost always wrong and is far more likely to harm you than your real doctor would.


I heard amitrip will cause weight gain. More reason to do imaprimine. But once again I need something for sleep,

Unfortunately, that is the dilemma. What promotes sleep may also cause weight gain. Amitriptyline shouldn't stimulate your appetite as much as mirtazapine, but it may also be a little less sedating.


Not sure if I should ask the dr for more ideas. I already have angered him with how picky I am.

Tough. Doctors are not the minor gods many see themselves as. They are the hired help. Someone we pay, either directly, or via taxes, for their knowledge and the first rule of business is the customer is always right. That said, much of your 'pickiness' is based on ignorance. You draw conclusions based on data you don't really understand and from what you've posted here you almost always get it wrong. Even worse when your conclusion is shown to be unsupported by the facts you continue to cling to it anyway. You're still clinging to the immune stuff like a tar-baby, for example, unwilling/unable to let it go. You are only hurting yourself with this. If you don't trust your doctor then get another if you can and then resist second guessing them on the treatment proposed. They know a lot more about it than you do and causing you harm is not in their best interest.

SEANML
23-12-20, 19:52
I do trust him, he is quite knowledgeable. He had said there was not much more in the sedatives area (sleeping pills are out of the question. We both agree those side effects are much worse then the alternatives) He had suggested changing olanzapine to ziprasadone (but you said it can gain tolerance) and for mirtazapine he had suggested those 3 (amitrip,imap,anafril.) But I did think of suggesting that promazine not sure if it is in canada though.) I think it's called Chlorpromazine and that version looks nasty for side effects, worse then amitrip lol)

I want to take amitrip cause I have done it before but I need to let go of this endless auto immune bit before I go near it. Afraid to open up a can of Health anxiety or something. I know I was only on 10mg but it felt good.

You have tried your best at calming me, it has helped but now the rest has to come from me. I have to accept that there may be temporary hair loss, and that auto immune is not a side effect. It may take some time but I have faith. I keep reading everything you have said since the beginning, you are very knowledgeable.

I wish there was other options other then tcas but I guess thats what mirtazapine is. I am close to accepting the sleep eating but I know I need another med (as you have seen I have nasty ocd and health anxiety) I try to talk myself down but the repetitive record just wont stop no matter what I say or do. It effects me even in my life away from here. I need something for my ocd/anxiety (olanzapine was his attempt to solve it) Not sure if amitrip would help or if it would just help with the sleep.

panic_down_under
24-12-20, 11:17
He had suggested changing olanzapine to ziprasadone (but you said it can gain tolerance)

As a generalisation ziprasidone (Geodon) is moderately less sedating than olanzapine and my observation is tolerance to the sedation builds relatively quickly compared to other antipsychotics, but YMMV on both. It may have one significant advantage for you in that it is less likely to trigger weight gain compared to olanzapine and might produce some weight loss.


But I did think of suggesting that promazine not sure if it is in canada though. I think it's called Chlorpromazine and that version looks nasty for side effects, worse then amitrip lol

Promazine is the precursor of chlorpromazine and is the better med. I know it's not approved in the U.S. for human use, only as a veterinary sedative/anaesthetic, but thought it was in Canada. I wouldn't take chlorpromazine as a sleep aid.


I want to take amitrip cause I have done it before but I need to let go of this endless auto immune bit before I go near it. Afraid to open up a can of Health anxiety or something. I know I was only on 10mg but it felt good.

Maybe the thing to do is to keep your focus on that last sentence, and not the first.


I need something for my ocd/anxiety (olanzapine was his attempt to solve it) Not sure if amitrip would help or if it would just help with the sleep.

Unfortunately, the only way to know is by trying it. There are never any guarantees with any of these meds as they all work indirectly through brain changes, not directly in the way say aspirin does for headaches and that means individual biology is much more a factor than it is with most other medications.

Have a very Merry Christmas and may the New Year usher in better days. Take care :)

SEANML
24-12-20, 21:49
Merry xmas and thank you for all the help. I decided I will try switching olanzapine with ziprasadone (keep mirtazapine for now) and ask the dr about his suggestions for an ocd med in the near future (amitrip seems to be for anxiety and depression) take away the ocd and my anxiety depression will also go away :) 1 drug at a time, first to see if my hunger cravings go away by eliminating olanzapine. If that fails then I will change mirtazapine to something else for sleep. I will also ask him if promazine exists in Canada.If so then maybe try that out instead of mirtazapine. If not then we fall back on my trying to accept amitrip and overcome my fears that are so ridiculous (ana, rheumatoid and hair loss). If I keep up at this rate I will loose hair from stress lol.

1 problem with ziprasadone.I have to eat a meal before taking it. Isnt that linked to prostate cancer late night eating? I already do it enough on my meds now lol) Now im back in circles again on what med to take.
Take zipras and I have to still eat before bed or take amitrip and still eat as well possibly and once again could have nasty side effects that I cant seem to get over hair loss and ana and rhematoid blaw blaw blaw
. Im driving myself insane. Wish the meds I was taking worked to help my ocd, instead they relive anxiety somewhat but cause sleep eating (wich in return could cause prostate cancer I saw a study about that 20% risk)All the meds could cause sleep eating lol
I know you can't help me here but I just had to vent big time. I talk to the dr on the 6th

Also pondering if anafril would be better (due to my ocd issues) I heard that drug helps with it, and you said that Breast fibroadenosis wont happen to men.
Merry xmas happy new years all. Im so lost. What is your opinion of anafril, I am almost comfortable to use that med other then the hair loss risk.My ocd has been getting much worse as you can see lol.Just a crap load of side effects for anafril it seems (have you taken it?)But no auto immune/ana crap.

***Big thank you for your absolute patience and time you have spent trying to reassure me. It means alot (to not be alone in this journey)
Just simple I am afraid of ana/rheumatoid/hair loss and the sleep eating. I need to try to accept some things but I really need to find a medication that will work on my out of control ocd. Am I wrong or is anafril for ocd?
*does anafril sedate?
Sorry once again for my insanity levels here. But at one point your information to me will be accepted I am just not sure when or how.

panic_down_under
26-12-20, 12:14
I decided I will try switching olanzapine with ziprasadone (keep mirtazapine for now)

Ziprasidone for olanzapine seems like a good idea.


first to see if my hunger cravings go away by eliminating olanzapine. If that fails then I will change mirtazapine to something else for sleep

Mirtazapine is probably driving the carb cravings more than olanzapine, but you never know.


If that fails then I will change mirtazapine to something else for sleep. I will also ask him if promazine exists in Canada.

Good idea.


and ask the dr about his suggestions for an ocd med in the near future (amitrip seems to be for anxiety and depression)

All ADs may be affective for OCD, however, clomipramine (also the SSRI fluvoxamine (Luvox)) has a superior record. However, that doesn't necessarily guarantee it will work for you. It all comes down to how it meshes with your biology.


1 problem with ziprasadone.I have to eat a meal before taking it. Isnt that linked to prostate cancer (late night eating? I already do it enough on my meds now lol) Now im back in circles again on what med to take.

It is usually less sedating than olanzapine so it probably won't sedate you enough that you need to take it just before bed. Take it with your regular evening meal.


but cause sleep eating (wich in return could cause prostate cancer I saw a study about that 20% risk)

Never get carried away by a single study and especially not by an observational study. Plus, why are you worrying about a cancer that usually only impacts men of advanced years? I hate to be a party pooper, but the grim reaper always gets us eventually no matter how risk adverse we are. Living your life to forestall death is not only futile it usually ensures you never really live. It isn't the years in your life that count, but the life in your years!




"Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming "Wow! What a ride!"

Hunter S. Thompson


Breast fibroadenosis wont happen to men

Except is circumstances where high oestrogen levels are a factor it can't because males lack the breast tissue in which it grows.


Just simple I am afraid of ana/rheumatoid/hair loss and the sleep eating.

*Temporary* hair loss is the only side-effect which applies. It comes down to what do you value more, a full head of hair all the time, or quality of life?

SEANML
26-12-20, 18:04
Thank you for the information, also Luvox wont help with the sleep bit I don't think but will see if it exists as a daytime med in Canada.
I am almost certain going to change mirtazapinewith something and then change olanzapine a month later to ziprasadone. Or the other way around zipras and then mirtaz . All I know is my repetitive thinking is nuts now, I carry 3 thoughts at a time now.

So no cancer from anafril/hair loss is temporary and ziprasadone take it at meal time and then goto bed 2 hours later.
Also don't even know if I will get hair loss until I try the meds (as it says hair loss is rare) Anafril cancer cannot and will not occur on me because I am a male(If I am understanding) but is there a way that it could happen? I have pecks (use to workout)
Have you or have you known anyone with success on anafril?


I like imaprimine side effects (no cancer or lupus like anafril has those side effects "lupus erythematosus (https://www.drugs.com/cg/lupus-erythematosus.html) rash") So now its between imaprimine and amitriptyline (more comfortable with imap because it does not have any auto immune stuff or cancer) amitriptyline has that 1 thing that bothers me ana/rheumatoid. Theres gotta be other meds that produce sedation like mirtazapine but with less nasty side effects?And help with ocd...

So far the only med he has suggested that I can deal with is imaprimine but you say it wont sedate like amitriptyline. Oh I so wish I never saw side effects I should have just taken what he suggested.

Also I need to stop concerning myself with studies and start concerning myself on what makes me feel good/better.

And lastly start living my life and stop worrying about everything (that is easier said then done but I will try)

Anafril (can it be sedating?)Can amitrip help with ocd and imaprimine? Do they all sedate?

Do you know anyone that had success with ocd and ADs and what were they. I still wish I could accept amitrip side effects but that drug is not for ocd (i read it was for anxiety and pain mainly) I just hate the "cancer" bit for anafril and the auto immunes for both. Argh

You have been very helpful in this troubling time, I want you to be very aware of this. I really dont know why why mind went crazy again ( I was living life to the max for 3 years and then this came back)

*Also I wont worry about observational studies, I guess they are not the most accurate form of data. Sorry for this big message I just had to put it all out there, about to go eat my bed time snack and pass out (cant resist the eating on my meds)


I feel so bad bugging you sorry

panic_down_under
27-12-20, 09:28
Thank you for the information, also Luvox wont help with the sleep bit I don't think but will see if it exists as a daytime med in Canada.

I think you need to separate the antidepressant part from the sleep part. While it would be great to have a single med that solves both, it doesn't always work that way.

Plus, I'm wasn't recommending fluvoxamine. It often works well, but it activates many liver enzymes which can complicate things if you're on many medications.


I am almost certain going to change mirtazapinewith something and then change olanzapine a month later to ziprasadone. Or the other way around zipras and then mirtaz . All I know is my repetitive thinking is nuts now, I carry 3 thoughts at a time now.

Then let you GP make the call. That's what he gets paid for.


So no cancer from anafril/hair loss is temporary and ziprasadone take it at meal time and then goto bed 2 hours later.

That sums it up


Anafril cancer cannot and will not occur on me because I am a male(If I am understanding) but is there a way that it could happen? I have pecks (use to workout)

Unless you used to and/or are take oestrogen supplements, no.


Have you or have you known anyone with success on anafril?

Lots online and one of my oldest friends has been on it since the 1970s.


I like imaprimine side effects (no cancer or lupus like anafril has those side effects "lupus erythematosus rash")

...Oh I so wish I never saw side effects I should have just taken what he suggested.

You really are determined to make life as difficult for yourself as possible by continuing to look up things without having the knowledge to know what is and isn't important. There are no 100% safe medications. People have choked on super pills. You could even fall under the proverbial bus on the way to/from the pharmacy. About the only certainty in this is doing nothing is riskier than taking any one of these meds is likely to be.


So far the only med he has suggested that I can deal with is imaprimine but you say it wont sedate like amitriptyline.

Please reread my first paragraph above.


Anafril (can it be sedating?)Can amitrip help with ocd and imaprimine? Do they all sedate?

Both clomipramine and imipramine are likely to be less sedating than amitriptyline. Both amitriptyline and imipramine can be effective for OCD, but the only way to find out if they will be is by trying them.

My advice, pick one and run with it. If it doesn't work out then switch to one of the others. You really don't have anything to lose and much to gain. If you can't decide either leave it up to your GP, or pick one out of a hat. Taking any one of them has a good chance of working, going around and around in circles never will. :sad:

SEANML
27-12-20, 12:16
What I dont get is that anafril causes auto immune like amitriptyline. But you say amitriptyline is not an immune causer. Or does anafril just cause lupus like symptoms but not actual lupus?

Parts of me want to get the courage to take one but it's hard. I dont like risk. I didn't notice hair loss on amitriptyline but I have rheumatoid factor and ana already, couldn't amitriptyline trigger the real deal?

I just need your help to convince me that anafril or amitriptyline wont cause cancer or auto immune. I'm sorry you must be so frustrated. Maybe studies exist. Imaprimine has the least scary side effects other than hair loss.

Do you know if there is other sedatives and other OCD meds other then tcas? My dr feels amitriptyline is the closest sedative to mirtazipine. He said mirtazipine is potent. I talk to him the 6th but in afraid to ask other options. He has said I'm difficult. I get it. I just wish something was as equal to mirtazipine

I'm afraid to also take anafril or imaprimine because then I wont sleep if they dont sedate. I use 3 drugs to put me down, and I still take a hour or 2 to sleep. And I wake alot lol.

Also can nortriptiline be of any sleep use/ocd/anxiety?

***On a plus side note I am closer to accepting one of the drugs (amitriptyline) not yet but I keep telling myself I took it for a few weeks before so it's not a big dealio. Just the ana/rheumatoid is scary and also as I said it does not say its for ocd.And my precious hair lool (3 years of hard work growing this beautiful mop of a dew)

panic_down_under
28-12-20, 00:30
Parts of me want to get the courage to take one but it's hard. I dont like risk.

You do riskier things every day as part of the normal day to day activities. Plus, doing nothing is arguably much riskier.


I didn't notice hair loss on amitriptyline but I have rheumatoid factor and ana already, couldn't amitriptyline trigger the real deal?

the evidence says no.


I just need your help to convince me that anafril or amitriptyline wont cause cancer or auto immune. ...Maybe studies exist. Imaprimine has the least scary side effects other than hair loss.

I can't convince you, you have to do that yourself. I've already posted all the information you need to make a decision.


My dr feels amitriptyline is the closest sedative to mirtazipine.

He's right.


I'm afraid to also take anafril or imaprimine because then I wont sleep if they dont sedate. I use 3 drugs to put me down, and I still take a hour or 2 to sleep. And I wake alot lol.

You could still take low, sedating doses of mirtazapine if you needed to. Plus, you may sleep better just from having the anxiety/OCD under control.


Also can nortriptiline be of any sleep use/ocd/anxiety?

Nortriptyline is the active metabolite of amitriptyline. It is less sedating than its parent.


On a plus side note I am closer to accepting one of the drugs (amitriptyline) not yet but I keep telling myself I took it for a few weeks before so it's not a big dealio. Just the ana/rheumatoid is scary and also as I said it does not say its for ocd.And my precious hair lool (3 years of hard work growing this beautiful mop of a dew)

It is your choice. You can spend the rest of your life trapped in this circle and possibly die prematurely from some stress triggered disease, or you can take a leap of faith.

If you can't bring yourself to take meds then is therapy a possibility? It can be as effective as ADs.

SEANML
28-12-20, 11:32
Therapy is not affordable. But my dr said if I could get cognitive one day its recommended. As meds is not a long term solution.

So amitriptyline causing ana, rheumatoid doesn't mean it gives autoimmune? So close now

panic_down_under
28-12-20, 13:03
Therapy is not affordable.

The Canadian healthcare system doesn't pay for at least some therapy?


As meds is not a long term solution.

What is his definition of 'long term'? ADs have kept me mostly anxiety free and reasonably sane (some of those who know me well may disagree :sad:) since early 1987, nearly 34 years. They don't work that well for everyone, but I'm by no means a rare exception.


So amitriptyline causing ana, rheumatoid doesn't mean it gives autoimmune? So close now

I have explained why these fears are unfounded and provided evidence for this. You're just keep going around in circles.

SEANML
28-12-20, 18:38
Nope they do not cover any other then a(waiting for one now) Psychologist. My sleep dr is being of help on the side. As he use to be a phycologist :)

He meant long term at the dosing I am at (vyvanse 70mg,mirtazapine 30mg olanzapine 25mg trazadon (now 50mg) and a melatonin 10 mg. Plus I drink a crap load of coffee. He said this amount of medication is not good.

I checked over your ana answer, I just didn't understand it on how it shows amitriptyline is not ana/RF maker. Sorry my brain injury makes reading large documents hard. Thanks for all your effort thought, you must have read it and understood it . You have alot of knowledge and resources :)

panic_down_under
29-12-20, 06:25
Nope they do not cover any other then a(waiting for one now) Psychologist. My sleep dr is being of help on the side. As he use to be a phycologist :)

A psychologist should be able to help you with cognitive and/or behavioural, or mindfulness therapy techniques.


He meant long term at the dosing I am at (vyvanse 70mg,mirtazapine 30mg olanzapine 25mg trazadon (now 50mg) and a melatonin 10 mg. Plus I drink a crap load of coffee.

Woo!! Back up the truck! You are on the maximum dose of a very potent stimulant, lisdexamfetamine (Vyvanse), and drink "crap loads of coffee". No wonder you can't sleep despite taking huge amounts of several sedating meds!

I suggest you get a second opinion about your medication regime, if possible. At the very least stop drinking coffee!


I checked over your ana answer, I just didn't understand it on how it shows amitriptyline is not ana/RF maker.

The side-effect listing for antinuclear antibodies (ANA) seems to rest on the single case noted in the patient information sheet I linked (PDF (https://www.arrowpharma.com.au/wp-content/uploads/1970/01/Rithmik_PI.pdf), p 14) in which a patient also had pulmonary fibrosis of the lung. Both high ANA and RF are a very common side-effect of pulmonary fibrosis with about 30% (https://emedicine.medscape.com/article/301226-workup) having one, or both, but as far as I can tell there have been no other reports in the medical literature associating ANA and RF with amitriptyline. OTOH, there are many studies reporting, or recommending amitriptyline be prescribed for pain relief for patients with ANA and RF.

I've done further research on ziprasadone and it is a more potent SRI than I thought which likely makes it problematic with clomipramine, and possibly imipramine too. It depends on the dose.

SEANML
29-12-20, 12:47
So the reason ana rf was in the side effects is due to a person having lung issues no other people had the ana,rf? If I understand you correct.

Only reason I'm changing my meds is to solve the insane food cravings. Makes me a fat monster. I cant resist I've tried. I sleep amazing other then that. The drugs I'm on have made me hungry always. And 30 min after I take them I raid the nuts and olive oil. No other food satisfy it.

So ziprasidone would not be good with those 2 meds? I am trying to get comfy with amitriptyline now. Just to be honest it really constipated me. I got the constipated IBS version. I will only be changing mirtazipine and olanzapine 1 month at a time. Not sure wich one yet as I'm scared I wont sleep. I need sleeper alternatives.

All I know is something triggered me to have OCD, anxiety again 6 months ago. Before that I was fine other then some sleep difficulties. I dono the culprit.

The high dose vyvanse is to counteract the food cravings from my sleep med. I was on 60mg ritalin in the past with less stimulants affect, but my hunger was too much. I take them also to help with my fatigue. I will make a slow attempt on my coffee starting tomorrow though. All I know is in my past I slept better with ritalin but I need off all these hunger meds. I dono which one caused it. Mirtazapine and olanzapine are only a year of use. I want off food cravings drugs so I can go back on my ritalin. Atleast with ritalin you can take off days. 24/7 stimulated is rough. No days of rest. I make sure to have my last cup 6 hours before sleep atleast. Part of me wonders if the vyvanse trigger my old disorders to re surface?

Do you know if there is other sleeping meds other the tcas,benzos and sleeping pills. Was gonna ask my sleep dr the same question. To my understanding I'm on the most powerful combo but cant take hunger. It's the only effect I get. Wish I never had to change.

Hey! What about taking ziprasadone and olanzapine instead of mirtazapine? In theory that could work couldnt it?

panic_down_under
30-12-20, 11:24
So the reason ana rf was in the side effects is due to a person having lung issues no other people had the ana,rf? If I understand you correct.

Yes. I can't say with 100% certainty that amitriptyline wasn't responsible for the immune dysfunction, but if there is only one known case linking the med to the dysfunctions and it also had another factor, the lung fibrosis, which is known to cause ana and/or rf in 30% of cases then Occam's razor says it would be the most likely culprit, not the med.


So ziprasidone would not be good with those 2 meds?

It depends on the dose. It is something your GP needs to work out.


I am trying to get comfy with amitriptyline now. Just to be honest it really constipated me. I got the constipated IBS version.

Most of the TCAs can cause constipation (and dry mouth). It is usually less severe with clomipramine and imipramine than amitriptyline. Eating lots of fibre and ensuring you're well hydrated will help, I also found sprinkling a tablespoon of crushed linseed, aka flax seed, on the morning cornflakes help too.


All I know is something triggered me to have OCD, anxiety again 6 months ago. Before that I was fine other then some sleep difficulties. I dono the culprit.

...The high dose vyvanse is to counteract the food cravings from my sleep med.

...Part of me wonders if the vyvanse trigger my old disorders to re surface?

So you take meds to help you sleep then a stimulant to ease the food cravings from the sedatives which forces you to take higher doses and/or more sedatives? Does that sound reasonable to you?

Did the OCD and anxiety start soon after you began taking lisdexamfetamine? If so, it could well be the trigger. Taking a stimulant with an anxiety disorder is often problematic.


I was on 60mg ritalin in the past with less stimulants affect, but my hunger was too much.

...All I know is in my past I slept better with ritalin but I need off all these hunger meds.

Did you need fewer sedatives, or lower doses of them when you were on methylphenidate (Ritalin)?


I dono which one caused it. Mirtazapine and olanzapine are only a year of use. I want off food cravings drugs so I can go back on my ritalin

Mirtazapine is almost certainly the one causing most of the food cravings.


Do you know if there is other sleeping meds other the tcas,benzos and sleeping pills.

Doxepin perhaps. It is about as sedating as mirtazapine, but usually doesn't produce food cravings to the same severity. It depends on whether it is still available in Canada. It still is here in Oz, but Lesley - WiseMonkey - posted a while ago that it had been taken off the NZ market. TCA prices have also increased lately. Not sure if the two are linked.


What about taking ziprasadone and olanzapine instead of mirtazapine? In theory that could work couldnt it?

Taking two antipsychotics is not a good idea, and even less so just for sedation. I'm not a fan of antipsychotics for anything other than the illnesses they are made for.

SEANML
30-12-20, 11:43
Ritalin only took mirtazapine and 10-20 mg olanzapine now I need 25mg. I can concentrate better though now. There is a chance that I will try ritalin again but that's not going to be a concern until I get the sleep drugs figured out (Ritalin wasn't as powerful for the good side effects, and I was still quite tired on 6 of them. But I like that my weekends I could avoid taking any and just relax. But first the hunger has to be solved because its intense without vyvanse. So mental problems came 1 or 2 months after vyvanse was started.
Ritalin took the heavy sedation as well. But less mental issues. Had them but less intense. Also less coffee.

I know vyvanse lasts longer and is more intense for my ADHD and energy levels. It most likely has contributed to the sleep. But I need new meds before I can even think of touching it. Only imaprimine seemed safe but you say it wont sedate . What do you take if I may ask?

Oops I may have asked my dr for the wrong thing. Which on prescribes meds? Only that one is covered

Anti-psychotics never caused me an issue other then bed and seroquel caused that Seborrheic dermatitis and possibly un controllable hunger. That's why I'd prefer them. Amitriptyline and the other tcas scare me for the side effects. Less with anti psychotics, been on them for years.

I need a med that's not a tca but helps with sleep with less hunger. In my opion TCAs seem to have some scary side effects compared to the drugs im aware of,

Is there any sedatives that are not a TCA? Any other suggestions? I will be asking my dr that question.Id take imaprimine if it was a sedative,amitrip still frightens me sadly. Gotta be other non tcas out there. I just cant touch hypnotics, too dangerous in all my drs opinions

panic_down_under
31-12-20, 10:30
So mental problems came 1 or 2 months after vyvanse was started.

Which may be significant. You need to tell your doctor this.


Only imaprimine seemed safe but you say it wont sedate . What do you take if I may ask?

A TCA that isn't available in Canada, dosulepin, aka dothiepin, (Prothiaden).


Amitriptyline and the other tcas scare me for the side effects. Less with anti psychotics, been on them for years.

See, that's the problem. You've been on antipsychotics for years so are comfortable with them and fear TCAs because they are something new. You have also become fixated on side-effects which you will almost certainly never experience, but your mind can't let go. Had you been on TCAs for years and now been asked to take antipsychotics you'd be just as scared of their side-effects...and with more justification.


In my opion TCAs seem to have some scary side effects compared to the drugs im aware of,

Only in your imagination. I would not take the two antipsychotics except if I had schizophrenia or maybe bipolar depression. Nor am I a fan of mirtazapine.


Id take imaprimine if it was a sedative,

Hoping for a med which solves two different issues is often futile. It is almost always better to take the best med for each problem than one med which does neither task well.

SEANML
31-12-20, 10:46
In your opinion what med would you suggest for sleep and then a med for ocd/anxiety.

Olanzapine did work but seems it's no longer as potent. Just wish I could overcome my amitriptyline fears and tcas in general. Just shoot if I got rheumatoid I'd be so depressed .
I'm terrified of auto immune and cancer.

Is amitriptyline my only best bet for sleep? I feel either raise olanzapine or add another anti phycotic with olanzapine and then take mirtazipine away.
Your version is add amitriptyline and take away mirtazipine? Then I'd constantly wonder if I was getting ANA. By the sounds of it imaprimine is useless in your eyes?

panic_down_under
31-12-20, 12:04
In your opinion what med would you suggest for sleep and then a med for ocd/anxiety.

Try doxepin if you can get it for sleep instead of mirtazapine, and clomipramine or imipramine for OCD, or amitriptyline if insomnia is still an issue.


Just shoot if I got rheumatoid I'd be so depressed .
I'm terrified of auto immune and cancer.

Then isn't it fortunate that this not a real issue with any of the TCAs under discussion, only a problem created by your mind.


I feel either raise olanzapine or add another anti phycotic with olanzapine and then take mirtazipine away.

Taking two antipsychotics would be seriously nutz, imo.


Your version is add amitriptyline and take away mirtazipine?

No, my 'version' is take what will likely be the more effective meds for OCD, clomipramine, or imipramine if your mind won't get over its fears about clomipramine. And for sedation ditch the mirtazapine for something else such as doxepin. Also try lowering the trazodone to no more than 50mg to boost its sedative effects.

Imho, mirtazapine is at the heart of most of your problems. It is almost certainly the principle cause of your hunger issues. Do something about them and the others things would likely become more manageable.


By the sounds of it imaprimine is useless in your eyes?

Why would you think that? I was on it for years. Great med. Clomipramine probably has an edge with OCD, but for other anxiety disorders imipramine is often very effective. It was the 'gold standard' AD for panic disorders for decades until the SSRIs became available and they didn't become more popular because they are more effective, they are not, but because they are thought safer in overdose which isn't actually true of all of them.

SEANML
31-12-20, 14:19
I think side effects wise amitriptyline is better the doxepin. I just need to convince myself ana wont happen. And the other med would be imaprimine for ocd/anxiety if that makes sense? Can I take 2 tcas? Can imaprimine help with OCD? Clomiaprimine makes me nervous for the breast fibrodenosis and systemic lupus rash. You have almost settled my mind on amitriptyline.

Also what am i missing , are antipsychotics that intense to take 2 at once (olanzapine and ziprasidone). I dont get noticed side effects from 1.

panic_down_under
01-01-21, 05:02
I think side effects wise amitriptyline is better the doxepin.

I'm not suggesting you take doxepin for OCD/anxiety, but only a low dose for insomnia.


I just need to convince myself ana wont happen. And the other med would be imaprimine for ocd/anxiety if that makes sense? Can I take 2 tcas?

Taking amitriptyline at low doses for insomnia won't work. If you take it at antidepressant level doses then no, you can't also take clomipramine, or imipramine and you shouldn't need to anyway.


Can imaprimine help with OCD?

Yes, it could, as I have repeatedly told you. Are you hoping for a different answer?


Clomiaprimine makes me nervous for the breast fibrodenosis

Do you lay awake at night worrying about getting ovarian cancer? If not, why not?


and systemic lupus rash.

You got seborrheic dermatitis from quetiapine (Seroquel). Did your world end? No? Lupus is no different. In the very unlikely event it becomes a problem then you switch to another med and life goes on.


Also what am i missing , are antipsychotics that intense to take 2 at once (olanzapine and ziprasidone). I dont get noticed side effects from 1.

Then you've been lucky.

We seem to be just going around in circles getting nowhere. You're not really in a frame of mind to do anything.

My advice, replace the mirtazapine because it is doing you real harm right now because of weight gain. Once you are settled on the replacement then you can start thinking about treating the OCD/anxiety. Insomnia and OCD are two separate issues and should be treated as such.

SEANML
01-01-21, 12:01
So for insomnia would you suggest amitriptyline?Do low doses sedate? Doxepin has a risk of 3 cancers (that is more scary then rheumatoid). Sorry for bugging you so much, we are getting close to a end solution.

panic_down_under
01-01-21, 13:01
So for insomnia would you suggest amitriptyline?Do low doses sedate?

No, low doses don't sedate. You take amitriptyline for OCD/anxiety. Any sedation is a bonus.


Doxepin has a risk of 3 cancers (that is more scary then rheumatoid).

No, it does not. All that is telling you is that someone in the trial was found to have lung cancer at stage one. Trials usually run for less than 6 weeks. Lung cancers generally take years to grow big enough to be detected by x-rays. Do you think that if a med caused lung cancer in 6 weeks it would be approved, let alone still be being prescribed 50 years later? Same goes for malignant melanoma - skin cancer. Doxepin is sold in cream form (https://www.medicinenet.com/doxepin-topical_cream/article.htm) to treat skin conditions! We know what causes both these cancers, and doxepin isn't it. Cysts are not cancers. You're just again scaring yourself over nothing because you are unable to evaluate what you're reading. Meanwhile the meds that you are on are probably causing you actual harm.

Check out this study: Relationship between anti-depressant use and lung cancer survival (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603309/):
Previous preclinical work demonstrated that tricyclic anti-depressants have antitumor efficacy in lung cancer.

and this one showing that adding serotonergic ADs, including doxepin (also clomipramine) to anti cancer drugs increases their effectiveness: Serotonergic system antagonists target breast tumor initiating cells and synergize with chemotherapy to shrink human breast tumor xenografts (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5458271/)

Plus, the side-effects are based on the doses prescribed to treat anxiety and depression, 75-150mg. The effective dose for insomnia can be as little as 3mg, though 10-25mg is more usual.


Sorry for bugging you so much, we are getting close to a end solution.

I doubt it. Again, do something about the mirtazapine and then come back if you need info on meds for anxiety. You're unlikely to get anywhere without fixing the hunger issue first.

SEANML
01-01-21, 14:29
So I can understand better(amitriptyline is not the med for sleep, it's for ocd anxiety.)I would need a high dose to sleep? The med for sleep is doxepin ? I just want to get things straight, I talk to the dr the 6th. So lung cancer and the other cancers are impossible to have been caused by the drug? They just have to say everything that happened during the trials?

That cancer bit scares the crap out of me, amitriptyline never shows any random cancers.Also wont it cause hunger compared to amitriptyline.I dont want to quit one drug to gain the same side effects. Only side effects I get that I notice is my hunger is insane,

Please bare with me we are slowly getting somewhere,I was close to taking amitrip but now you say it wont sedate. Doxepin the cancers make me super nervous, what if they did somehow come from it?

What dose for sleep would be for amitriptyline? Im just having a hard time getting over the cancers for doxepin, why would they mention them if it wasnt of concern?

I was close to accepting amitri or just doing ziprasadone with olanzapine (cause I don't get any side effects with antiphycotics, couldnt that be a solution?)

A part of me wants doxepin to work for me to pick (but the cancers being mentioned) scare the crap out of me, Amitrip doesnt have that. I am trying to read the studies to better understand everything. Just having a hard time getting over the cancers. Not many drugs mention cancer in side effects.

All I know is the world sells cancer causing things for money (like smokes/alcohol ) they just tell you it causes it. Whats the meaning "frequency not reported"?

Also is olanzapine and doxepin safe to be taken together?

panic_down_under
02-01-21, 03:26
So I can understand better(amitriptyline is not the med for sleep, it's for ocd anxiety.)I would need a high dose to sleep? The med for sleep is doxepin ?

Yes, amitriptyline for OCD/anxiety, and doxepin for insomnia.


So lung cancer and the other cancers are impossible to have been caused by the drug? They just have to say everything that happened during the trials?

Correct


That cancer bit scares the crap out of me, amitriptyline never shows any random cancers.Also wont it cause hunger compared to amitriptyline.I dont want to quit one drug to gain the same side effects. Only side effects I get that I notice is my hunger is insane,

Doxepin may still cause some carbohydrate cravings, but not as much as mirtazapine which is notorious for the cravings it creates. All sedating meds cause some cravings, the trick is to pick the milder ones.


Please bare with me we are slowly getting somewhere,I was close to taking amitrip but now you say it wont sedate.

It will, but not as much as doxepin, or mirtazapine.


Doxepin the cancers make me super nervous, what if they did somehow come from it?

What if a piece of space junk hit you on the head tomorrow? Doxepin has been in use since 1969. If it was causing cancers do you think it would still be sold? It isn't an irreplaceable drug. These days it is mostly sold as an antihistamine and there are many other antihistamines.


What dose for sleep would be for amitriptyline?

You won't be taking it for sleep. The dose for anxiety is 75-150mg (300mg for inpatients).


Im just having a hard time getting over the cancers for doxepin, why would they mention them if it wasnt of concern?

By law they have to list everything that came up during the trials, irrespective of whether they think the drug caused them.


I was close to accepting amitri or just doing ziprasadone with olanzapine (cause I don't get any side effects with antiphycotics, couldnt that be a solution?)

Taking two antipsychotics is unwise especially as you are already taking the maximum olanzapine dose.


A part of me wants doxepin to work for me to pick (but the cancers being mentioned) scare the crap out of me, Amitrip doesnt have that. I am trying to read the studies to better understand everything. Just having a hard time getting over the cancers. Not many drugs mention cancer in side effects.

You're just going around in circles, getting nowhere.


All I know is the world sells cancer causing things for money (like smokes/alcohol ) they just tell you it causes it.

Doxepin is long out of patent and is cheap. Nobody is making fortunes selling it.


Whats the meaning "frequency not reported"?

They don't know how often it was reported. My guess it was only once.


Also is olanzapine and doxepin safe to be taken together?

Yes. The only effect from taking them together is they each increase the sedation of the other. But that is true of mirtazapine and olanzapine too.

SEANML
02-01-21, 12:04
I got a few days to get over the cancer bit. I will try my best. Just made me nervous. I kno lung cancer is a sneaky 1 that's why it makes me nervous. They also mentioned 2 other cancers. Just makes me wonder if somehow it was carcinogenic in a way.

I know my current drug cocktail can be hard on my body just wish there was no cancer . It doesn't cause alot of scary stuff. How sure are you? I trust you. You seem better informed then me. I just wonder if it causes cancer so legally they mention it and can still sell it. Like the suicide warnings they have.

Amitriptyline looked good but shoot never took doses that high. I did 10mg for 2 weeks. But my insomnia is worse now most likely. My moms told me to take whatever I feel is best, a part of me thinks amitrip just cause it doesnt mention cancers. I just dont like my odds for cancer being mentioned so many times.On the plus amitrip will also help with ocd/anxiety while putting me to bed (less chemicals needed the better right?)

I realize my current drug cocktail is probably the cause of my heart pains/heartburn and so on (i know now that what I am doing will break my body down and it needs to be changed)

panic_down_under
03-01-21, 01:52
know my current drug cocktail can be hard on my body just wish there was no cancer . It doesn't cause alot of scary stuff. How sure are you?

I'm a lung cancer survivor so I take anything which may cause it very seriously.


Amitriptyline looked good but shoot never took doses that high. I did 10mg for 2 weeks.

10mg is nowhere near enough to trigger an antidepressant response. You will need at least 75mg, perhaps more. The recommended maximum dose is 150mg (300mg in a hospital inpatient setting).


But my insomnia is worse now most likely. My moms told me to take whatever I feel is best, a part of me thinks amitrip just cause it doesnt mention cancers. I just dont like my odds for cancer being mentioned so many times.On the plus amitrip will also help with ocd/anxiety while putting me to bed (less chemicals needed the better right?)

You'll be taking amitriptyline for your anxiety/OCD. Any sedation from it will be a bonus, not the reason for taking it.

Treating insomnia is a different question. Doxepin, or promazine should be better than mirtazapine as they are less likely to cause the severe carbohydrate cravings you're experiencing.


I realize my current drug cocktail is probably the cause of my heart pains/heartburn and so on (i know now that what I am doing will break my body down and it needs to be changed)

Yes. As I've said before doing nothing is likely to be the very worst of your options.

SEANML
03-01-21, 09:00
I got a few days to try and except doxepin, I dont think promazine is in canada. I understand what your saying but it's just the fact that they suggested those cancers in side effects. Concerns me.

Amitriptyline just may cause autoimmune, less serious compared to may cause cancer. And at the right dose I will get sleep and help with OCD combo with 1 pill. Not sure about craving though.

Promazine I think is by a different version of chemistry in Canada. Forgot the name.

I just cant overcome the cancer what ifs

panic_down_under
03-01-21, 10:55
I just cant overcome the cancer what ifs

It's a pity you can't resist googling what you don't have the knowledge to correctly evaluate, but to quote the last words of the immortal Australian sage on life and the human condition, Ned Kelly, "such is life". :sad:

SEANML
03-01-21, 12:08
Couldn't amitriptyline be a 2 in one? Sleep and OCD. With doxepin I'd need another pill to battle my issues.

But yes I wish I could overcome cancer, doxepin seems like a powerful sleeper. Have you used it? Just those cancers and what if is too strong. I'd feel I took something that I'd regret years later if I got lung cancer plus melanoma runs in the family rather not risk it with a med for just sleep.

And Amitriptyline you are pretty sure wont give ana/rheumatoid. It will put me to sleep plus treat my mental problems. Doxepin may cause cancer and just puts me to sleep, no other benifits if im correct.

Nervous about amitriptyline but less than how I'm terrified of doxepin, auto immune is less scary then cancer. All I think is they posted the cancers for a valid reason, maybe they thought it caused it possibly.

panic_down_under
03-01-21, 12:57
Couldn't amitriptyline be a 2 in one? Sleep and OCD. With doxepin I'd need another pill to battle my issues.

Amitriptyline will likely be sedating, but not to the same degree as mirtazapine. I think you will need something else if you want to replace mirtazapine.


But yes I wish I could overcome cancer, doxepin seems like a powerful sleeper. Have you used it? Just those cancers and what if is too strong. I'd feel I took something that I'd regret years later if I got lung cancer plus melanoma runs in the family rather not risk it with a med for just sleep.

And Amitriptyline you are pretty sure wont give ana/rheumatoid. It will put me to sleep plus treat my mental problems. Doxepin may cause cancer and just puts me to sleep, no other benifits if im correct.

Nervous about amitriptyline but less than how I'm terrified of doxepin, auto immune is less scary then cancer. All I think is they posted the cancers for a valid reason, maybe they thought it caused it possibly.

Pick the med you think will cause you the least stress and then take it. Just going around in circles as you've been doing for weeks now will get you nowhere.

SEANML
03-01-21, 15:09
What about the 25mg of olanzapine on top of amitriptyline. Or you think doxepin is the only match for mirtazipine replacement? I just dono if I can handle the anxiety of it having cancerous things

panic_down_under
03-01-21, 22:53
What about the 25mg of olanzapine on top of amitriptyline.

There's only one way to be certain and that's by taking it.


I just dono if I can handle the anxiety of it having cancerous things

Then don't take it as the stress will likely cloud your perception of the med making for an unpleasant experience.

SEANML
04-01-21, 11:51
And your pretty certain I shouldn't get ana / RF with it? Just double checking your answer.

panic_down_under
04-01-21, 12:37
And your pretty certain I shouldn't get ana / RF with it? Just double checking your answer.

My answer remains the same, both on ANA and RF, and on cancer with the others. It doesn't matter how often you circle around this, the facts are not going to change.

SEANML
05-01-21, 13:37
thanks for all your help and information.

I will be changing my meds in the next month, just have to wait until I am off work probation. Cant afford to change things around while I am trying to pass for a job. Mom called and says it's time now to make the change (Sees massive anxiety) But to be honest I am still trying to grasp that amitriptyline will not cause auto immune heh, Doxepin is a no go for sure sadly. I talk to my dr tomorrow about the meds I just dono a part of me still thinks 2 antiphycotics instead of amitriptyline but the other side says bite the bullet and try amitriptyline.

panic_down_under
06-01-21, 01:26
I will be changing my meds in the next month, just have to wait until I am off work probation. Cant afford to change things around while I am trying to pass for a job. Mom called and says it's time now to make the change (Sees massive anxiety) But to be honest I am still trying to grasp that amitriptyline will not cause auto immune heh, Doxepin is a no go for sure sadly. I talk to my dr tomorrow about the meds I just dono a part of me still thinks 2 antiphycotics instead of amitriptyline but the other side says bite the bullet and try amitriptyline.

Well, you know my position on this, but it's your and your GP's call.

SEANML
06-01-21, 14:58
so nervous of change and amitrip. Trying to convince myself itll be ok

panic_down_under
06-01-21, 22:33
so nervous of change and amitrip. Trying to convince myself itll be ok

Unfortunately, pill-phobia is the 'freebie' many of us get as a 'bonus' to our primary disorder. Sometimes you need to make a leap of faith to get ahead. My advice, stop reading things you don't understand and rely on the advice of your doctor and your pharmacist. It is not in their interest to harm you.

SEANML
07-01-21, 11:33
I understand, and sadly my doctor did not call yesterday for some odd reason. Maybe a weird sign to show I am not ready for the change yet. Just scared.

I understand that living the way I am is not the best but meds scare me. A fear that I must get over soon I hope.Thank you for all your patience

panic_down_under
07-01-21, 21:47
I understand that living the way I am is not the best but meds scare me.

I understand, but you need to do yourself a huge favour and not look up information about new meds. This is not helping you.
If you had started taking amitriptyline on the day this thread began you would now be on the threshold of kick-in.

SEANML
28-02-21, 09:19
Couldn't find your suggestion for OCD medication. I got lost reading everything. Can you refresh me? Sry

panic_down_under
28-02-21, 09:36
Couldn't find your suggestion for OCD medication. I got lost reading everything. Can you refresh me? Sry

In order, clomipramine, imipramine, amitriptyline. But we've been through this and it was clear that you've so convinced yourself that they will harm you even though the overwhelming evidence contradicts what you believe so it is all moot. The best med in the world won't work if you can't take them. :sad:

SEANML
28-02-21, 12:25
Didn't think amitriptyline helped OCD. Was going to ask for that med. My ovd/anxiety is preventing me from living

panic_down_under
28-02-21, 23:36
Didn't think amitriptyline helped OCD.

All ADs may treat OCD, but some might, repeat might have an edge.

SEANML
02-03-21, 15:53
Have you heard of Cymbalta? I decided to ask for that med because all the side effects are liked by me :)

panic_down_under
02-03-21, 22:37
Have you heard of Cymbalta? I decided to ask for that med because all the side effects are liked by me :)

Duloxetine is as likely to work as any other AD. If you are willing to take it then go for it.

And please stop reading about side-effects. You don't have the knowledge to evaluate what you're reading and just worrying for nothing. Meanwhile the disorder will likely do you more harm than any of the meds you've rejected ever would. If you'd taken any of the ADs you've asked about you could be anxiety free now.

SEANML
03-03-21, 19:46
I understand, in the end I have caused harm (the over eating led to a compromise on my stomach wrap. I get heartburn 24/7 now (wont take ppis as they are nasty long term) Long story short I learnt the path I was going was not the right way to go. I will be talking to my dr at the end of the month. I am making a promise to myself to take Cymbalta I need to start living my life instead of hiding from everything and being all antisocial. My ocd is also through the roof since my heartburn came back 24/7. Scared shitless about getting barrettes now that my surgery stretched. I am praying that I get a new operation but testing takes a year sometimes and then I have to pray he will re operate :( I am a huge mess now so I will take cymbalta if that's the key to ending this insanity.

Thanks again for all your patience and reassurances. You have been a great help and soon I will be on something that helps :) Even though the damage is already done . Only scary side effect was interstitial lung disease. Yes I know I should not have read them.

panic_down_under
04-03-21, 03:57
so I will take cymbalta if that's the key to ending this insanity

There are no guarantees in life, but in almost all circumstances doing nothing is the worst of all the available options.

SEANML
04-03-21, 13:10
Have you heard of cymbalta and the lung disease? I am going to take it anyways just thought Id ask if that side effect rang a bell.Scared me but I realize every med will have a side effect I wont like so deal with it.

panic_down_under
05-03-21, 00:10
Have you heard of cymbalta and the lung disease?

Interstitial lung disease is a listed rare potential side-effect of most SSRIs and SNRIs and at last count some 400 other medications including aspirin and other NSAID painkillers and antibiotics have been associated with it. It is more likely to be a problem in the elderly so maybe stop taking duloxetine when you're 70-75 yo.

SEANML
05-03-21, 11:43
Well its between cymbalta and amitriptyline. I got a few weeks to decide. Thanks for the comment. Was afraid I'd get it even though its rare. Already have lung issues from my reflux

SEANML
11-03-21, 15:28
Part of me thinks I should just listen to the doctors suggestion of Zoloft. He said he never had a patient complain about heartburn. I only came up with cymbalta but that can cause heartburn aswell and is not for OCD. Whats your opinion? Trying to make the right decision. Neoplasm for loft worried me too lol. By I am close to deciding on a pill.

panic_down_under
11-03-21, 23:21
Trying to make the right decision.

No one can predict which is the best med for you so just pick one and try it. Pick a name out of a hat if you have to, but take something. There is a very good chance that with a month or two you will be doing better than you are now.

vforu
12-03-21, 07:05
Thông tin vui đến với các bạn muốn có xiền từ 18 + nhé mọi người.
Bỏ ra 5 phút để đăng ký căn cước chúng ta lấy 3tr mua sắm.
Hạn mức khách mới tối đa 4 trd lần sau nh*n đến 10 trd.
Đăng ký: https://instabio.cc/nhanngay

SEANML
12-03-21, 11:50
Just worried about the heartburn from zoloft. But as the dr said you wont kno if you get heartburn until you try it. Do you kno much about zoloft? I kno you are familiar with tcas and those dont cause heartburn. Hence why I'm deciding zoloft or amitriptyline or cymbalta