Lofepramine

[milliemoo]

Hi I have just started on lofepramine for GAD after many failed attempts with SSRI's and SNRI's. I am on day 1 and not really sure how I feel at the moment....

Anyone else had any luck with it??

[panic_down_under]

Hi I have just started on lofepramine for GAD after many failed attempts with SSRI's and SNRI's. I am on day 1 and not really sure how I feel at the moment....

Anyone else had any luck with it??

Lofepramine is a stronger inhibitor of noradrenaline, aka norepinephrine, than serotonin so is a good choice if SSRIs/SNRIs haven't worked. It usually triggers fewer of the ongoing TCA side-effects such as dry-mouth and constipation and is nearly as safe as the SSRIs in overdose.

[milliemoo]

It has made my anxiety a lot worse since starting it!! I am really worried that It won't work for anxiety as it's main use is depression and I am not depressed just severely anxious!! Do TCA's really work for anxiety??

[panic_down_under]

It has made my anxiety a lot worse since starting it!!

This is common with most antidepressants initially, though usually minder with the TCAs than SSRIs/SNRIs. It usually diminishes within a few weeks. Ask your GP to prescribe a small dose of diazepam (Valium) if it gets to be too much.

I am really worried that It won't work for anxiety as it's main use is depression and I am not depressed just severely anxious!! Do TCA's really work for anxiety??

Well they have been keeping me almost totally panic free for over 30 years.

The various anxiety disorders and depression are just different points on a continuum of disorders produced by the same underlying biological deficit, the reduction in hippocampal neurons caused by chronically high brain stress hormone levels, and will respond to the same meds.

I forgot to mention in my previous post that the main problem with lofepramine is its short half-life which means it needs to be taken several times a day. Some don't mind this, but it can be frustrating for others. If it is for you then desipramine (Pamelor) would be a good alternative. It is the active metabolite of lofepramine having similar psychodynamics, with desipramine being slightly more potent, milligram for milligram.

[milliemoo]

I had a pretty good day yesterday but today has been awful, anxiety, feel like I wanted to cry all day but didn't feel depressed but then this evening felt really down and loads of negative thoughts!! Feelings are all over the place! I'm hoping it's just the tablets doing something to my brain lol!! I don't have a problem with twice a day dosing as long as it works! I have so far not had much luck over the last two years, with SSRI's and venlafaxine!!

[panic_down_under]

Feelings are all over the place! I'm hoping it's just the tablets doing something to my brain lol!!

I wouldn't read anything into how lofepramine is affecting your feelings, atm. Antidepressants can be weird meds at the beginning. It pays to just go with the flow. The good news is you have now been on it long enough for plasma levels to have stabilized so things should begin settling down soon.

How much are you taking?

[milliemoo]

I started on 35mg twice a day then went to 70mg twice day but that was too much so I've gone back to the 35mg, was going to let that settle till the weekend then up my dose again.

[panic_down_under]

I started on 35mg twice a day then went to 70mg twice day but that was too much so I've gone back to the 35mg, was going to let that settle till the weekend then up my dose again.

Sounds like a good plan. You could also try taking only an extra half a tablet, i.e. 52.5mg twice a day for 2-3 days before going up to the whole 70mg morning and night.

[milliemoo]

So I'm now on 52.5 in the morning and 70 at night - yesterday I had such a good day but today I've been so anxious again and feeling tearful although don't know why!! One of the things that triggers my anxiety is worrying that the tablets are not going to work! As I said before I have been through so many for the past two years I just get scared that I'll be like this forever 😪

I know deep down that it's too early to tell but after having a good day yesterday today is just a downer. Sorry I'm just venting my frustration. Anyway onwards and upwards and we will see what tomorrow brings.

[panic_down_under]

One of the things that triggers my anxiety is worrying that the tablets are not going to work!

Well, the good news is this will likely resolve once the med begins working. Fortunately, antidepressants don't need belief in them to work. Despite the claims of their critics, they don't rely on the placebo effect.

I know deep down that it's too early to tell but after having a good day yesterday today is just a downer.

Antidepressants typically take 3-12 weeks to kick-in so it is way to early to draw any conclusion about the likely effectiveness of lofepramine.