The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.
No, and I've been on similar meds at much higher doses than you're likely to ever be, 350mg for imipramine which is well above even the maximum inpatient dose, and 225mg for dosulepin. Nor have I heard of anyone else doing so in the 20 or so years I've been participating in support groups. Given amitriptyline is used to treat ana symptoms it would hardly be surprising that sometimes someone will have an increase while on the med. Doesn't mean it was caused by it. If you treat a lot of people with a med which can make their condition worse then that should become obvious very quickly.
The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.
This is not an issue. Methylphenidate (Ritalin) is an extremely weak serotonin reuptake inhibitor and amitriptyline is only a moderate one. The only TCAs which inhibit serotonin reuptake sufficiently for serotonin syndrome/toxicity (SS or ST) to be a potential issue are clomipramine (Anafranil) and imipramine (Tofranil). To quote Dr Ken Gillman, one of the two guys on the planet who knows most about serotonin syndrome/toxicity (SS or ST):
"for instance, methylphenidate (which is classified as an amphetamine) seems to be mainly a DA re-uptake inhibitor, and not a releaser. It produces no risk of ST or a pressor response."
from 'MAOIs and releasers, including amphetamines' at his website
The Canadian Family Physician's clinical review 'Demystifying serotonin syndrome (or serotonin toxicity)' (PDF) makes the same points:
"Tricyclic antidepressants are also serotonin reuptake inhibitors, with clomipramine and imipramine being the most potent and likely the only TCAs to be involved in serotonin toxicity; other TCAs such as amitriptyline are weaker inhibitors and are thus unlikely to cause toxicity.
Serotonin releasers: Serotonin releasers cause more serotonin to be released from the presynaptic terminal into the synapse. Serotonin releasers include amphetamine, but not methylphenidate, and the illicit drug ecstasy (3,4-methylenedioxymethamphetamine)."
The one issue with the combination is amitriptyline may increase the effects of methylphenidate so some dose adjustments to the latter may be needed and your doctor needs to monitor this. Such drug interactions are why medications have to be prescribed and not sold over-the-counter and your doctor should be able to manage this. It is his/her main job.
The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.
thank you for that info I go visit my new doctor in January. But I see my main family doctor next week (for the last time)
Current dr just said "be careful" lol. I know alot but I dont know Serotonin syndrome, never had it luckily
Can you suggest other meds like traz/mirt/ ? Just to give me other ideas to read up on and maybe discuss with a doctor? Seroquel was a fail :P and benzo is horrid on my brain injury.
I am trying the amitrip again but too be honest I hate starting new meds and side effects :P . I didnt even like Mirtazapine . I was able to sleep on just 200mg traz for 20 years lol. Something went horribly wrong and not I am trying all these drugs that have weird side effects :P Traz never had side effects for me :P
Supposedly amitrip can be a really good drug if I give it it's chance. But I just have fears of side effects you kno a worrier :P
Last edited by SEANML; 10-12-19 at 21:41.
It is much, much rarer than Dr Google suggests. Very few doctors have ever seen a genuine case. It is something more likely with MAOI class ADs.
I think TCAs and SSRIs/SNRIs are better bets than some of the marginal ADs such as mirtazapine (which is more sedative than antidepressant).Can you suggest other meds like traz/mirt/ ? Just to give me other ideas to read up on and maybe discuss with a doctor? Seroquel was a fail :P and benzo is horrid on my brain injury.
The only people who are happy at the prospect of starting an AD are those who've never been on them. They are a necessary evil. The thing to keep in mind is that while the initial side-effects can be unpleasant, they are rarely a sign of harm.I am trying the amitrip again but too be honest I hate starting new meds and side effects :P .
You were lucky. Trazodone is just as capable of producing severe side-effects as any other AD. It all comes down to how a med meshes with individual biology. Interestingly, however, trazodone can counter some common SSRI/SNRI side-effects.I was able to sleep on just 200mg traz for 20 years lol. Something went horribly wrong and not I am trying all these drugs that have weird side effects :P Traz never had side effects for me :P
Unfortunately, in addition to our main anxiety disorder many of us also get med phobia as a freebie. Personally, I would have preferred the steak knives!Supposedly amitrip can be a really good drug if I give it it's chance. But I just have fears of side effects you kno a worrier :P
The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.
Hmm have you hear much about Nortriptiline?
It is a TCA which mostly inhibits noradrenaline, aka norepinephrine reuptake. It can be very effective and is definitely worth a try if serotonin biased reuptake inhibitors prove ineffective, or intolerable. Old school psychiatrists would treat treatment-resistant depression by combining it with a SSRI, usually sertraline, to essentially create a bespoke SNRI, but most psychiatrists these days seem oblivious to the potential/advantages.
The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.
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