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Thread: Mass Hunger

  1. #11
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    Re: Mass Hunger

    Quote Originally Posted by SEANML View Post
    Hey have you ever use amitrip?
    No, but about 8 years on the similar imipramine and the last 25 on another TCA, dosulepin.
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  2. #12
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    Re: Mass Hunger

    Quote Originally Posted by SEANML View Post
    adhd and for my natural chronic fatigue. That is what the ritalin is fo.

    Today I woke up very confused. I will be calling my dr today. Not feeling myself, kind of oddly disconnected.


    Hey have you ever use amitrip?

    You honestly never saw anything about ana with this stuff?

  3. #13
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    Re: Mass Hunger

    Quote Originally Posted by SEANML View Post
    You honestly never saw anything about ana with this stuff?
    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.
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  4. #14
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    Re: Mass Hunger

    Quote Originally Posted by panic_down_under View Post
    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.

    Thank you for all this information, it has greatly relaxed my anxiety towards this medication.
    Dr says just carefule with my ritalin dosing due to the serotonin syndrome

  5. #15
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    Re: Mass Hunger

    Quote Originally Posted by SEANML View Post
    Dr says just carefule with my ritalin dosing due to the serotonin syndrome
    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.
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  6. #16
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    Re: Mass Hunger

    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 22:41.

  7. #17
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    Re: Mass Hunger

    Quote Originally Posted by SEANML View Post
    I know alot but I dont know Serotonin syndrome, never had it luckily
    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.

    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 think TCAs and SSRIs/SNRIs are better bets than some of the marginal ADs such as mirtazapine (which is more sedative than antidepressant).

    I am trying the amitrip again but too be honest I hate starting new meds and side effects :P .
    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 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
    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.

    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
    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!
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  8. #18
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    Re: Mass Hunger

    Hmm have you hear much about Nortriptiline?

  9. #19
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    Re: Mass Hunger

    Quote Originally Posted by SEANML View Post
    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.
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    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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