Mental Health Imipramine (TCA) doesn't work. What next?

[Zon]

About a month ago I got a prescription from my doctor for Imipramine (TCA) 10mg per day for anxiety and depression but the positive effect is little to none and it seems to be causing me some mild stomach problems as well as affecting my sleep.

I have another appointment this week and want to do some research before I do on what medications might work for me.

I have pretty general depression, social anxiety and the occassional panic attack. I drink alcohol (ususally around twice a week), and don't want to stop. And would also be nice to take the occassional drug if possible but I can give that up if I need to.

But where should I start? What medications are best to look into that have helped other people on here?

 

[silverwheel]

My two cents is that a different medicine in the same class would be the best place to start. A different tricyclic like Amitriptyline perhaps. How much alcohol do you drink? Your stomach and sleep problems could be the result of alcohol not mixing well with your new medicine. I've found that it's best to avoid alcohol when acclimating to a new medication. It will complicate your side effects, and will prevent you from getting an accurate assessment of how the medicine is doing. Quit for a little while to give the Imipramine an honest chance, and if you still get the same side effects, you'll know for certain that it's not right for you.

 

[Zon]

My two cents is that a different medicine in the same class would be the best place to start. A different tricyclic like Amitriptyline perhaps. How much alcohol do you drink? Your stomach and sleep problems could be the result of alcohol not mixing well with your new medicine. I've found that it's best to avoid alcohol when acclimating to a new medication. It will complicate your side effects, and will prevent you from getting an accurate assessment of how the medicine is doing. Quit for a little while to give the Imipramine an honest chance, and if you still get the same side effects, you'll know for certain that it's not right for you.

Well the other thing I was thinking was if I should use a higher dose of a TCA. From what I have read 10mg is incredibly small, almost unheard of. The side affects are relatively mild so maybe taking a larger amount would increase the good effect enough to make it worth taking. Do you think these are also good for social anxiety though? I felt a very very slightly more positive mood with 10mg but couldnt notice any improvement in other areas.

Oh sorry I didn't mention how much I drink. Not a huge amount, just once or twice a week out drinking with friends.

 

[silverwheel]

I can't give a good answer for how tricyclics do with social anxiety. It is possible that tapering up on your Imipramine will make it good for you. I'd talk with your doc about trying that before trying a different med. It's good that your side effects are mild - they might go away altogether fairly soon, but even if they don't, it sounds like you'd be able to increase the dosage without too much worry. Your doc will probably want to try a theraputic dose of the Imipramine before switching it out for something else.

 

[Zon]

Well I think the side affects are mild because of the extremely low dose, so if increasing the dose affects the positives and negatives equally it still wouldn't be worth it for me to take. The main problem for me is lack of motivation, and feeling tired all day doesn't really help with that.

I've been reading online that SSRIs have less sideaffects, especially less sedative so am thinking to ask to switch to that. Am just a little worried that people say they are harder to stop taking, and I also wouldn't be able to roll on pills for weeks or months after stopping SSRIs...Anyone know if this info is correct?

Right now am just trying to decide to give TCAs a bit of a better chance for the same of being able to take a break from them and have a little roll every now and then, or go straight for the SSRIs which sound to me to be a more affective medication...

 

[paranoid android]

Imipramine can be rather stimulating for some people actually. I have never taken it but of the Tricyclics it get's a name for being somewhat stimulating because of the NRI effects. I found Amitriptyline and the much rarer Trimipramine (a sort of weird tricyclic with atypical anti-psychotic properties) and found them to work. It's just trial and error really