[Cheburashka]

Hi. First post here. I've had symptoms of depression pretty much all my life and am currently trying to get my meds right. I live in a small town and there's only one person who does the prescribing. Recently, I've been feeling like he just picks drugs at random without thinking about side effects.

The symptoms of my depression are basically a flat, non-emotional response to everything around me. I don't feel sad, but I don't feel connected to other people. I'm trying to break out of that pattern because it's affecting my work, my relationships, etc. I have so much energy going into maintaining this false equilibrium that there's nothing left for anything else. One other weird thing--I can "feel" where the emotional responses are supposed to be in my brain (kind of nutty-sounding, but it's there) so I know what things are supposed to feel like. They just don't anymore. I'm also taking lisinopril and hydrochlorothiazide for high blood pressure (genetic).

My history with antidepressants:

Years ago, I tried Wellbutrin, Effexor, Paxil and Zoloft. Each of these made me feel "stimulated" but their net effect was to block out any emotional reactions. I felt like everything was fine and just motored along without making any changes.

about four months ago I started seeing a new therapist who has a good grounding in psychiatric medications. He's been having me try treatments other than SSRIs to see if any of them help. He had me on the Emsam patch for two weeks, but I discontinued because it was $300 a week and he felt that he could get the same response from a different drug. Next, he tried Protriptylene, which seemed great at first, but led to side effects once I hit a theraputic dose. One side effect was orthostatic hypotension, but the worst was that my scalp tingled constantly and all of my involountary muscle reactions slowed down. I could walk into a brightly lit room and count to five while my pupils slowly contracted. Creepy. There was also very little change in my emotional state, in fact it felt like there was a wall around the sweet-spot in my brain where I was supposed to be feeling things. After three weeks on 20mg of Protriptylene and no reduction in side effects, I dropped down to 10mg to reduce the side-effects and asked him for another suggestion.

Two days ago he had me cut the Protriptylene to 5mg and is slowly ramping me up on Desipramine. I'm at 50mg now and my recommended dose is 200mg. The Desipramine feels like it's homing in on the emotional center in the brain--I'm actually "feeling" for the first time in years, and it's great. Unfortunately, the orthostatic hypotension is back in spades. I almost passed out last night when standing up from the couch.

I'd like to continue on Desipramine, but I'm afraid that a bigger dose will make the hypotension even worse. Has anyone here had similar results? Any recommendation for something that might work better?

Thanks

[Eliza Jane]

I had that issue on desipramine when I took it a long time ago. Nortryptiline is in the same class of drugs. I've never taken it, but hubby does and doesn't have o.h. issues.

Good luck!
EJ