Anyone tried old style tricyclic meds?

[Sunnyscot80]

Hi all,

After a very long battle with postnatal depression which manifests as severe anxiety, including derealization, nocturnal panic attacks, nightmare, insomnia and horrific morning anxiety, my psych has now recommended I try a tricyclic med.

Ive tried pretty much all the ssri's (setraline, mirtazapine and lexapro) which just make the aggitation worse, or make me very sick. I also tried venlafaxine which was OK but I felt off my face (in an illegal drug kind of way!).

I'm desperate and feel theres not much left for me. I hate this anxiety. And the nocturnal panic attacks / waves of adrenaline are just the worst.

I was wondering if anyone has had similar symptoms and had any luck with tricyclics? I'd maybe try venlafaxine again (reluctantly) to see if the 'off my chops' feeling passed.

There was also talk of valdoxan but its hard to get here in Scotland on the NHS. Any advice appreciated 🙏❤️

Op. I sleep great. It's not a sedative AD but I take it evenings just before bed and sleep really well on it. Better than I have in years.

Clearly works for my genetics. Worth a go. I can function again. Before I was a weepy mess struggling on every front.

I also regained being able to think clearly. Foggy mind all gone. Feel "normal" if there is such a thing.

This is how I have seen others on MN describe various ADs when they really work for them. Sadly it is a case of trial and error.

On the basis SSRI like sertraline made me feel off my face and you are the same, perhaps you will suit vortioxetine as well? Worth a go. You've nothing to lose.

Absolutely nothing to lose. Oh to feel 'normal' again! I've forgotten what it's like.
Derealization is my worst symptom, which I understand is from high anxiety. If it helped that I'd be over the moon.
The psych was keen for me to try it at the last meeting so I think I'll take it. If that doesn't work, sounds like there's a whole host of tryclics I can try. Which is reassuring.

@thesootherfairy what dose of vortioxetine are you on?

I was on lofepramine and that was the drug that revolutionised my life. SSRI’s had not worked. It took the edge off my constant bumpiness, but didn’t make me tired.

@Thighdentitycrisis have you noticed any issues with your memory after taking it over a long period of time (it's similar to the time I've been on tryclics.)
I'm not sure if it's the ADs or my age !!
OP sorry for asking other questions. Tricyclics are so seldom discussed.

I was depressed, but the cause was ADHD.

Once that was diagnosed and treated, I came off the lofepramine.

[quote dahliaaa]@Thighdentitycrisis have you noticed any issues with your memory after taking it over a long period of time (it's similar to the time I've been on tryclics.)
I'm not sure if it's the ADs or my age !!
OP sorry for asking other questions. Tricyclics are so seldom discussed. [/quote]
@dahliaaa no problem! The input from everyone has helped so much x

I would love to hear from anyone who has experienced derealization. I feel very detached from reality. Like I'm in a bubble. I hate it. I'm hoping the meds will help with thjs.

I’ve had derealisation. It was horrible.

I felt like a ghost and that l didn’t really exist, and that l was just made up of swirling bits of fog. I felt like bits of me were drifting off. It was horrible.

@ArseInTheCoOpWindow that's how I feel. All the time. Constantly. And I cant feel my feelings. Like I know I love my kids but I just can't feel things. I'm just numb. (If I'm not crying about how shit I feel. I can always feel that!)

@ArseInTheCoOpWindow it all started with Pnd 4 months after dd was born, when I stopped breastfeeding her.

It’s just part of depression and anxiety. I would say though it’s one if the worst experiences I’ve had. But it will pass when you are better.

@ArseInTheCoOpWindow thank you xx

I tried citalopram (gave me a tremor and I felt numb), Setraline (gave me horrific nightmares and permanent nausea and Paroxitine which made my anxiety worse. GP suggested Lofepramine. When I started on it, I got really dizzy on standing, I had to drink loads of water to manage it. That eased off over time. It managed my anxiety by simply feeling more balanced.

I’m on Amitriptyline now to prevent migraines. I take 30mg which isn’t really enough to manage anxiety. I tried increasing it but it makes me really drowsy and I just couldn’t tolerate 40mg. It also makes my eyes dry so I had to change contact lenses (random side effect).

I took Pregablin for something else. If you’re worried about weight gain, I would definitely give that a swerve, it gave me an insatiable appetite!

As far as I understand it derealisation is part of the anxiety. It's your brains response to being overwhelmed - so it effectively 'shuts off.'
It improves once the anxiety starts to ease x

@dahliaaa

I’m in the same boat as you I’m afraid so couldn’t say!
I find I’m quite forgetful now but probably since the menopause I’m much more anxious which makes it hard to retain information

@dahliaaa

As far as I understand it derealisation is part of the anxiety. It's your brains response to being overwhelmed - so it effectively 'shuts off.' It improves once the anxiety starts to ease x

That's how I under it too.

**understand

@Thighdentitycrisis that's interesting. I have a very full on job too so that may be part of it as well.

I'm also on Chlomipramine, for long term depression and anxiety.

It has rubbish side affects. For the first few years I had terrible dry mouth, I get rubbish night sweats when I wake up drenched and shivering and I'm tired all the time.

However the benefits of being able to leave the house and live outweigh the side affects.

Since being a teenager I've tried multiple antidepressants that would initially work then stop. Amytriptline, venlafaxine, I tried Prozac but didn't last more than 2 days in that as it upset my stomach.

I'm due to give birth in August and I'm terrified of PND.

@Spottybutterfly I'm sorry you suffer with the side effects. It does sound like it has helped the depression and anxiety though. Did you find it made your appetite increase lots too? A lot of people have said its one for weight gain.
Congratulations on your pregnancy! I am sure all will be well, you are stable on meds. Do you have any extra help or guidance from a perinatal doctor? I know sometimes they see mums if you've struggled with mental health before pregnancy. Pandas are great group for mums ane mums to be. if you've any worries it can be worth speaking to them x

@Spottybutterfly what dose are you on?
All the best for the birth. Take it a step at a time and if you do feel like you need extra support speak to your health visitor or gp straight away. You may find that the fact you are already on ADs makes a difference.

Thanks for the support ladies. I never linked it to my weight gain but now I think of it I gained 2 stone on it until I dieted for my wedding lat year. Basically accepted while dieting I would always be hungry.

The peri-mental health team have assessed me and said I'm fine for now but to ask to be transferred if things decline.

I'll have a look in to pandas now.

Just spoke to psychiatrist who has offered either valdoxan, vortioxetine or lofepramine. Lofepramine was her preferred tryclic as its the least toxic in an overdose and I have suicidal thoughts. Especially just before my period. Does anyone else find their mental state even worse at that time?
Not sure which drug to choose! She's calling me back tomorrow.

I definitely find my MH is worse during my PMS.