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Old 08-30-2010, 09:38 AM   #1 (permalink)
 
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Default Activating vs sedating antidepressants

Hi, could some of you more knowledgable people please write a list of some of the more common antidepressants and whether they are generally known to be activating or sedating?

It's a property that's fairly important to a lot of us i think, and doctors tend to not give out much information on the stuff they are prescribing us.
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Old 08-30-2010, 09:42 AM   #2 (permalink)
 
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I'll start with a couple that I know.

Sedating:
Mirtazapine
Amitryptaline
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Old 08-30-2010, 07:53 PM   #3 (permalink)
 
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Quote:
Originally Posted by rocknroll714 View Post
  • Sedating:
    • Tricyclic Antidepressants:
      • Amitriptyline
      • Butriptyline
      • Clomipramine
      • Desipramine
      • Dosulepin
      • Doxepin
      • Imipramine
      • Iprindole
      • Nortriptyline
      • Protriptyline
      • Trimipramine
    • Tetracyclic Antidepressants:
      • Amoxapine
      • Maprotiline
      • Mianserin
      • Mirtazapine
    • Phenylpiperazines:
      • Etoperidone
      • Nefazodone
      • Trazodone
  • Stimulating:
    • Norepinephrine reuptake inhibitors:
      • Atomoxetine
      • Mazindol
      • Reboxetine
      • Viloxazine
    • Monoamine oxidase inhibitors:
      • Selegiline
      • Tranylcypromine
    • Others:
      • Bupropion
  • Neutral/Mixed:
    • Selective serotonin reuptake inhibitors:
      • Citalopram
      • Escitalopram
      • Fluoxetine
      • Fluvoxamine
      • Paroxetine
      • Sertraline
    • Serotonin-norepinephrine reuptake inhibitors:
      • Desvenlafaxine
      • Duloxetine
      • Milnacipran
      • Venlafaxine
    • Monoamine oxidase inhibitors:
      • Isocarboxazid
      • Moclobemide
      • Phenelzine
    • Others:
      • Agomelatine
      • Buspirone
      • Tandospirone
      • Tianeptine
Did I get all of 'em? I think I did.
I would have to dissagree with one on your list. I took protriptilyne for 10 months and it is a VERY activating Tricyclic. It's properties are Neurodenergic and it really is very activating.

Just don't plan on having sex on protriptilyne for very long because it causes massive PE.
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Old 08-31-2010, 09:55 AM   #4 (permalink)
 
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Thanks for the info guys

What does the 'mixed' category mean?
Different effects for different people? Or different effects depending on dose?
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Old 08-31-2010, 04:02 PM   #5 (permalink)
 
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Originally Posted by solitary existence View Post
Thanks for the info guys

What does the 'mixed' category mean?
Different effects for different people? Or different effects depending on dose?
He just means that the mixed catagory have both Activating and sedating Properties both. For example Venlafaxine (Effexor XR) is often sedating at low dosage, but at much higher dosages it becomes more activating.
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Old 08-31-2010, 05:21 PM   #6 (permalink)
 
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Quick question, if you don't mind, about the stimulating MAOI Parnate.

On Wikipedia it says it is therapeutically contraindicated in individuals with migraines and chronic headaches.

I'm currently looking for a stimulating med due to extreme fatigue and haven't had any success after max dosage of Wellbutrin both alone and combined with other antidepressants such as Effexor. Since I suffer from migraines and chronic headaches and am currently being treated for them by a neurologist and am on Topomax and Maxalt, does this mean I am doomed, in terms of finding a stimulating medication?
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Old 08-31-2010, 05:40 PM   #7 (permalink)
 
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Originally Posted by rocknroll714 View Post
Indeed, while the TCAs are generally thought to be quite sedating, they are also mixed in a complicated manner similarly to the MAOIs. They have two major sedating actions and two minor ones - the first two are antihistamine and α1-adrenergic-blocking properties, and the latter two are serotonin reuptake inhibition and 5-HT2A receptor blockade; then, they have norepinephrine reuptake inhibition as the major stimulating component and 5-HT2C receptor antagonism as a very minor one. The potencies of various TCAs in producing these effects varies considerably, and as a result, they have sometimes been categorized something like as follows:
  • Tricyclic Antidepressants:
    • Sedating:
      • Amitriptyline
      • Butriptyline
      • Doxepin
      • Trimipramine
    • Neutral-ish:
      • Clomipramine
      • Dosulepin
      • Imipramine
      • Iprindole
    • Stimulating:
      • Desipramine
      • Lofepramine
      • Nortriptyline
      • Protriptyline
In general, all TCAs tend to be relatively sedating at first while the H1 receptor downregulates, but once it has fully desensitized (which it will, at least in my personal experience with mirtazapine), some TCAs like protriptyline and desipramine can indeed become quite activating. Apologies for not discussing this before, I didn't want my posts to get too complicated and thus confusing, but since you brought it up, here you are! :P
I found Nortriptilyne to even be far less stimulating than Protriptilyne. Nortrip wasn't sedating, but not as stimulating as Protrip. The side effect profile between the two was very different also.
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Old 08-31-2010, 05:44 PM   #8 (permalink)
 
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Thanks for the response.

Yeah, I've had migraines and chronic headaches since I was 13 and I have had treatment from a neurologist since then. I am 21 now.

My headaches have always been bad. The wellbutrin and Effexor combination (both at max dosage) didn't make my headaches any worse, even though they were still bad. How much of a problem is this when considering an MAOI such as Parnate while taking medication associated with headache control? If it is a problem would dexedrine be a better course of action?

Thanks for the advice.
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Old 09-15-2010, 12:42 AM   #9 (permalink)
 
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I have found that the combo Effexor + Remeron(aka california rocket fuel) is very stimulating/activating for me. I take 75mg Effexor and 30mg Remeron. But in my case its too stimulating and im going to suggest to my doc to wean completely off Effexor, as im more looking for an anxiety reducing effect. Though this combo is super if you are in a really deep depression and cant get anything done.
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Old 09-15-2010, 08:33 AM   #10 (permalink)
 
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Originally Posted by TyrosineKinase View Post
Quick question, if you don't mind, about the stimulating MAOI Parnate.

On Wikipedia it says it is therapeutically contraindicated in individuals with migraines and chronic headaches.

I'm currently looking for a stimulating med due to extreme fatigue and haven't had any success after max dosage of Wellbutrin both alone and combined with other antidepressants such as Effexor. Since I suffer from migraines and chronic headaches and am currently being treated for them by a neurologist and am on Topomax and Maxalt, does this mean I am doomed, in terms of finding a stimulating medication?
If you are looking for a very stimulating antidepressant then MAOI Parnate would be one for sure. I have Atypical Depression which makes you feel very heavy and sleepy all the time. I started Parnate a few months ago and it's like Rocket fuel.

So much so that it has even caused me insomnia. Given I couldn't even stop sleeping before this is a pretty tall order for any antidepressant. I have found that Parnate is by far the most activating AD I have ever taken.

Problem is that the side effects are pretty difficult the first couple months and you may have to raise dosage very slow as I did. Right now 40Mgs for me is the sweet spot, but i had to add just 50Mgs of Trazadone at night to sleep. I would say Parnate works very well if you have a particular set of depressive symptoms, mainly being Atypical depressive symptoms, but some with SA also take it.

I don't think anyone with even mild Hypomania should try it. That might be a problem.
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