Elavil/tricyclics

[Guest guest]

About elavil and sedation... It really does get better over time, but if you can't wait it out, consider another drug in the same class. Imipramine and desipramine are a lot less sedating, in my experience. I've heard nortriptyline is also less sedating. I didn't find that to be the case, but I was in poor health when I took it, so it's hard for me to judge.

There's a lot of disagreement among docs (in my experience) about whether one tricyclic is better than others for vulvar pain. My doc favors desipramine because it's more selective for norepinephrine--the brain chemical some people believe affects pain. But in my case, desipramine worked the least well. (It's really energizing, though) Dr. believes it's individual who responds to which drug and just a process of trial and error. A rheumatologist I saw who sees quite a few vulvar patients (because they also have fibro) told me that elavil seems to work best because it's "dirty"--less selective about which brain chemicals it works on. This also means more side effects, though. I had GREAT results with imipramine, but it seemed to lose its effectiveness after about 8 months.

There's a drug called Provigil which is a narcolepsy med. When I was really suffering with elavil sedation, my psychiatrist prescribed this--one in the a.m., 200 mg--and it helped a lot. Cleared the fog. According to my psychiatrist, this is not an addictive drug. Expensive, but not addictive. Honestly, I haven't researched this. There was a big article in the NY Times a while back about Provigil. It's slightly controversial because it got approved to treat "shift work disorder" which is questionable as a "disorder." Anyway. It's worth looking into.

Lia