Tricyclic antidepressants are effective for my cfs

cfsJapan

cfsJapan

Messages
15
I don't have any cognitive depression symptoms, but taking tricyclic antidepressants greatly reduces my brain fog and chronic fatigue.

However, the problem is that even the smallest dose has too many side effects on my heart and my liver values rise abnormally, so I can't continue taking them (is drug hypersensitivity a common symptom of CFS?)

Imipramine, Nortriptyline, and clomipramine all worked for me, so most tricyclic antidepressants may work for me.

In this case, if I can't use tricyclic antidepressants, what medication would you recommend for me? (Of course, the basic premise is that treatment methods vary from person to person, but if there is something similar to tricyclic antidepressants with fewer side effects, I think it would be effective for me.)

The symptoms I'm suffering from are brain fog (feeling of pressure on the brain), abnormal fatigue, abnormally low cortisol levels, erectile dysfunction, waking up in the middle of the night, dry eyes, and acne.

These all developed almost simultaneously after experiencing chronic stress from the age of 15 to 17.

I have also been diagnosed with mixed ADHD and ASD, but for some reason, taking tricyclic antidepressants improves both. (Even though I have been diagnosed with ADHD, all stimulants have the opposite effect. Drugs that increase dopamine make me manic.)

LDN didn't work for me at first, and neither did Mestinon

Cymbalta, an SNRI, worked for my brain fog at first, but it stopped working after two months.

I would like to try anything I can, even if it's not tricyclic antidepressants.

I don't mind the risks, so if there are any promising treatments (medicines), please let me know.

However, almost all supplements and Chinese medicines have been completely ineffective, so I feel that nutritional therapy and supplements have their limits.

I would like to find a revolutionary drug that will change the situation. I have a hunch that it may be a drug related to JAK inhibitors or autoimmune disease.

(Sorry for the incoherent writing. This has become a long story, so even partial answers are welcome.)
 
katabasis

katabasis

Senior Member
Messages
177
I'm glad you hit upon a strategy for managing your illness, even if you're running into difficulties finding the right drug. It's still fortunate to know something CAN help.

Can I ask what your liver values look like, specifically? A lot of tricyclics/related drugs can cause a modest rise in liver enzymes, which may even be transient in some cases. And if the rise is small enough, I think there may not be too much danger in continuing to take the drug. You might even be able to offset very slight hepatotoxicity with compounds like milk thistle extract (silymarin) which are hepatoprotective.

One alternative option you may want to look into is mirtazapine, another antidepressant. Its structure is somewhat different from tricyclics, so it's possible this won't give you the same issues (liver response to drugs/toxins is very individual and kind of a crap shoot, so you sort of need to experiment to figure out whether something will adversely affect your liver). Mirtazapine is really unique because it doesn't inhibit serotonin/norepinephrine reputake like most tricyclics (and of course SNRIs and the like) - but it shares a lot of the other effects like blocking serotonin receptors, histamine receptors, alpha-2 adrenergic receptors, etc. You mentioned that you didn't get sustained benefits from Cymbalta, so perhaps it's these secondary mechanisms that are what make the tricyclics effective for you.

As for other substances, the ones which have helped me most are guanfacine (NOT guaifenesin, don't get it confused), saffron extract, ketotifen, and baicalin. I'm still severe, but these have pushed me almost to moderate at times, instead of the low end of severe I had been at.

I've also heard some people have success with sirolimus (rapamycin), and there's some new clinical trials for it that look promising. I tried it and had a bad reaction to it, but it might be worth a shot for you nonetheless.
 
cfsJapan

cfsJapan

Messages
15
bad1080 said:
i had the same thing happening to me, it was messing with my q time, gave me tachycardia and i had to take beta blockers for it
Click to expand...
What happened after that? Are you still taking medication? If you don't mind, I would like to know which tricyclic antidepressants you used and how much. For me, 10mg of Imipramine or Clomipramine is my limit.
 
B

bad1080

Senior Member
Messages
299
cfsJapan said:
What happened after that? Are you still taking medication? If you don't mind, I would like to know which tricyclic antidepressants you used and how much. For me, 10mg of Imipramine or Clomipramine is my limit.
Click to expand...
i am not 100% sure it was a tricyclic antidepressant, it might've been bupropion (i don't remember the dose, sorry it's been a while. but maybe that's the one that gave me paranoia). definitely one of those where you have to monitor the heart (electrocardiogram) on a regular basis if you take them.
the beta blockers then gave me depression as a side-effect, funny how that works...
my doctor then told me to use the beta blockers as needed and he gave me something with potassium as alternative. now i don't take beta blockers at all and i found folate to be very helpful (i take 400µg per day). i only very rarely (almost never) have the tachycardia since i started taking it on a regular basis.

vitamin d was helpful for my brain fog.
 
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D

datadragon

Senior Member
Messages
433
Location
USA
Antidepressants such as imipramine have a strong secondary anti inflammatory effect so they work best when currently testing in a high inflammatory state to bring it down. Ongoing use after bringing it down to normal levels may contribute toward enhancing those side effects. Further they are metabolized partially through cyp2d6 which can sometimes cause blood levels to be higher then expected due to several factors such as genetic mutations. Higher blood levels would amplify the drugs effect.

https://img.auctiva.com/imgdata/1/9/6/8/1/0/0/webimg/1078908000_o.png
Post in thread 'Akathesia caution - neurological damage from some medications'
https://forums.phoenixrising.me/thr...mage-from-some-medications.91177/post-2448621
https://www.ncbi.nlm.nih.gov/books/NBK425164/
 
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