AboutDr Alan Galbraith Expertise I can answer most questions on drugs, both medical and "recreational". Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease.
Organizations Institute of Biology, London.
Publications Principal author of "Fundamentals of Pharmacology" 4th Edition published in November 2003 by Pearson Education, Australia.
Question QUESTION: I have been diagnosed with Dysthymia/Major Depression. In your opinion would Imipramine be an antidepressant suitable for Dysthymia? I am presently on Prozac but it does not seem to be working for me anymore.
Thanks
Karen
ANSWER: Dear Karen
Imipramine is suitable for dysthymic depression but is best combined with some form of psychotherapy eg cognitive behaviour therapy. You did say yesterday that the SSRIs and/or Wellbutrin were troublesome so imipramine is definitely one of the drugs of choice. Both psychotherapy and the pharmacological treatment of your condition could be prolonged – maybe even a year or more. Most patients know within themselves when to stop therapy which should be a tapering of the dose.
Regards
Alan Galbraith
---------- FOLLOW-UP ----------
QUESTION: Sorry, one more question. Because the Prozac did so well for me for so long, I was thinking maybe I should try another SSRI first before trying the Imipramine. I've been reading that Zoloft is supposed to be good for Dysthymia. Do you agree?
Answer Dear Karen
I was under the impression that you preferred to change to another class of antidepressants because of the akathisia but have been assuming wrongly. However, I agree that SSRIs are the better alternative as they are less prone to adverse effects and most people tolerate them well. Yes, certainly give Zoloft a try and it is easier to go from Prozac to Zoloft than to imipramine i.e. there need not be a worsening of the condition until the new drug kicks in.
Regards
