Imiprimine Was Lowered and I'm Spiraling Out of Control
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Q:  Imiprimine Was Lowered and I'm Spiraling Out of Control

I've been on 100mg of Imipramine for 3 years with good outcome - I've gained about 10 lbs per year on it, but have recently had problems with my heart racing to 130 beats per minute sometimes.  I'm 45 years old and am also on androderm for low testosterone, armour thyroid for low thyroid, and xanax for night time anxiety.  I'm now down to 30 mg of Imipramine and I'm getting very negative and my mind is racing - I can't concentrate.  My Dr has me changing to Seroquel after I'm completely off of the Imipramine.  I getting very nervous - can't concentrate - and at work today - a few people told me to cut back on the coffee - since I noticed this behavior in myself - I switched to tea to avoid a headache but I feel very agitated and physically feel like I have to keep moving.  I can't bear the thought that I'll say something inappropriate at work and get myself in trouble - but I'm quickly spiraling out of control - what can I do? I just want to escape.


Hello Mike --
Well, first of all, I hope that you and your psychiatrist are in close communication about what is going on here.  Obviously, it doesnít sound good.  I hope that by now you have already discussed the option of going back up on imipramine and regrouping before the next reduction.

The good outcome that you had for a while on imipramine , and your current regimen, put you in a position where I canít really comment easily, but here is one thought: if you and your psychiatrist decide to try again later to lower imipramine, one option might be to try to move it down very slowly.  Although it is not a standard practice at this time, taking as much as four months to taper an antidepressant may have some physiologic justification.  I summarized that justification in an essay about antidepressant withdrawal and that might be of interest if you go back up and then start down again later.

Good luck with the process.  If you havenít talked to your psychiatrist about all this already, give her/him a call.

Dr. Phelps

Published June, 2009


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