Surmontil (Trimipramine) feedback needed

[CryptsOfEternity]

So, I have my personal rx benzos, and other avenues for benzos, although I wish access to Euro or American only (I'm obsessed with Doral, which seems is never prescribed...Doral being Quazepam, the only benzodiazepine found not to mess with the REM stage of sleep, giving one a natural sleep. Further research has shown me that the TCA antidepressant Trimipramine is very good for light depression/fuzzy mind caused by lack of sleep, I'm one of those people who cannot perform if I have spent a white night or if I slept less than 9-10 hours.

Trimipramine is indicated to be taken at bed time. I'm seeing my psychiatrist next monday, just to renew my Valium script but also, to his probable delight, suggest an antidepressant, mainly for the fact it helps for sleep a lot and doesn't mess with the natural stages of sleep too. There's 12.5, 25, 50, 75 and 100mg dosages for this thing, so I guess it's like most antidepressants, you start at the lowest dose and if that is effective don't need to raise the dose but if you have to, I see that 25mg seems to be the most common nightly dose, and if it makes me wake up in a good mood, it's very welcome.

I'd like to hear someone who has used Surmontil/Trimipramine before, some empirical data although imperfect can be helpful. When I looked at the monograph, 2 of the studies on efficacy out of 3 used 75mg right off the bat, I doubt that will happen with me, especially since I cannot take SSRI or SNRI antidepressants since I am Bipolar I, these send me into mania where I stop needing to eat and sleep and cause violent outburst and total lack of inhibition, more so than benzos, where consequences don't scare me. Which is unlike me, Paxil did this to me, the 10mg starting dose was fine, but when upped to 20mg a day (for no reason, doc just renewed it after 6 weeks with the 0.25mg xanax to be taken 4 times a day at 20mg) made me unlike myself, totally manic.

I mentioned SNRI's because Effexor XR is that, not an SSRI. Start doses of 37.5mg XR gave me very large pupils like if I had been eating mushrooms and made me feel very nauseous, had to go buy myself some dimenhydrinate at the pharmacy to handle it. It had this whole kind of strange body feeling and I know that I could not continue to take it.Manerix (moclobemide) is an antidepressant that worked for me, and it boosts benzodiazepines and opioids, so a plus in of itself, but it raised my pulse too much, it may be a reversible MAOI, only available in Canada, Australia and the UK...I think (about the UK), no dietary restrictions, still they warn about eating too much aged cheese. But I think it's just the possible side effect of tachycardia inherent to Moclobemide (generic name), that I got, and I already tend to have high pulse at rest...cause is unknown as of yet, it could be endocrine or cardiac...my endocrinologist says I have low T (which I already knew, because of the opioid i am scripted for pain, buprenorphine, strange how the 2 medication for pain also used for ORT (according to a nurse at the pain clinic and 2 doctors) seem to cause endocrine problems unlike all other opioids. I'll check into having that changed once I get it down to a dosage which will make it easy to switch to a fulll agonist...the way buprenorphine works is very unusual and sticks to opiate receptors, especially the mu receptor more than anything else, so much that if I needed something stronger in case I get hurt badly or other reasons where another painkiller is needed, I would need to have Abstral, which are sublingual Fentanyl pills, from 80ug to 800ug, the 600ug ones helped me big time when the pain clinic authorized it after a snowboarding injury.

Shortly, any user with experience with Trimipramine is welcome to tell me how it went for them. I don't want to try yet another antidepressant and dump it.

[CryptsOfEternity]

Thanks for your response and well wishes. I didn't get to see my psychiatrist, had to have it pushed later due to sinusitis-bronchitis, I'm lucky enough to live in a town where 8 doctors from 8am to 5pm monday to saturday are available for visits at home. My GP takes emergencies but sometimes you'll get an appointment the next day if you call too late. Anyway, I'm on Cefzil and after 4 days I'm starting to feel normal again, the deluge of secretions from my sinuses have drastically reduced, breathing is easier and when I cough something doesn't come up right away, which was extremely annoying because if I lied on one side in my bed I would cough and it would always come from my right side. The doctor when he listened to my breathing with the stethoscope said that yes, it seems like I had bronchitis mainly on that side, maybe pneumonia, but my breathing wasn't impaired so much like the few times I had pneumonia, where I had to use my Symbicort inhaler like crazy in the past. This one manifested as a hoarse throat/voice and that particular kind of headache associated with fever. I'm only disappointed that as he was writing the script, he was writing in Hycodan syrup (hydrocodone 5mg/5ml) rx cough syrup, that I was already on an opiate everyday and he didn't want me on 2 because of respiratory issues, he's right in his reasoning, I just much prefer hydrocodone to what I'm scripted :p

So until the doctor came to my home, it was tylenol every 4 hour, pretty much the only thing it's good for (fever) and hydroxyzine (I got an rx, mainly to help for sleep and require less benzos, which works pretty well, at the 50mg dose I get) for the unholy amount of sinus secretions. I like to think this gives me time to think about it some more, but unlike SSRI/SNRI antidepressants, I've tolerated low doses of TCA's like nortriptyline and amytriptyline for tension headaches/arnold's neuralgia I dealt with for 3-4 years and saw 4 neurologists until one found what it was that was going on then, back a decade ago, heh, strangely enough the first time I saw a doc about that strange neuralgia was at the ER who said it could be arnold's neuralgia and scripted me nortryptyline at bed time with Fiorinal C 1/2.