I wish it weren’t, but today is one of those days. After more than a decade of taking newer antidepressants for depression and anxiety, I’ve begun taking a drug developed before I was born – the tricyclic antidepressant nortriptaline, or Pamelor.
I’m doing this not for mood issues, but because I’ve been suffering from chronic migraines for nine months, and a litany of other drugs have done nothing to prevent them. But my decision to substitute Pamelor for Prozac – my doctors didn’t want me taking both, in addition to Wellbutrin, my other antidepressant – is significant because I’m a child of the SSRI era who had a miracle turnaround when I first began Prozac over a decade ago.
If weren’t for the headaches, you can bet I wouldn’t go anywhere near a tricyclic. The SSRIs and their cousins, the SNRI antidepressants, of which Wellbutrin is one, have worked too well, and the rumored side effects of the tricyclics have scared me off.
This is the second time that the migraines have induced me to do what neither intense anxiety or unrelenting depression could: get me to try a psychotropic I was otherwise opposed to trying.
The first two tries came last spring, when daily migraines were making it impossible for me to write, just as my book deadline was approaching. I briefly tried Topamax and Depakote, drugs originally used for epilepsy that are now commonly employed as mood stabilizers in bipolar disorder. Those did nothing for my headaches and made it even harder for me to think clearly enough to write. I gave them up after a few weeks.
It’s tough for me to describe exactly why I’ve been so opposed to the tricyclics except to say that I’ve been hesitant to mess with a good thing. And, thus far, the newer antidepressants have done a very good job at modulating first my depression and, later, my anxiety.
Replacing Prozac with Pamelor troubles me. Prozac was the first psychotropic drug I ever took, and I experienced what seemed a miracle turnaround in energy levels, mood, social skills and focus. True, it hasn’t worked that well for me in years, but I still have what you might call a sentimental attachment to it.
My other reason for finding the tricyclics distasteful is not one I like to admit. They just don’t have the shiny, new appeal and the promise of transformation I associate with Prozac and its newer cousins.
Feeling this way is silly, because I’ve read all kinds of studies that talk about how one’s attitude toward taking medication can be a huge factor in its effectiveness; that is, my reluctance to take a tricyclic probably will only make me less likely to respond favorably to it, either for migraines or for mood issues.
I also know enough to be skeptical of how the pharmaceutical companies have branded the newer antidepressants. Furthermore, the drugs I take have been available as generics for a while, so it’s not like they carry the appeal of exclusivity and brand-name panache.
But all those bouncy Zoloft-blob ads from the late 90s really stuck with me, I guess. I spent my teenage years feeling depressed and hoping to be rescued by such a medication. In the end one of them – Prozac – did just that. When Prozac pooped out, other drugs stepped in. And when those stopped working, I was able to go back to Prozac.
Pamelor strikes me as dull and dowdy and unappealing. This is all so very silly that I’m a bit embarrassed to write it. Why do I feel this way? Shouldn’t I be hopeful it’ll rescue me from my migraines, and perhaps do as good of a job for my depression and anxiety, to boot? I do hope so, of course. But I also know I’m only taking it because I haven’t been able to find anything else.
photo credit: Wellesenterprises