Ascendin

US Brand Name: Asendin
Other Brand Names: Amoxan (Japan)
Asendis (England; Ireland)
Defanyl (France)
Demolox (Denmark; India; Portugal; Spain)
Generic Name: amoxapine
Other Forms:
FDA Approved Uses: Neurotic or reactive depressive disorders as well as endogenous and psychotic depressions. It’s approved for depression with anxiety and/or agitation.
Off-Label Uses: Panic/anxiety disorders, bulima.
Pros: It’s been for awhile, so doctors are familiar with its uses and effects. It starts to work very quickly. It almost does the antipsychotic-antidepressant combo by itself the way it blocks dopamine and works on serotonin & norepinephrine.
Cons: The dopamine-blocking does expose you to the potential for Tardive Dyskinesia and Neuroleptic Malignant Syndrome. See the section on antipsychotics for more information. It also carries warnings for heart weirdness, so if you have any heart issues or family history of such, an EKG is in order.
Typical Side Effects: The so-called anticholinergic typical when starting antidepressants – headache, nausea, sweating, dry mouth, sleepiness or insomnia, and diarrhea or constipation and blurry vision. If you get any, or all, of these, expect them to pass in a week or two.

Not So Common Side Effects: Urinary hesitancy (a.k.a. forgetting how to go), heart palpitations, rashes. The urinary hesitancy is something that meds that hit your norepinephrine receptors will just do randomly through the course of treatment.

Freaky Rare Side Effects: Testicular swelling, painful ejaculation. This is the drug for sex addicts anonymous.

Interesting Stuff Your Doctor Probably Won’t Tell You: Asendin (amoxapine) is an odd hybrid of antidepressant and antipsychotic, so your doctor probably won’t go over the whole antipsychotic drill with you.
Dosage: Initial dose is 50mg two to three times daily. After two to three weeks that may be increased to 100mg two to three times daily. Presuming this stuff works, the maintenance dose of 200-300mg may then be taken all at once at bedtime. Inpatients may receive up to 600mg a day. Yow! With all meds of this generation I honestly wouldn’t trust it above the 200mg a day level unless you were really desperate, nothing else worked and this stuff does.

Days to Reach a Steady State: None is published. Based on the half-lives I’m presuming 7-8 days, if everything is nice and linear.

When you’re fully saturated with the medication and less prone to peaks and valleys of effects. You still might have peaks of effect after taking many meds, but with a lot of the meds you’ll have fewer valleys after this point. In theory anyway.

How Long it Takes to Work: 80% of people taking Asendin (amoxapine) report it working between 4 and 14 days.

Half-Life & Average Time to Clear Out of Your System: It does a double metabolism. The first time around is 8 hours. Then the major metabolite has a half-life of 30 hours. Expect it to clear out of your system or to be able to step down a dosage every 8 days.

If you’ve worked your way up to a particular dosage, it’s usually best to spend this many days at the next lowest dosage before going down the next lowest dosage before that and so forth. This is the least sucky way to avoid problems when stopping any psychiatric medication. Presuming you have the option of slowly tapering off them.
Comments: Be sure to read the sections on antidepressants if you haven’t done so already. You should also read up on antipsychotics as well, as Asendin (amoxapine) is structurally similar to Loxitane (loxapine).
Approved by the FDA to treat depression in September 1980, Asendin (amoxapine) is a fast-acting med that provides moderately strong reuptake of norepinephrine and light reuptake of serotonin. It’s the affinity for dopamine receptors that sets this med apart, giving it a combination of old-school antipsychotic as well as antidepressant action. The combination of the two types of medications is a potent one. So much so that Lilly is marketing one such combination of Prozac (fluoxetine) and Zyprexa (olanzapine) as an entirely new drug: Symbyax. However the concept isn’t all that new, it’s been around since before 1982, when Triavil / Etrafon, a combination of Trilafon (perphenazine) and Elavil (amitriptyline) were introduced. But if you’ve been through every possible combination of antipsychotic and antidepressant and none works for you, Asendin (amoxapine) may be what you’re looking for.

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