Posted by Ritch on January 26, 2002, at 0:41:41
In reply to Re: TCA's and BPD-Link? » Elizabeth, posted by Chloe on January 25, 2002, at 17:15:47
> > >There have also been some studies and case reports suggesting that TCAs (amitriptyline in particular) can have "paradoxical" effects in depression associated with BPD, making patients feel worse rather than better. I believe that TCAs can worsen symptoms such as self-destructiveness, paranoia, and hostility.
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> > There may be a relationship between BPD symptoms and mixed mania or hypomania in bipolar disorder. Tricyclics are thought to be more likely to trigger or exacerbate dysphoric (mixed) manic states than other ADs, and this may be why they make some borderline patients worse: because dysphoric mania is part of the problem.
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> Elizabeth,
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> I just added 20 mgs of Amitriptyline to my cocktail for neuropathic scalp pain. I also take less than 2 mgs of celexa, plus a low dose of neurontin and lithium.
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> After two weeks on amitriptyline, I am having increased cycling and horrific aggitated mixed states. I have not lost my temper in such abrupt and abusive ways in so long. I am sure it's the amitrip. and asked my pdoc to switch to doxepin. She refused. Saying that all TCA;s are alike. Changing won't make a difference. So she said to decrease the celexa more and see if the cycling stops. But I think it's the Ami...Celexa can make me irritable, but not explosive, hostile and rageful, like I feel on ami...
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> Anyway, I was hoping you had a link that I could give to her that says Ami is "particularly" bad for the rapid cycling bipolar (ex-BPD, since I have not been self destructive in over a decade..), like me. Any info would be greatly appreciated.
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> If I just didn't have this dumb scalp pain induced from the lithium, I could just go up on that and I think the cycling would decrease. But without a TCA, the burning is so painful, I can't tolerate the Li...
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> Many thanks for answering. I really enjoy reading your informative posts.
> ChloeHi Chloe,
Just an FYI, I am taking Celexa and have taken Celexa and/or Nortripyline recently and have found that Celexa and other SSri's can and have caused just as much or worsened *cycling* than TCA's do (I am BPII as well-and have been on several TCA's in the past), the difference is that TCA's have more tendency to *not* help impulsiveness like SSri's seem to help. It is interesting that your pdoc wants you to wean off the Celexa, did she mention any reasons why she thinks that might be the culprit for your troubles?
Mitch
poster:Ritch
thread:90799
URL: http://www.dr-bob.org/babble/20020124/msgs/91647.html