Posted by Ritch on January 27, 2002, at 22:05:04
In reply to Re:TCA less likely to cause rage?, posted by Chloe on January 27, 2002, at 17:50:28
> Mitch,
> Do you think that amitrip in itself, being a "dirty" drug, could be contributing to my rages? Or do you think all the TCA's are pretty much the same?
> I like the sedating effect of Ami (at last I sleep at night!!!), but I do think it causes my heart to race at time during the day...And I get so damn furious and hostile, I can't think straight.
> Of course I haven't had time for the depokote to work yet...
> But is there another "calming" or sedating TCA that might work better than Ami for neuropathic pain (and sleeping at night, too!)?
> I have heard that Doxepin has some antihistimine in it. Is it the same kind like in Remeron or Zyprexa? I hate the appetite increase thing. I know I wouldn't like Doxe if it's similar to them..
> Any thoughts?
>
> Best,
> ChloeChloe, I have tried most of the TCA's for several weeks and some cases several years. Doxepin was the first antidepressant I took and I had the dose up to 150mg/day for a while (with lithium). All of the TCA's have antihistaminic effects more or less-one could say they are antihistamines that happen to have antidepressant properties. Doxepin even at 75mg/day gave me tachycardia. For some weird reason it was the worst when I first woke up in the morning. I would be dreaming and then I would startle and wake and my heart would race up to 150+bpm for a few minutes.
I had more *rages* while on high-dose doxepin (doxepin has an anti-serotonin effect) than low-dose amitriptyline (no remarkable rage incidents there). All TCA's are *dirty* to some extent-that is if you look at them as several drugs in one-they can be helpful for irritable bowel(anticholinergic action), insomnia(sedative-antihistaminegic action), neuropathic pain (NE-opioid potentiation?).
Notriptyline was the easiest one for me to tolerate (the active metabolite of amitripytline). I didn't get any dizziness and vertigo on it like the others, and dry mouth wasn't as bad. Also, FWIW, I didn't experience any noticeable appetite increase with it either( unlike Remeron or Seroquel). Desipramine did aggravate temper and caused some hypomania, though. Maybe if you could switch the amitriptyline to nortriptyline and still get the analgesic effect you need with fewer side effects??? Ask your doc. I found low-dose Celexa + low-dose Nortriptyline to work quite well.
BTW, Older antipsychotics like chlorpromazine are structurally quite similar to the first TCA's. Older AP's and even the newer ones like Zyprexa have a fairly powerful antihistaminic effect. Nortrip. has a much lowered antihistaminic effect, but it doesn't increase extracellular serotonin very much-although it *does* downregulate serotonin receptors (which is probably helpful for panic sufferers).
Mitch
poster:Ritch
thread:90799
URL: http://www.dr-bob.org/babble/20020124/msgs/91825.html