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Re: Who takes tricyclics? » femlite

Posted by Francesco on January 10, 2004, at 17:47:55

In reply to Who takes tricyclics?, posted by femlite on January 10, 2004, at 16:37:28


> I have read some interesting info on tricyclics, but am curious as to why so few people take them. Are they passe and therefore underprescribed? OR considered ineffective?

I don't think they're considered ineffective, quite the opposite, but they're believed to have a worse side-effects profile compared to SSRIs.
However many people found them more tolerable and I'm one of them. I have had a long experience with clomipramine, which is considered the worst in term of side-effects but I did take it for years while I could not stand an SSRI for more than six months (prozac 6 months, celexa 2 months, paxil two months). What is most important is that secondary amines are considered best in term of side-effects. This is the reason why now I'm going to start desipramine.

> I am thinking about amitriptyline as an AD as I also have problems with chronic pain.

I have took it for a while but it was so many years ago I can't remember nothing about it.
What follows is a table of the side-effects of TCAs whic was sent me by Psychobabble's fellow.
It comes out that amytriptiline is one of the worst offender but I have heard it's used at low doses for chronic pain ... another issue is the antidepressant dosage though. Good luck !

PERRINE

(Listed from least to most tolerable in the general sense)

Amitriptyline (tertiary amine TC)
_Weight Gain: High
_Sedation: High
_Anticholinergic: High
_Hypotension: High
_Cardiotoxicity: High

Clomipramine (tertiary amine TC)
_Weight Gain: Medium
_Sedation: Medium
_Anticholinergic: High
_Hypotension: Medium
_Cardiotoxicity: High

Maprotiline (secondary amine TC)
_Weight Gain: Medium
_Sedation: Medium
_Anticholinergic: Medium
_Hypotension: Medium
_Cardiotoxicity: Medium

Doxepin (tertiary amine TC)
_Weight Gain: Medium
_Sedation: High
_Anticholinergic: Medium
_Hypotension: High
_Cardiotoxicity: Medium

Imipramine (tertiary amine TC)
_Weight Gain: Medium
_Sedation: Medium
_Anticholinergic: Medium
_Hypotension: Medium
_Cardiotoxicity: High

Amoxapine (secondary amine TC)
_Weight Gain: Medium
_Sedation: Low
_Anticholinergic: Low
_Hypotension: Medium
_Cardiotoxicity: Medium

Desipramine (secondary amine TC)
_Weight Gain: Medium
_Sedation: Low
_Anticholinergic: Low
_Hypotension: Low
_Cardiotoxicity: Medium

Nortriptyline (secondary amine TC)
_Weight Gain: Medium
_Sedation: Low
_Anticholinergic: Low
_Hypotension: Low
_Cardiotoxicity: Medium

-----------------------------------

GORMAN

Imipramine
_Anticholinergic: XX
_Sedation: X
_Insomnia: X
_Weight Gain: XX
_Dizziness: XX

Desipramine
_Anticholinergic: X
_Sedation: -
_Insomnia: X
_Weight Gain: X
_Dizziness: XX

Amitriptyline
_Anticholinergic: XXX
_Sedation: XX
_Insomnia: -
_Weight Gain: XX
_Dizziness: XX

Nortriptyline
_Anticholinergic: X
_Sedation: X
_Insomnia: X
_Weight Gain: X
_Dizziness: X

Doxepin
_Anticholinergic: XX
_Sedation: XX
_Insomnia: -
_Weight Gain: XX
_Dizziness: XX

Trimipramine
_Anticholinergic: XX
_Sedation: XX
_Insomnia: -
_Weight Gain: XX
_Dizziness: XX

Protriptyline
_Anticholinergic: XXX
_Sedation: -
_Insomnia: XX
_Weight Gain: -
_Dizziness: X

Maprotiline
_Anticholinergic: X
_Sedation: XX
_Insomnia: -
_Weight Gain: X
_Dizziness: X
------------------------------------------------------

SMITH

http://www.umich.edu/~pharm660/addrugs.pdf

Amitriptyline
_Sedating: +++
_Anticholinergic: +++

Doxepin
_Sedating: +++
_Anticholinergic: +++

Imipramine
_Sedating: ++
_Anticholinergic: ++

Desipramine
_Sedating: ++
_Anticholinergic: +

Nortriptyline
_Sedating: +
_Anticholinergic: ++

Protrityline
_Sedating: 0
_Anticholinergic: ++
--------------------------------------------


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poster:Francesco thread:299074
URL: http://www.dr-bob.org/babble/20040109/msgs/299124.html