Posted by King Vultan on July 15, 2004, at 8:17:32
In reply to Re: Pamelor - How does it work, posted by KaraS on July 15, 2004, at 1:33:28
>
> Todd,
> Why does it produce tachycardia in some people (like me) and not in others? (That's probably not a fair question since many of us can be fairly idiosyncratic in our reactions.) Also, I'm assuming that the tachycardia is in response to NE activity and I'm wondering if I will react to all meds that act on NE that same way (even though I desperately need to stimulate NE activity).
> Kara
Tachycardia is also an anticholinergic effect, which may also be playing a role here. Nortriptyline's ACh effects are regarded as being rather mild, but it is derived from amitriptyline, the most anticholinergic of all antidepressants, and some people are perhaps reacting to this effect. I honestly can't remember if I suffered much tachycardia on nortriptyline; I think my heart rate was elevated, but perhaps only into the 80's. On desipramine, which is a more powerful NE reuptake inhibitor and has very low ACh effects (for a tricyclic), I experienced definite tachycardia. On protripyline, which is about as powerful an NE reuptake inhibitor as desipramine but is drastically more anticholinergic, I suffered even worse tachycardia.In answer to your question, though, people obviously can have different reactions to the same med, probably due to differences in receptor densities or some other darned thing. I seem to be relatively sensitive to the tachycardia effect myself but viewed an occasional reading at rest of between 100-110 without a great deal of alarm when I was on these drugs. Seeing it occasionally go over 110 frankly made me a bit nervous, but most of the time it seemed to be in the 90's, even on protriptyline, and considering my cardiovascular health seems to be very good to begin with, I came to regard these readings without a great deal of concern.
Todd
poster:King Vultan
thread:364847
URL: http://www.dr-bob.org/babble/20040714/msgs/366400.html