Posted by Incubusfan on February 18, 2009, at 12:11:49
In reply to Re: Tricyclic least likely to mess with the heart? » Incubusfan, posted by SLS on February 17, 2009, at 14:19:07
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> Desipramine does have a mild muscarinic cholinergic receptor binding affinity. However, I don't know how important that is to the overall set of side effects.
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> Anticholinergic effects will certainly contribute to cardiac effects of drugs. However, the NE reuptake inhibition of desipramine is so potent, that most people notice an accelerated heart rate. Remember, there is a balance between sympathetic (NE) and parasympathetic (ACh) autonomic nervous systems. Too much NE or not enough ACh produce very similar symptoms: tachycardia, palpitations, dry mouth, sweating, mydriasis, blurred vision, urinary retention, etc. I found imipramine to be worse, which, of course, makes sense, as it does have the additional anticholinergic properties.
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> http://www.drugs.com/sfx/desipramine-side-effects.html
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> Personally, I have no fear of any of the tricyclics except for, perhaps, protriptyline. It is extremely anticholinergic along with NE reuptake inhibition.>
> Thanks for asking. No, I am still stuck at 250mg, and I continue to deteriorate. This was unexpected. I would have thought that being so close to my therapeutic dosage that I would have at least maintained some sort of plateau. Now, I can't help but to have some trepidation that even 300mg won't do it. I still think it's the right drug for me, though. I guess we will know better in 2 weeks.
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> Take care and be well.
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> - Scott
Spoke to my pdoc yesterday, he seems to like Noritriptyline the best in terms of side effects.When asked if any tricyclics will not mess with the heart, he basically said no,and then exactly what you said Scott in terms of the systems involved with affected heart rate.
The summer will be a better time for me to test side effect heavy meds, as I'll be able to lie in bed without consequence, if need be. For the moment, I'll be taking 4mg of Trilafon.
I'm going to ask my doctor about trying Wellbutrin SR at 300MG next week(No insurance, and the XL generic is apparently garbage).
Thanks!
- Mike
poster:Incubusfan
thread:880691
URL: http://www.dr-bob.org/babble/20090213/msgs/880911.html