Posted by Vincent_QC on March 9, 2009, at 8:44:13
In reply to Re: Nortriptyline = Tachycardia » Vincent_QC, posted by linkadge on March 8, 2009, at 11:37:29
> Nortriptyline is a powerful inhibitor of norepinephrine reuptake. They still havn't really discovered drugs which targed monoamines in the CNS. As a result, drugs like nortriptyline result in increases in cardiac NE. The effect on BP and heart rate is probably dependant on one's genetic disposition. While TCA's tend to increase pulse in almost everybody, the extent of which probably depends on baseline cardiac NE lvels.
>
> You could try a more balanced TCA such as imipramine. Clomipramine is more slective for serotonin and nortriptyine more selective for NE.
>
> Other than that, I assume you have tried the SSRI's(?)
>
> Some people add a beta blocker to a TCA, but I think thats just getting too dirty, and possibly still unsafe.
>
> Linkadge
>Hi !
You're probably right about that. It's probably also linked to the genetic as well because in my familly, my dad have to take huge dose of Avapro (irbesartan) to treat hypertension and he is in a good physical condition, a lot active for is age...My sister, who is on Cymbalta, who is also a Ne reuptake, have some cardiac effects as well, high blood pressure and high pulse rate, around 100-110...If I add to this the fact that i'm almost innactive since more than 2 years, that I eat not very well (not a lot and it's often just carbs), the fact that I smoke one pack of cigs a day, that I do insomnia at night, maybe all of this can make my heart more sensitive to the NE effect of the more powerfull AD's who hit the NE...
A more well balanced TCA like Trimipramine or Doxepin seem more interresting, I know they are more sedative but take at bedtime, they will not cause agitation on me and worse at least my GAD or my panic disorder problems...
For the weight gain, I know I have to be more active and I need to move more at daytime, but being active when you have no energy and no motivation at all is really hard...
So that's it...maybe I will also ask to try something like Vigabatrin (Sabril) and wait a little bit before I begin another AD...switching of meds often like I do since last october make my brains a little bit f*ck*d up I think. They need a break and I need a break also...
Since nothing seem to reduce my SAD problem, I will ended up at the same place and in the same state that I Was 2 years go...And for the SSRI's and SRNI's or others meds like Trazodone, Remeron, Wellbutrin, Ritalin, Propanol (Inderal), Neurotin, Lyrica...I try all of them with the exception of the weak SSRI Luvox, who seem to be the worst of them, being award of this by my new PDoc who really don't like it and certainly don't want to prescribe it to me anyway since he find it not usefull in GAD or SAD, even in depression...
That's it, I call right now to leave a message to the PDoc, I hope he will not be in vacation already for 2 weeks...
I will give some news more later!
Thanks everyone for your help!
Bye!
Vincent ;-)
poster:Vincent_QC
thread:884225
URL: http://www.dr-bob.org/babble/20090304/msgs/884569.html