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Re: SLS - what other TCA's have you tried? » linkadge

Posted by SLS on July 30, 2009, at 18:07:05

In reply to SLS - what other TCA's have you tried?, posted by linkadge on July 30, 2009, at 17:18:22

> What other TCA's have you ever tried? How did they affect you? What worked or works better with the nortriptyline?

Right now, by HR is 80 bpm.

imipramine
desipramine
amoxapine
amitriptyline
nortriptyline
protriptyline
trimipramine

Protriptyline was a bad drug for me, I'm not sure why. It is probably the most anticholinergic. I didn't monitor my HR while I was on it. It made me feel much worse.

I have never tried doxepin.

You might want to examine trimipramine (Surmontil). I wish I had monitored my HR while I was on it. One would think that it would be less cardiotoxic given that it doesn't inhibit the reuptake of norepinephrine. I cannot be sure, though. I think you will find that most of the references to individual tricyclics are actually taken from a general description of the drug class as a whole. Therefore, one cannot be sure if trimipramine is any better or any worse than other TCAs when reading these "stock" drug descriptions.

Here is one study comparing maprotiline and trimipramine:

http://www.ncbi.nlm.nih.gov/pubmed/2859273?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Also:

http://www.ncbi.nlm.nih.gov/pubmed/2693051?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedreviews&logdbfrom=pubmed

"The side effect profile of trimipramine is in some ways similar to those of the tertiary amine TCAs with a preponderance of anticholinergic and sedative effects. Its cardiotoxic properties are minimal, with some findings suggesting a very favourable profile."

I wish I could help you pick the right drug. Trimipramine might have a reduced cardiotoxic profile, but your concerns over genotoxicity might disuade you from trying it.

Because I have been on nortriptyline for so long, and knowing that people have been on it for decades, I can't help but to encourage you to continue with it. Like I said before, you are not married to the drug. If your EKG is normal, I don't think you really have anything to worry about. Keep researching these issues. But try to look for information that includes statistics representing the frequency of untoward events.


- Scott

 

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