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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by ELA on January 10, 2002, at 11:10:03
Hi,
I'm currently taking amitriptyline and citalopram for my depression. I have been on them a couple of months now and have noticed a few things.
I am very shaky all the time, I often feel quite dizzy and "out of it" at random times of the day and I am not sleeping very well and have been experiencing very vivid dreams when I do sleep.
A bit worried about this, just wondering if a professional or someone in the know can tell me if this is normal? I am also taking Warfarin because I had several pulmonary embolli 2 months ago.
Thanks!
Posted by lou pilder on January 10, 2002, at 11:45:38
In reply to nasty effects from tricyclics, help needed..., posted by ELA on January 10, 2002, at 11:10:03
> Hi,
>
> I'm currently taking amitriptyline and citalopram for my depression. I have been on them a couple of months now and have noticed a few things.
>
> I am very shaky all the time, I often feel quite dizzy and "out of it" at random times of the day and I am not sleeping very well and have been experiencing very vivid dreams when I do sleep.
>
> A bit worried about this, just wondering if a professional or someone in the know can tell me if this is normal? I am also taking Warfarin because I had several pulmonary embolli 2 months ago.
>
> Thanks!
Tricyclic Adverse Reactions.
These are very dangerous drugs. Email me personally and I will tell you ofthe horrors that these drugs can induce. Lou louelsa@cs.com
Posted by finelinebob on January 10, 2002, at 13:07:13
In reply to Re: nasty effects from tricyclics, help needed..., posted by lou pilder on January 10, 2002, at 11:45:38
> Tricyclic Adverse Reactions.
> These are very dangerous drugs. Email me personally and I will tell you ofthe horrors that these drugs can induce. Lou louelsa@cs.com**Any** adverse reaction to ingested substances can lead to that being a very dangerous substance for someone. Peanut oil is one very dangerous substance that comes to mind.
As it is, SSRIs were nearly toxic for me versus nortriptyline, on which I have virtually no side effects. Your Mileage May Vary.
ELA,
feeling worse as a result from any medication is NOT normal. Such as the roller coaster you can have when starting up a new med ... but then, since your body is adjusting to the med you can't quite call that normal until giving it a chance to stablize.Since you've been on both for a couple of months, adjustment probably isn't the issue.
It's so hard, when changing meds can change "who you think you are" and "how you feel" so profoundly, to know what "right" means if you want to know if what you're feeling is "right". Or "normal". Or even "better."
I was on Wellbutrin and Prozac once. The Wellbutrin was bringing on some psychotic episodes, so I was also on an extremely low dose of Perphenazine. My PDoc knew that Prozac and Perphenazine didn't mix well, but all published studies indicated this interaction occuring at doses of Perphenazine 20 times greater than my dosage. Turns out I was hypersensitive. Over the course of two months, I became agoraphobic, terrified of being alone. Can't remmber the term for it, but I also stiffed up, hunched over, and got very wooden in my movements. The funny thing is I thought I was getting better because of the turn I saw in the rather strained relationship with my girlfriend at the time. Being so terrified of nothing, I started "needing" her more and more ... which made me think things were getting better overall instead of seeing it as yet another aspect of the generalized anxiety and agoraphobia (I couldn't even face the morning commute to work alone ... I'd wait till she left, even if it meant being very late for work!).
Finally, my therapist (who seemed to be the only one who saw what was going on) took me into the emergency room where the psych team on call could also quite clearly see the effects of the interaction.
Moral of the story: you shouldn't have to produce an argument to support a meds' efficacy--if it works, there shouldn't be much ambiguity about that. If you've been on it for several months and you feel awful, it probably is doing more harm than good. You shouldn't have to live with the misery to achieve some potential good, which sounds like its getting smothered by the bad right now.
Adding a third med on top of amitriptyline and citalopram may not be the answer, so don't just go looking for something to treat the symptoms. You need to bring this up with your PDoc--and don't be wimpy about feeling rotten, like I usually am with my PDoc!--and look for a course that might be better for you. You didn't say if you were on one of those two by itself at first or whether you started both at the same time. Whatever the situation, you should explore what alternatives you have with your PDoc.
[btw, the end of my big crisis was (1) that I finally got the anxiety aspect of my disorder treated since my PDoc put me on clonazepam, and (2) a little later we finally ditched SSRIs completely and put me on nortrip. Those two plus a little Ritalin have kept me pretty stable for the last two years. Not perfect, but stable enough for my talk therapy to make some advances ... maybe with a bit more progress on that side, I might be able to take some risks changing meds for a better solution some time in the near future....]
flb
Posted by bob on January 10, 2002, at 19:16:15
In reply to Re: nasty effects from tricyclics, help needed..., posted by finelinebob on January 10, 2002, at 13:07:13
> Moral of the story: you shouldn't have to produce an argument to support a meds' efficacy--if it works, there shouldn't be much ambiguity about that. If you've been on it for several months and you feel awful, it probably is doing more harm than good. You shouldn't have to live with the misery to achieve some potential good, which sounds like its getting smothered by the bad right now.
>********************************************
I think you just described the state of modern pschopharmacology there. I think most people taking these meds are exchanging a certain amount of physical comfort, for the chance to feel better mentally. For some this trade-off may be almost imperceptible, for others, it is almost too much to bear.
This is the end of the thread.
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