Psycho-Babble Medication Thread 99075

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Anybody else hate tricyclic antidepressants?

Posted by OldSchool on March 20, 2002, at 17:51:30

I HATE TCAS!!! I have moderate high blood pressure problems, which was set off from taking some Pamelor over a year ago. I recently tried taking some old Pamelors I still had at bedtime for mild insomnia and DAMN has it fucked my BP all up again!!! Those little 25 mg Pamelor tabs just make me feel so fucked up cardiovascular wise. They spike my pulse real bad and along with that my blood pressure. I guess its the anti-cholinergic side effects...I dont know what it is for sure.

I took all the rest of my Pamelors I had and chucked those suckers in the trash. I have decided I am NEVER again taking another tricyclic antidepressant, cause everytime I do, except for the first time I took them, I have cardio problems. I am forever sticking with modern class antidepressants...SSRIs, Wellbutrin, Serzone, Remeron, stuff like that. Im DONE with old dirty drugs.

I am also very very skeptical about this claim that tricyclics are better than plain old SSRIs for severe depression. I took Pamelor once for two months successfully, no cardo problems. It did elevate my resting heart rate which my Pdoc says was the anti-cholinergic side effects. I found that Pamelor had no better antidepressant effect than plain old Effexor, or Wellbutrin, or Zoloft or Paxil...or any other modern class AD. SSRIs give a more activating "real world" antidepressant effect for me. Just feels like normal. TCAs makes me feel like Im sedated off my ass all the time, but with cardio probs. TCAs have a lot more side effects....sedation, weight gain, cardio symptoms like a elevate resting heart rate, "brain fog." I dont believe this crap that TCAs are superior to SSRIs...I think its the other way around.

Add TCAs to the list of drugs I hate, along with anti-psychotics.

God I am so disgusted feeling, when my BP spikes I feel like total crud.

Old School

 

Re: Anybody else hate tricyclic antidepressants?

Posted by Bekka H. on March 20, 2002, at 23:11:48

In reply to Anybody else hate tricyclic antidepressants? , posted by OldSchool on March 20, 2002, at 17:51:30

Hi Old School.

I hate TCAs, too. They really are "dumb drugs." When I was on TCAs, my resting heart rate, even before I got out of bed in the morning, would be between 98 and 105! My blood pressures were deadly. So, for all my complaints about all the newer ADs, at least they aren't as bad as the TCAs, except for some medication combos I've been on that also gave me hypertensive crises and other cardiovascular complications.

Bekka

 

Re: Anybody else hate tricyclic antidepressants? » OldSchool

Posted by Bob on March 21, 2002, at 1:18:13

In reply to Anybody else hate tricyclic antidepressants? , posted by OldSchool on March 20, 2002, at 17:51:30


> God I am so disgusted feeling, when my BP spikes I feel like total crud.
>

What are your symptoms when you feel like this? I'm wondering if I've ever experienced it?

How do you monitor your blood pressure?

Bob

 

Re: Anybody else hate tricyclic antidepressants?

Posted by Cmatt on March 21, 2002, at 3:41:36

In reply to Anybody else hate tricyclic antidepressants? , posted by OldSchool on March 20, 2002, at 17:51:30

Hello,


For me, it's just the opposite. I can't tolorate any of the newer antidepressants, and other than a slight dry mouth, no side effects from Elavil at all, and Elavil tends to make me feel as natural as if I wasn't even taking the drug.

Apparently, TCA's just do not suit your body chemistry.

For me, SSRI's just make me tired.


Cmatt

 

Re: Anybody else hate tricyclic antidepressants?

Posted by sjb on March 21, 2002, at 7:59:32

In reply to Anybody else hate tricyclic antidepressants? , posted by OldSchool on March 20, 2002, at 17:51:30

Yeah, I agree. I didn't last long on the one I was on, though I can't remember which one it was but it was a TCA. Told my PDoc I got all dizzy and whoozy upon standing. This was a real problem w/ my job as a PC tech, as I'm up and down, moving things, under desks, etc. and at the gym. Everytime I got up from a machine I'd think I'd pass out and just have to stand there swaying for a while. The sedation was awful too. I only lasted for week, or so, and it was around Thanksgiving. Just watched my family go out for dinner, as I was totally useless. Only "activity" was switcing couches. It was one of the worst holidays I've had and that's saying something as I have quite a few loners.

 

Re: Anybody else hate tricyclic antidepressants?

Posted by OldSchool on March 21, 2002, at 17:56:31

In reply to Re: Anybody else hate tricyclic antidepressants? » OldSchool, posted by Bob on March 21, 2002, at 1:18:13

>
> > God I am so disgusted feeling, when my BP spikes I feel like total crud.
> >
>
>
>
> What are your symptoms when you feel like this? I'm wondering if I've ever experienced it?

Um lets see. My chest hurts, its super tight there, I get a feeling of "pressure" everywhere, in my chest, on the back of my head, etc. Cant relax, feel irritable and pissed off sometimes but thats mild. Just feel like I want to sit down and relax when I get like that. Feel like I cant breathe good or get a breath of air. Feet swell up a little bit. Cant exercise good like I normally can. Get shooting pains down my left arm.


>
> How do you monitor your blood pressure?
>

BP monitor at my local drugstore, Eckerds or CVS.

Old School

 

Re: Anybody else hate tricyclic antidepressants? » OldSchool

Posted by Bob on March 21, 2002, at 18:54:44

In reply to Re: Anybody else hate tricyclic antidepressants?, posted by OldSchool on March 21, 2002, at 17:56:31

> >
> > > God I am so disgusted feeling, when my BP spikes I feel like total crud.
> > >
> >
> >
> >
> > What are your symptoms when you feel like this? I'm wondering if I've ever experienced it?
>
> Um lets see. My chest hurts, its super tight there, I get a feeling of "pressure" everywhere, in my chest, on the back of my head, etc. Cant relax, feel irritable and pissed off sometimes but thats mild. Just feel like I want to sit down and relax when I get like that. Feel like I cant breathe good or get a breath of air. Feet swell up a little bit. Cant exercise good like I normally can. Get shooting pains down my left arm.
>
>
> >
> > How do you monitor your blood pressure?
> >
>
> BP monitor at my local drugstore, Eckerds or CVS.
>
> Old School

I get those kinds of feelings from SSRIs. I'm starting to wonder if maybe I don't get blood pressure spikes from SSRIs. I've never heard of that though. I get these periods where I feel terrible physically, and have to just sit down and relax, until it goes away. Like you said, I can't exercise or be active when I feel like that.

Bob

 

Re: Anybody else hate tricyclic antidepressants?

Posted by Elizabeth on March 22, 2002, at 21:16:46

In reply to Anybody else hate tricyclic antidepressants? , posted by OldSchool on March 20, 2002, at 17:51:30

Hi dude. Yeah, TCAs can cause hypertension (just like Effexor can), although hypotension is the more common and better known side effect. How high did your BP get, BTW?

I wouldn't say I "hate" TCAs, but they're definitely not for me. I'm sure I've told the tale of what happened when I was taking desipramine (my serum level turned out to be very high). That was the only TCA I tolerated at the usual dose; the others all had nasty side effects at low doses (probably had high levels of those too, but I never got it checked until I tried DMI).

I think the risks of TCAs aren't taken seriously enough by pdocs.

> I am also very very skeptical about this claim that tricyclics are better than plain old SSRIs for severe depression.

"Severe depression" can mean a lot of different things. I think TCAs are better than SSRIs for some types of severe depression. I wonder if most people who respond to TCAs might also respond equally or better to Remeron or Effexor, tho'.

> TCAs makes me feel like Im sedated off my ass all the time, but with cardio probs.

Ever try desipramine? It doesn't have much in the way of anticholinergic effects, and it's not very sedating. I didn't have any side effects at all until that weird seizure/confusional state thing happened.

> God I am so disgusted feeling, when my BP spikes I feel like total crud.

I can relate to that.

-elizabeth

 

Re: Anybody else hate tricyclic antidepressants? » Bob

Posted by Elizabeth on March 22, 2002, at 21:19:52

In reply to Re: Anybody else hate tricyclic antidepressants? » OldSchool, posted by Bob on March 21, 2002, at 18:54:44

> > Um lets see. My chest hurts, its super tight there, I get a feeling of "pressure" everywhere, in my chest, on the back of my head, etc. Cant relax, feel irritable and pissed off sometimes but thats mild. Just feel like I want to sit down and relax when I get like that. Feel like I cant breathe good or get a breath of air. Feet swell up a little bit. Cant exercise good like I normally can. Get shooting pains down my left arm.
>
> I get those kinds of feelings from SSRIs. I'm starting to wonder if maybe I don't get blood pressure spikes from SSRIs.

That's not very likely. OldSchool describes some symptoms that are sometimes associated with acute hypertension, but they can also be due to other things. Can you say more about what happens for you, when it happens, etc.?

-elizabeth

 

Question for Elizabeth...

Posted by Lia Mason on March 22, 2002, at 21:36:26

In reply to Re: Anybody else hate tricyclic antidepressants? , posted by Elizabeth on March 22, 2002, at 21:16:46

I'm curious... (cuz I'm trying to tolerate imipramine and feeling tired) You say desipramine is the only one you tolerated. Did you try imipramine? I've been led to believe they're so similar that if i don't tolerate imipramine, it's not worth a try at desipramine.

Any feedback appreciated!

Lia

 

Re: Anybody else hate tricyclic antidepressants?

Posted by OldSchool on March 22, 2002, at 21:36:46

In reply to Re: Anybody else hate tricyclic antidepressants? , posted by Elizabeth on March 22, 2002, at 21:16:46

> Hi dude. Yeah, TCAs can cause hypertension (just like Effexor can), although hypotension is the more common and better known side effect. How high did your BP get, BTW?

Not very high. But too high for my taste and comfort. My family doc says I have "low tolerance for pressure" and I agree. If my BP even gets on the low end of high I feel it. Chest tightness and pain, that sort of thing. The best I felt cardio wise anytime recently was when I took Amantadine...chest tightness was GONE and BP DROPPED.

>
> I wouldn't say I "hate" TCAs, but they're definitely not for me. I'm sure I've told the tale of what happened when I was taking desipramine (my serum level turned out to be very high). That was the only TCA I tolerated at the usual dose; the others all had nasty side effects at low doses (probably had high levels of those too, but I never got it checked until I tried DMI).
>
> I think the risks of TCAs aren't taken seriously enough by pdocs.
>

I think TCAs suck. They are dirty, nasty drugs with a bunch of side effects.

> > I am also very very skeptical about this claim that tricyclics are better than plain old SSRIs for severe depression.
>
> "Severe depression" can mean a lot of different things. I think TCAs are better than SSRIs for some types of severe depression. I wonder if most people who respond to TCAs might also respond equally or better to Remeron or Effexor, tho'.

Yeah, Remeron and high dose Effexor are both excellent meds for severe depression. Unfortunately I cant take Effexor now cause of BP probs, otherwise Id be back on that drug in a flash. Remeron is a bit too sedating for me these days. But its good, I agree. I just get a more "real world" AD effect from plain old SSRIs than tricyclics. Tricyclics I feel like Im loaded on benadryl or something all the time.

>
> > TCAs makes me feel like Im sedated off my ass all the time, but with cardio probs.
>
> Ever try desipramine? It doesn't have much in the way of anticholinergic effects, and it's not very sedating. I didn't have any side effects at all until that weird seizure/confusional state thing happened.

Nah, thats OK. Even desipramine is a TCA and does have some mild anti-cholinergic side effects. Milder than Pamelor but still there.


Old School

 

imipramine vs. desipramine » Lia Mason

Posted by Elizabeth on March 23, 2002, at 14:10:22

In reply to Question for Elizabeth... , posted by Lia Mason on March 22, 2002, at 21:36:26

> I'm curious... (cuz I'm trying to tolerate imipramine and feeling tired) You say desipramine is the only one you tolerated. Did you try imipramine? I've been led to believe they're so similar that if i don't tolerate imipramine, it's not worth a try at desipramine.

They're chemically very similar: desipramine is the N-demethylated metabolite of imipramine. Pharmacologically they're very different. Desipramine is relatively selective as a NE reuptake inhibitor, whereas imipramine has more effect on serotonin. Imipramine also blocks several other receptor types that aren't affected by desipramine: H1 (histaminic), M1 (cholinergic), and alpha1 (adrenergic) receptors. The receptor blockade is responsible for a number of the side effects of tricyclic ADs: sedation, weight gain, constipation, dry mouth, orthostatic hypotension, etc. What side effects did you experience on imipramine?

-elizabeth

 

Re: imipramine vs. desipramine-Elizabeth

Posted by Lia Mason on March 23, 2002, at 19:19:14

In reply to imipramine vs. desipramine » Lia Mason, posted by Elizabeth on March 23, 2002, at 14:10:22

Elizabeth,

Thank you so much! This is exactly the info I've been after.

I'm at 60 imipramine. I'm starting to get that floaty, dopey, sleepy feeling... I had it bad on 80 Pamelor so got off it. It's not just in the morning--it's constant. I wonder what the prognosis is... will the fog eventually clear? That's it for side effects.

Your info interests me very much (re: NE versus serotonin action). I was nonresponsive to desipramine 14 years ago, but... it's the first antidepressant I ever took and i can't recall if we gave it a fair shot. Prozac came on the market and I was switched to that with marvelous antidepressant results and bad side effects. So... I'm trying to go back to the tricyclics for less sexual dysfunction. Given how I'm doing at 60 imipraminr, though, it seems unlikely I'd make it to 200.

I have a sense that serotonin is more the issue with me, so... desipramine may not be my drug. Thanks for your insights.

L

 

Re: Anybody else hate tricyclic antidepressants? » Elizabeth

Posted by Bob on March 25, 2002, at 0:23:57

In reply to Re: Anybody else hate tricyclic antidepressants? » Bob, posted by Elizabeth on March 22, 2002, at 21:19:52


> That's not very likely. OldSchool describes some symptoms that are sometimes associated with acute hypertension, but they can also be due to other things. Can you say more about what happens for you, when it happens, etc.?
>
> -elizabeth

I definitely would not call my symptoms indicative of "acute" hypertension. They consist of a very heavy, rubbery type feeling. I start feeling kind of weak, and I have to lay down and wait for it to pass. When I lay still, I can feel my body throbbing slightly, like after you've exercised, except not it's not a good feeling. It's kind of difficult to describe, actually. Maybe it's related to blood sugar fluctuations. Who the hell knows anymore!??

Bob

 

Re: Yessss! Loathe even the memory » OldSchool

Posted by Zo on March 25, 2002, at 17:03:04

In reply to Anybody else hate tricyclic antidepressants? , posted by OldSchool on March 20, 2002, at 17:51:30

They were each--and I tried them all, they were the only thing available---a horror of their own. I don't care that it was all side-effects, I felt so much worse. . .

Jumped to Wellbutrin, in 1989, which was my first actual relief. But. . .became forever allergic to it within 3 years.

Zo

 

Re: imipramine vs. desipramine » Lia Mason

Posted by Elizabeth on March 26, 2002, at 21:36:45

In reply to Re: imipramine vs. desipramine-Elizabeth, posted by Lia Mason on March 23, 2002, at 19:19:14

> Thank you so much! This is exactly the info I've been after.

You're welcome. I'm glad to be of help whenever I can.

> I'm at 60 imipramine. I'm starting to get that floaty, dopey, sleepy feeling... I had it bad on 80 Pamelor so got off it. It's not just in the morning--it's constant. I wonder what the prognosis is... will the fog eventually clear? That's it for side effects.

Desipramine doesn't usually cause the tired/dizzy feelings that people often get on TCAs. It tends to be activating, if anything.

Oh, one thing you should probably consider if you've had a hard time tolerating TCAs: some people don't metabolize them very well, so the drugs build up in their bodies. This happened to me which is why I stopped taking desipramine. You can have your serum level tested; safe therapeutic ranges have been determined for imipramine, desipramine, and nortriptyline (maybe amitriptyline and/or clomipramine, not sure about those).

> Your info interests me very much (re: NE versus serotonin action).

I'm not sure it really matters that much, but I'm glad you're interested. :-)

> Prozac came on the market and I was switched to that with marvelous antidepressant results and bad side effects. So... I'm trying to go back to the tricyclics for less sexual dysfunction.

Desipramine wouldn't be expected to cause sexual problems to nearly the extent that Prozac does, but on the other hand, because they don't work in the same way, desipramine might not work for the same people for whom Prozac works.

Well, anyway, whatever you try next, I hope you find something that works for you sooner or later (preferably sooner).

best,
-elizabeth

 

Re: Anybody else hate tricyclic antidepressants? » OldSchool

Posted by Elizabeth on March 26, 2002, at 21:46:53

In reply to Re: Anybody else hate tricyclic antidepressants? , posted by OldSchool on March 22, 2002, at 21:36:46

> > How high did your BP get, BTW?
>
> Not very high. But too high for my taste and comfort.

So, not dangerously high, but unpleasant? I always would get this prickly feeling on my scalp about 30 minutes after I took each dose of Parnate (10 mg). It turned out that my BP was rising, though not as much as it had when I was taking 20 mg at a time.

> My family doc says I have "low tolerance for pressure" and I agree. If my BP even gets on the low end of high I feel it. Chest tightness and pain, that sort of thing. The best I felt cardio wise anytime recently was when I took Amantadine...chest tightness was GONE and BP DROPPED.

That's interesting, I didn't know that amantadine would do that. Did it help with the pseudoparkinsonism at all?

> Unfortunately I cant take Effexor now cause of BP probs, otherwise Id be back on that drug in a flash.

Did it make your BP go up when you tried it before? I'm taking 375 mg and mine is unchanged.

> Remeron is a bit too sedating for me these days. But its good, I agree.

It didn't seem to do anything for me. No sedation, no weight gain, no mood effects, nothing.

> I just get a more "real world" AD effect from plain old SSRIs than tricyclics. Tricyclics I feel like Im loaded on benadryl or something all the time.

They have a lot in common with Benadryl (most of them anyway) -- the anticholinergic/antihistaminic stuff, that is. That's responsible for a lot of their side effects, too.

> Nah, thats OK. Even desipramine is a TCA and does have some mild anti-cholinergic side effects. Milder than Pamelor but still there.

Did you try it, though? And did you ever have your serum levels checked when you were on TCAs? That can cause a lot of side effects, not to mention serious danger. Although I do get the impression that you're generally sensitive to side effects, given that you've been having a hard time finding something that works for you it might be worth considering. Of course I hope the ECT works, but are you thinking about having maintenance ECT if it does?

-elizabeth

 

Re: Anybody else hate tricyclic antidepressants? » Bob

Posted by Elizabeth on March 26, 2002, at 21:55:47

In reply to Re: Anybody else hate tricyclic antidepressants? » Elizabeth, posted by Bob on March 25, 2002, at 0:23:57

Hi Bob. I think the symptoms you mentioned might be due to tachycardia (increased heart rate). It seems a little likelier than hypertension from SSRIs.

SSRIs do tend to cause panic-type anxiety a lot (especially for people who have panic disorder), with lots of peripheral symptoms. People sometimes feel very shakey and agitated (the big feature of panic anxiety, if you're not familiar with it, is feeling like you're having a heart attack or something). A lot of different people (independently) use the expression "jumping out of my skin" to describe the feeling. Could that be what you had?

Just some thoughts.

-elizabeth

 

Re: Yessss! Loathe even the memory » Zo

Posted by Elizabeth on March 26, 2002, at 21:57:04

In reply to Re: Yessss! Loathe even the memory » OldSchool, posted by Zo on March 25, 2002, at 17:03:04

Zo -- what happened when you were taking TCAs? Just the usual side effects?

-elizabeth

 

Re: Anybody else hate tricyclic antidepressants? » Elizabeth

Posted by Bob on March 27, 2002, at 14:30:27

In reply to Re: Anybody else hate tricyclic antidepressants? » Bob, posted by Elizabeth on March 26, 2002, at 21:55:47

> Hi Bob. I think the symptoms you mentioned might be due to tachycardia (increased heart rate). It seems a little likelier than hypertension from SSRIs.
>
> SSRIs do tend to cause panic-type anxiety a lot (especially for people who have panic disorder), with lots of peripheral symptoms. People sometimes feel very shakey and agitated (the big feature of panic anxiety, if you're not familiar with it, is feeling like you're having a heart attack or something). A lot of different people (independently) use the expression "jumping out of my skin" to describe the feeling. Could that be what you had?
>
> Just some thoughts.
>
> -elizabeth

Well, I actually do have problems with agitation and akathisia on SSRIs (when I'm not drowsy and sleeping), but the syptom profile I was describing was not that. The problem I was referring to leaves me feeling digusting, tired, sweaty, and sick. I have to lay down and rest when I feel that way. Once I lay down and rest, I notice my body kind of throbbing. There's not necessarily any anxiety or agitation associated with this state, I just feel physically bad.

 

Re: Anybody else hate tricyclic antidepressants? » Bob

Posted by kazoo on April 1, 2002, at 0:06:13

In reply to Re: Anybody else hate tricyclic antidepressants? » Elizabeth, posted by Bob on March 27, 2002, at 14:30:27

In 1971, my doctor found it necessary to prescribe 450mgs. of Elavil taken h.s. to alleviate what he believed to be a form of atypical depression. He warned me of "some drowsiness" but this, he said, would wear off after a week or so.

I was in a stupor for ten whole months.

During those ten months, I didn't know if I were awake or asleep, alive or dead. I would dump boxes of Cheerios in a large salad bowl, fill it up with milk and sugar, put whipped cream on top, and sit mindlessly in front of the TV eating this mess from a soup ladle. I gained 70 pounds in the blink of an eye (although I don't remember blinking at all!).

I don't remember a Goddamn thing from that ten month period except that I think I went to work, I think I had a life and I think I was alive.

After the ten months, my hours at work changed, and I noticed a wonderful difference in my mood, so I flushed all my Elavil down the crapper.

Within 24 hours, I had a major convulsion with seizure-type animations and ended up at Yale New Haven Hospital. I slipped into a catatonic state for some time but came out of it. I was a mess.

During one particular period when strapped to the hospital bed, the doctor came in to see me and he was livid that I abruptly discontinued the drug without his permission. I said two words to him: "You're fired!" He never told me that this would happen if I did stop suddenly.

From that day on, I vowed never to touch a TCA again, and I haven't. You can put the whole lot of them on a barge and sink it.

They're pure crap and help no one.

Just another experience from the pile, so to speak.

kazoo


 

Re: Anybody else hate tricyclic antidepressants? » OldSchool

Posted by Dave1 on April 1, 2002, at 8:42:38

In reply to Anybody else hate tricyclic antidepressants? , posted by OldSchool on March 20, 2002, at 17:51:30

OldSchool,

The anafranil I'm taking now is making me fat.
Also, the anafranil makes me shake, which is scary because I'm afraid I'll get tardive dyskanesia. So far nothing else. When I was younger and took them, before the SSRIs, they also gave me some other minor problems.

Dave


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