Posted by Elizabeth on July 3, 2001, at 14:59:09
In reply to Re: Great xchange: comments Qs, posted by Indubious on July 1, 2001, at 15:05:32
Hi. Just so you know, it's sort of hard to tell who said what in this exchange because of the way the quoting is done. (I guess I could go back and read previous posts, but, well, you know.)
> > Thanks for sharing your experiences. Is there nothing you can take for the orthohypotension? (I think I have read that drinking a lot of water can help because it increases the blood volume in the veins.)
>
> I drink alot of water already, I take topomax and this is the south so with the threat of kidney stones, well I drink alot of water.Some people find salt tablets helpful; keeping yourself well-hydrated is crucial. It's also helpful to make a practise of getting up very slowly (especially first thing in the morning).
There's a steroid called fludrocortisone (Florinef) that you can use if the OH is really bad and other strategies don't work.> The racing heart must be troublesome. I know that omega 3 is supposed to be good for heart beat irregularities. Is yours just racing (this, alone, might drive me nuts) or irregular?
If it's racing, a beta blocker should help (these also help with tremors, rapid breathing or hyperventilating, etc.). If it's irregular, or if you're not sure, I recommend seeing a GP or cardiologist to try to figure out what type of abnormal rhythm you have, as different types of arrhythmias require different treatments (and the treatment for one type may worsen another type).
> Actually, it's the resting heart rate, my pdoc never checked it, my primary care doc did, it was 120 beats per...she made me stay for an EKG, an ECHO...I don't notice it all the time..
Good for your GP. What did the EKG and echo show?
> Does it have sexual dysfunction as a side effect?
Desipramine is less likely than most other ADs to cause this type of problem. Sexual dysfunction can be linked to serotonin (as with SSRIs and MAOIs), or it can be caused by anticholinergic drugs (like TCAs, drugs which block muscarinic acetylcholine receptors). Of all the TCAs, desipramine has the weakest anticholinergic and antihistamininic activity, and it is among the most selective norepinephrine reuptake inhibitors. It also is less likely to cause weight gain, dry mouth, constipation, etc. than other TCAs.
> > I'm 48. When did your depression start?
>
> In my early 20's...Age of onset makes a big difference, for one reason or other, in presentation, time course, and response to various treatments. (My depression was first diagnosed when I was 14, but I believe I had an episode when I was 10 or 11.)
> If so, estrogen might help, which in turn might allow you to lower your dosage and reduce the side effects. (Just a possibility.) The smoking is increasing your heart rate too.
Taking estrogens can be a bad thing if you smoke. But yeah, hormone supplementation can have an AD effect for some people.
> I know...I'm one of those smokers..I quit for a year, I smoke for six mo...I quit for a couple of years...my anxiety gets the best of me...I'm a very high stress person and it immobilizes me, smoking is my familiar stress response which sucks because I hate it.
Have you tried junk food as an alternative? < g > (Sorry.) Seriously -- Wellbutrin is supposed to be a good way to quit tobacco and stay off it; selegiline might help as well.
> > Course, because I started getting anxiety sort of attacks, I had to give up caffiene. I resent each one of these little comfort I give up.
I don't exactly resent them, but I get sad when I think about it.
> I responded to this thread because some people seem to feel a need to spread the notion that TCA's are evil and hurt people and bla bla bla...well, the only AD's that ever hurt me or made me sick were SSRI's and the only drug that ever saved me from myself was a TCA.
Yeah; TCAs are more toxic and more dangerous in overdose than other ADs (yes, including MAOIs), but they're a good, viable option for many people, and the only option for some. They should never be ruled out completely (especially since there are so many to choose from).
> I hope you find the information you need to make a good decision.
I second that.
-elizabeth
poster:Elizabeth
thread:67742
URL: http://www.dr-bob.org/babble/20010701/msgs/68833.html