Posted by fachad on July 22, 2002, at 21:23:39
In reply to Re: Anti-Histamines, Questions about Sleep Meds » fachad, posted by Shawn. T. on July 22, 2002, at 2:33:15
>I really hate the thought of someone being on Amitriptyline for any reason. It just has so many side effects; I can't name any other antidepressant that has more.
Yep, I think Elavil is the king of side effects. It is the only thing that works my wife, and she prefers the side effects to the IBS.
>...Ask your doctor about taking .5 to 1 mg of melatonin to help with insomnia.
Melatonin does not work for me at all. It makes me feel anxious.
> I normally wouldn't suggest this to anyone, but you might talk to your doctor about trazadone (Desyrel). I'd say start at 25mg/day and don't go over 50mg/day. I've heard bad things about taking too much trazadone.
Trazodone doesn’t' work for me either. I wake up after a few hours with a headache.
> Trimipramine has moderate anticholinergic effects. That's not acceptable.
"Not Acceptable" is a pretty strong statement. Very undesirable, yes, unpleasant also, but not unacceptable.
>Amitriptyline has rather strong anticholinergic effects.
Amitriptyline’s anticholinergic effects are not acceptable to me at this time for this indication. If I had something worse going on, and I was responding only to Amitriptyline, I'd reconsider at that point.
>I should have mentioned that Benadryl is an unadvisable sleep aid because of its anticholinergic effects.
They are pretty moderate compared to most TCAs.
>Anticholinergic drugs have negative effects on learning in humans. You just can't dispute that.
That statement is very general. I'm sure high doses of atropine would result in performance declines on human memory tests of random number recall.
But would those effects persist after the atropine wore off? How much would performance be impaired? Would subjects who were atropine naive be severely affected and subjects who were atropine experienced by mildly affected? Are the effects cumulative, as you are insinuating, or are they acute only? I think you can see what I mean about that being too general a statement to be meaningful.
>I disagree with your statement that I am extrapolating unrealistically from those studies.
What I am saying is that while those studies provide meaningful information, the kind of information they produce is not directly translatable to everyday human experience.
Neuroanatomy and neurochemistry have come along way, but they still have a long way to go. The nervous system has a remarkable ability to establish equilibrium against our best efforts to manipulate it. That's why people "lose response" to ADs. Their brain just says, "you give me more serotonin, fine, I'll give you less receptors. you sensitize my receptors, fine, I'll turn down the signal"...and on and on, for more levels than we have found.
>The prevention of the formation of long term potentiation in the hippocampus is not a "minute effect." Long term potentiation is perhaps the most important factor in the creation of memories. Your memories and experiences lead to the expression of your individuality. That's why this issue matters so much to me.
That's EXACTLY the type of extrapolating that I think is flawed. It goes way beyond the evidence. You are starting out with neuroanatomical microstructures, and are suddenly talking about personal identity and individuality. That's a very big leap.
>The tricyclics are horrible drugs IMO. I'm always glad to try to convince someone that hasn't been convinced yet.
Well, I'll agree with you there. But they do help people, and often the benefit they bring outweighs the harm they cause. In a way, I almost think it's a bit of a good thing, because they deter over usage of ADs. SSRI's look so harmless and easy to tolerate (at least on first glance, and compared to TCAs) that people think of them as "chicken soup" - can't hurt, might help. Well as you know, they can hurt, in more subtle ways than the immediate misery caused by TCAs.
poster:fachad
thread:113043
URL: http://www.dr-bob.org/babble/20020718/msgs/113354.html