Posted by SLS on July 10, 2004, at 18:15:39
In reply to Re: tachycardia vs. bradycardia, posted by KaraS on July 10, 2004, at 16:55:21
Hi Kara.
> Those were the two reasons - the 100 bpm heart rate and the insomnia.
In the grand scheme of things, I don't consider that very high. I hope I am not coming off as insensitive. I probably am. Sorry.
> I can't remember what dosage of nortriptyline I was on but I don't think I was anywhere near a therapeutic dosage yet either when I got that much tachycardia.
It really isn't dosage dependant in my experience. It starts at a very low dosage and remains static through the dosage range. That's been my experience, anyway. I am currently taking imipramine 300mg, and my heart rate is 85. Before your last post, I was thinking about a beta blocker too if you were still skittish about HR. I would use pindolol rather than propranalol if you are worrying about depressogenic potential. Pindolol is even considered by some to be an augmentor of antidepressants. It is a somato-dendritic 5-HT1a antagonist as well as a beta blocker. I still don't think it is necessary, though. Your "tachycardia" is absolutely the norm for these drugs. I would love to hold your hand through your first few weeks with them - really. :-)
As far as benzodiazepines are concerned, being physiologically dependant on them is not the same as being addicted to them. Too much fuss is made of all of this. Once you are brought into remission with an antidepressant, you are no less physiologically dependant upon it to maintain your wellbeing and staving off a discontinuation syndrome. If you have reached an impasse using the easy and convenient first-line alternatives, it is time to use the less convenient, more aggressive, and less pallatable ones. If nortriptyline is the miracle drug for you (and that's exactly what it would feel like), you will just have to get used to a *moderately* accelerated heartrate and the need to take a perfectly safe sleeping medication that might be difficult to discontinue *if* you should ever deem it desirable to do so. (You probably will be able to discontinue it within a few months). Who cares if you end up taking these two drugs for the rest of your life? I won't tell if you don't.
I'm just having a bit of fun poking at you a little bit.
:-)
- Scott
poster:SLS
thread:13117
URL: http://www.dr-bob.org/babble/20040710/msgs/364819.html