Posted by Vincent_QC on July 3, 2009, at 17:29:14
In reply to Re: Imipramine + higher pulse rate » Vincent_QC, posted by SLS on July 3, 2009, at 16:05:16
> Hi.
>
> When I am taking a tricyclic, I do not worry about the elevated heart rates that they can produce. I would say that anything up to 120bpm is reasonable and often lowers over time as one continues to take the drug after a few months."Ok, so that's totally normal to have a pulse rate of 110 and more on a small dose of 25mg of Imipramine? And I can excepted that it will be lowering over the time, even if I increase the dosage?"
Actually, the heart is not working as hard as you might think. Part of its drive to beat faster is to compensate for the decreased blood pressure caused by imipramine's effect on peripheral NE alpha-1 receptors (antagonist). The heart pumps faster, but with less force being necessary. Many people have been on tricyclics for over 20 years. These drugs are not beating the hell out of your heart.
>"OK, I understand that part also... I don't know what happen but since my BAD Parnate experience, I only focus on my heart... something that I never experienced before the Parnate. My heart was always normal... I think that it's common for peoples who do panic disorder to focus on body sensations like this no??? Is that mean that I can continue to go to the gym without taking care of my pulse rate? Since almost all my panic attacks start when I feel that my heart pump really fast, what can I do to stop that process? I can't do a CBT just for my heart focusing!!! lol"
> I would suggest that you just sit back, relax, and let the drug do its work. You will have side effects, which, at first, will be significant, but often reduce in magnitude over time. You still have yet to get to a therapeutic dosage. Keep track of your heart rate, but don't obsess over it.
>Ok, so I should monitered the heart how many times by day? Also, is it possible that "coffee" increase the pulse rate making the effect of the Imipramine on my heart worse? Also, when you mean "reduce in magnitude over time", if I increase the dosage by 25mg each week, that's mean that I will not reach the minimum goal of 150mg/day before 1 1/2 months... Does it mean that I will feel BAD for 1 1/2 months and more???
You know, I can deal with panic attacks who occur at the gym or in the street... but when I drive my car, I Can't deal with that... I don't want to kill someone else because I do a panic attack... I don't care about myself as much as I care about the others...
I understand also that all the TCA's increase the NE level at first and that the down regulation of the NE take some time to happen...but how many time I should excepted to feel more anxious and do more panic attacks? ... "
> Actually, if imipramine becomes intolerable or doesn't work, I would opt to go back to nortriptyline at some point with the understanding that the elevated heart rate is normal and to be expected for these drugs.The side effects with nortriptyline are quite a bit milder than with imipramine.
"Hummm and for the strange side-effects like feeling out of my body, dizness and feeling weird sensation in my head... is it normal???
I'm not sure that i'm interrested to return to the Nortriptyline cause it was worse than the Imipramine for the pulse rate... above 120, sometimes 140... at rest... and only at 20mg... I understand that the high pulse rate is not dangerous... but that's the kind of sensation I can't tolerate... a small increase of the pulse rate, mean around 90-100 is ok for me.. I can deal with that... but more than 120? Not sure..."
>
>
> - Scott"Did you ever try the Trimipramine??? Just curious... since I have insomnia... and begin again to take some seroquel at bedtime to be able to sleep, maybe it will be an interresting option for me... since the Trimipramine is the more sedating TCA...I Will avoid blending 2 kinds of meds... since the Seroquel can also increase the blood pressure sometimes...""
Anyway thanks for your answer Scott ! I will continue the imipramine, but take it at bedtime... will maybe avoid some focus on my pulse rate while I sleep !!! ;-)
I just hope the weird feelings I have right now will decrease over the time...and not increase with the dose increasement!!! ;-)
poster:Vincent_QC
thread:904757
URL: http://www.dr-bob.org/babble/20090630/msgs/904789.html