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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by automatedlady on April 22, 2003, at 10:33:10
I was on lofepramine (TCA not available in US) and it was the ONLY AD ever to work for me. I started to get my life back after six years of horrible depression. But after six months on it I realised my heart rate was consistently over 100 bpm, even in bed at night. My doc suggested beta blockers to lower the heart rate but he also warned they might make me "flat" (which was my problem **in the first place!!**) I was too scared to try them and ended up just coming off the AD instead.
I moved doctors and the new one offered me dothiepin but warned it was really sedating. Again, that is the ***last*** thing I need as my problem is total lack of energy. I tried like a quarter dose of the dothiepin one night and was unable to get out of bed till mid afternoon the next day. As I am currently trying to hold down a full time job (god knows how long that'll last the way I am at the moment) I **can not** afford to be sedated any more than I naturally am. I am also scared of putting on weight with a TCA, as I am already overweight.
Can anyone help? Has anyone had problems with tachycardia (fast heartbeat) and solved it with beta blockers? Or can anyone suggest a less sedating TCA? I have already tried four different SSRIs (prozac, effexor, cipramil, seroxat)and all made me worse (not only could I not get out of bed but I didn't even care - I lost all my friends/interests/hope and it took me 18 months to get any semblance of a life back once I stopped taking them).
I wonder whether MAOIs are a better choice for me, but as I have an eating disorder and a chaotic life I think it unlikely I would be able to handle the diet. please help - I am desperate now. for 6 months I started to get my life back together and now I can see it drifting away again. In the past my periods of depression were kind of containable because I was at uni and could get away with a lot of missing lectures etc. Now i am doing a really demanding and stressful job and am not coping at all. if I lose this job I will have no money, no support and nowhere to go.
Sorry - that was a bit long...
AL
Posted by zeugma on April 22, 2003, at 11:11:18
In reply to TCAs and tachycardia/sedation - please help!, posted by automatedlady on April 22, 2003, at 10:33:10
one thing you can do with the TCA is take it earlier. I had the same problem the first time I took nortriptyline years ago; I took it at night as per instructions and couldn't get up for work the next day. So I went off it and tried lots of other things that didn't worked and spent years in an unbelievable depression. I've found that if I take the TCA mid afternoon, I'm tired by 11 but not the next morning. Nortriptyline's a secondary amine TCA which is less sedating anyway so you might want to look at one of the secondary amines (nortriptyline, desipramine, protriptyline( [not sure which are available in the UK]. You could also look at reboxetine which causes NO sedation or cardiac side effects and which has a similar neurochemical mechanism to the TCA's.
Posted by mrporter1 on April 22, 2003, at 12:42:33
In reply to Re: TCAs and tachycardia/sedation - please help!, posted by zeugma on April 22, 2003, at 11:11:18
I take Atenolol daily to manage tachycardia. It works pretty well most of the time. Over the past few years I have had problems with minor tachycardia and a few major episodes of PAT with rates over 200. No major episodes since starting Atenolol daily.
I don't think that the beta blocker has made much of a difference with depression - I was down before and after. I also take Wellbutrin and Adderall. On Wellbutrin for years and started Adderall couple of months ago.
(Assuming you're working closely with your doctor) most beta blockers are pretty easy drugs. You could also speak with your doc about taking it only when you have a problem - not every day.
Hope this helps. Good luck.
Posted by Ame Sans Vie on April 22, 2003, at 13:42:41
In reply to TCAs and tachycardia/sedation - please help!, posted by automatedlady on April 22, 2003, at 10:33:10
It's funny that you would bring this up, as I spent a lengthy phone conversation with my grandmother on Easter Sunday, and this topic came up. She has been taking doxepin for years, and just recently has begun taking medication for tachycardia. She first tried beta-blockers (propranolol and atenolol, I believe) but both made her extremely depressed, though she's never had a problem with depression--the doxepin was for panic disorder. So she says she has used two non-beta-blockers, digoxin and nifedipine, at different times and they both relieved her symptoms with few or no side effects. Maybe you should bring this up with your doctor? There are plenty of other options as well... other calcium-channel blockers besides nifedipine, adenosine...
Posted by dave1 on April 24, 2003, at 8:44:01
In reply to TCAs and tachycardia/sedation - please help!, posted by automatedlady on April 22, 2003, at 10:33:10
Hi,
I took TCAs a while ago and they did have some annoying side effects. Weight gain and trouble urinating were the ones I remember. I was trying to get on one again but my pdoc won't give it to me because he says it can cause heart problems. I'm planning on going to another pdoc to get them because I want to try a TCA with li, or thyroid hormone. I'm overweight too but if the meds help, I'd be willing to put up with weight gain. Plus, if I felt better I'd probably be able to excercise and eat better to control my weight.
Regarding sedation, I think alot of times it goes away after your brain adjusts to the med. That's what happened when I took AP's.
Also, I don't think it would hurt to try a beta blocker. If it makes you flat then just stop it, if not then your in the clear.Dave
This is the end of the thread.
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