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Dr. Bob is Robert Hsiung, MD,
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Posted by KaraS on January 21, 2005, at 0:27:11
I'm supposed to start on maprotiline soon but I'm a little concerned about reading that it's contraindicated with thyroid medication, since I take thyroid hormone for hypothryoidism. Unfortunately the drug monograph and other information I've been able to find out are very vague on this issue. They mention thyroid medication as being contraindicated but they don't specify if they mean medication to treat hypothyroidism and/or hyperthyroidism.
In Dr. David Burns' "The Feeling Good Handbook" he states: "use TCA with caution in patients with thyroid disease, or those taking thyroid medication; may trigger abnormal heart rhythms."
My initial reaction was to assume that this was about hyperthyroidism but now I'm not so sure.
I'm only supposed to start on a low dosage of the maprotiline. I think that the last time I took it I was already on thryoid hormone but I'm not positive. Maprotiline helps me sleep and it works well in preventing panic disorder. The TCAs/tetracyclics have always worked so well for me on anxiety. I'd hate to have to give up this remedy.
Kara
Posted by johnsmith12345 on January 21, 2005, at 2:57:21
In reply to TCAs/tetracyclics contraindicated w/ thyroid med?, posted by KaraS on January 21, 2005, at 0:27:11
I believe thyroid is commonly used to augment TCAs. Did you read that it was contraindicated with all of them, or just Maprotiline? Here are some links:
http://www.acnp.org/g4/GN401000105/103_4.htm
http://www.acnp.org/g4/GN401000105/CH103.html#augmentation
Posted by jujube on January 21, 2005, at 14:23:15
In reply to TCAs/tetracyclics contraindicated w/ thyroid med?, posted by KaraS on January 21, 2005, at 0:27:11
Hi Kara,
It is my understanding that effects of TCAs and sympathomimetics may be increased when taken concurrrently with thyroid medications. I only came across one specific citing in reference documents I have on TCA interactions, and it was to Liothyronine (T3, Cytomel) and said the following: "Can enhance the effects of TCA. Abnormal heart rhythms can result. TCA blood levels may increase.".
Sorry I couldn't be more helpful.
Take care.
Tamara
> I'm supposed to start on maprotiline soon but I'm a little concerned about reading that it's contraindicated with thyroid medication, since I take thyroid hormone for hypothryoidism. Unfortunately the drug monograph and other information I've been able to find out are very vague on this issue. They mention thyroid medication as being contraindicated but they don't specify if they mean medication to treat hypothyroidism and/or hyperthyroidism.
>
> In Dr. David Burns' "The Feeling Good Handbook" he states: "use TCA with caution in patients with thyroid disease, or those taking thyroid medication; may trigger abnormal heart rhythms."
>
> My initial reaction was to assume that this was about hyperthyroidism but now I'm not so sure.
>
> I'm only supposed to start on a low dosage of the maprotiline. I think that the last time I took it I was already on thryoid hormone but I'm not positive. Maprotiline helps me sleep and it works well in preventing panic disorder. The TCAs/tetracyclics have always worked so well for me on anxiety. I'd hate to have to give up this remedy.
>
> Kara
>
Posted by Cairo on January 21, 2005, at 20:12:57
In reply to TCAs/tetracyclics contraindicated w/ thyroid med?, posted by KaraS on January 21, 2005, at 0:27:11
I believe thyroid medication may potentiate the effects of TCAs on heart rhythm via decreasing the TSH too much.
HOWEVER, I have wondered about the effect of Cymbalta upon my TSH level. My TSH level was creeping up, probably as a result of a sluggish HPA axis. Synthroid brought my TSH to less than 2, but with no relief of my symptoms (muscular, fatigue, weight gain, orthostatic dizziness, brain fog, atypical depression symptoms, etc.). Cymbalta has been the only med that seems to jump start my thyroid a bit as the dizziness, fog and fatigue have improved. I have wondered if my TSH has changed or if the Cymbalta is having an effect on the thyroid receptors or something. I won't know until my TSH is drawn in three months for my regular check. TCAs always seem to slow my metabolism down. There's got to be a connection here.
Cairo
> I'm supposed to start on maprotiline soon but I'm a little concerned about reading that it's contraindicated with thyroid medication, since I take thyroid hormone for hypothryoidism. Unfortunately the drug monograph and other information I've been able to find out are very vague on this issue. They mention thyroid medication as being contraindicated but they don't specify if they mean medication to treat hypothyroidism and/or hyperthyroidism.
>
> In Dr. David Burns' "The Feeling Good Handbook" he states: "use TCA with caution in patients with thyroid disease, or those taking thyroid medication; may trigger abnormal heart rhythms."
>
> My initial reaction was to assume that this was about hyperthyroidism but now I'm not so sure.
>
> I'm only supposed to start on a low dosage of the maprotiline. I think that the last time I took it I was already on thryoid hormone but I'm not positive. Maprotiline helps me sleep and it works well in preventing panic disorder. The TCAs/tetracyclics have always worked so well for me on anxiety. I'd hate to have to give up this remedy.
>
> Kara
>
Posted by KaraS on January 21, 2005, at 23:02:43
In reply to TCAs/tetracyclics contraindicated w/ thyroid med?, posted by KaraS on January 21, 2005, at 0:27:11
Thanks everyone for your input. I think that there is a definite relationship here and that the thyroid hormones do increase the effect of the TCAs on the heart. I would guess that the T3, which is a more immediate effect, is probably more of a problem than just taking T2. Since thyroid hormones are used to potentiate TCAs, I imagine that you just need to be careful dosage wise rather than avoiding the combination completely. Anyway, I think I'm going to cautiously start on a small amount of maprotiline and stay at a small dosage.
Thanks again.
Posted by jujube on January 22, 2005, at 15:02:55
In reply to Re: TCAs/tetracyclics contraindicated w/ thyroid med?, posted by KaraS on January 21, 2005, at 23:02:43
Good luck Kara. Hope you start to feel some welcome relief soon. I will be thinking good thoughts for you.
Take care.
Tamara
Posted by KaraS on January 22, 2005, at 15:35:41
In reply to Re: TCAs/tetracyclics contraindicated w/ thyroid med? » KaraS, posted by jujube on January 22, 2005, at 15:02:55
This is the end of the thread.
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