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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by linkadge on July 18, 2009, at 16:32:31
Has anyone had worsening of glycemic control while on nortriptyline or other TCAs?
Linkadge
Posted by 49er on July 18, 2009, at 18:23:07
In reply to nortriptyline + diabetes, posted by linkadge on July 18, 2009, at 16:32:31
> Has anyone had worsening of glycemic control while on nortriptyline or other TCAs?
>
> LinkadgeHi Linkage,
I don't know if this proves anything but when I was still on Remeron along with Doxepin, I forgot to take both meds before sleep. I must have been really tired:)
The next day, I didn't have my usual sugar cravings which I couldn't figure out until I realized I hadn't take the meds the previous night.
You were the one who told me that Doxepin caused your mom to have diabetes right?
Are you considering the med or are you already on it?
49er
Posted by Phillipa on July 18, 2009, at 21:41:51
In reply to Re: nortriptyline + diabetes, posted by 49er on July 18, 2009, at 18:23:07
Doxepin can cause diabetes? Phillipa
Posted by linkadge on July 19, 2009, at 7:49:21
In reply to Re: nortriptyline + diabetes » 49er, posted by Phillipa on July 18, 2009, at 21:41:51
Well apparently the TCA's are not good if you do have diabetes and some suspect that they actually cause it.
Linkadge
Posted by bulldog2 on July 19, 2009, at 16:08:03
In reply to Re: nortriptyline + diabetes, posted by linkadge on July 19, 2009, at 7:49:21
> Well apparently the TCA's are not good if you do have diabetes and some suspect that they actually cause it.
>
> LinkadgeThanks for the info! I have been on tcas in the past with no incident. I guess I was lucky to escape diabetes. How have others in this forum that have been on tcas fared in respect to diabetes?
Anyhow could you please provide us with a link or links of solid scientic studies that back up some of the above conclusions?
We wouldn't want people abandoning their tcas because of fear. Well especially if they are doing well. Many are on them for pain management in addition to depression.
Now if a tca causes sugar craving you have to try and manage what you eat. If you eat a bucket of sugar each night and get diabetes I wouldn't say the tca caused diabetes.
When on nortriptyline I did have an urge for carbs but managed to discipline myself and eat a high protein, omega-3 oils and complex carbs in low amounts.Now if one eats that way it would be hard to imagine that one would get diabetes!
I am looking forward to reading your studies. If these conclusions are backed up with solid medical studfies I will do my past to pass that info to family and friends. Thanks again!!
Posted by Phillipa on July 19, 2009, at 20:57:47
In reply to Re: nortriptyline + diabetes, posted by bulldog2 on July 19, 2009, at 16:08:03
I do know from seeing the results of TCA's before SSRI"s were out and volunteering in a psych ward that when some patients were given TCA's they gained extrordinary amounts of weight in a short time and their diets were limited. Whether they developed diabetes don't know but overweight is a cause if predisposed. Phillipa ps just google one and weight gain is a side effect
Posted by linkadge on July 19, 2009, at 21:43:24
In reply to Re: nortriptyline + diabetes, posted by bulldog2 on July 19, 2009, at 16:08:03
Just do a google search:
tricyclic antidepressant + diabetes
There are reports of worsening diabetes in humans and some animal data that suggests a diabetogenic effect.
Linkadge
Posted by Phillipa on July 19, 2009, at 22:04:52
In reply to Re: nortriptyline + diabetes, posted by linkadge on July 19, 2009, at 21:43:24
Link that search indicated that ad's for longer than a year or so both TCA's and SSRI's could lead to diabetes. Use CBT Phillipa
http://www.pharmacist.com/AM/Template.cfm?Template=/CM/ContentDisplay.cfm&ContentID=19728
Posted by SLS on July 20, 2009, at 5:36:00
In reply to Re: nortriptyline + diabetes, posted by linkadge on July 19, 2009, at 21:43:24
> Just do a google search:
>
> tricyclic antidepressant + diabetes
>
> There are reports of worsening diabetes in humans and some animal data that suggests a diabetogenic effect.
>
> Linkadge
A drug like nortriptyline can cause hypoglycemia also. Is there any indication just how frequently hypo- or hyper- glycemia occur with this drug? What do the studies you have found report as the absolute risk factor for diabetes?Since 1982, I have spent more time on TCAs than off them. I have had my blood sugar tested on numerous occasions, and it has been normal; this despite having gained weight (much of which I blame Abilify for).
I remember being a 17 year old who was prescribed nortriptyline as his very first antidepressant. I had at first been diagnosed as having hypoglycemia as the cause of my fatigue and feelings of depression. I was smart enough to read the drug label. It described hypoglycemia as a possible side effect. I took the drug for four days before deciding that I wouldn't take a drug that plays with blood sugar. I might have missed a golden opportunity to avoid a life of depression.
No doctor that I have seen has thus far expressed any worries over the development of diabetes with TCA. I'm not sure why. Maybe it just doesn't happen often enough to rise to that level of concern. Either that, or the association has never been made prior to recently. You would think someone would have figured it out a long time ago, though, if it were to occur frequently. From what I can see, amitriptyline is the big offender. It is also the TCA drug that I have seen produce the most weight in others. The really significant statistical increase in the occurrence in diabetes is reported when TCAs are combined with SSRIs.
All in all, I am not surprised that type 2 diabetes can be an outcome of taking TCA (amitriptyline) or SSRI (paroxetine) as is now reported. The only concern I have is that it might not happen with sufficient frequency to justify avoiding these drugs entirely. What I was surprised to find out, however, is that the combination of SSRI with TCA is substantially higher than either drug alone. Taking metformin can reduce this risk, though.
Several investigators believe that the diabetes is secondary to weight-gain. I'm not so sure, though. Perhaps there is something going on with noradrenergic control over blood glucose.
Just one more thing to worry about, I guess. Getting regular blood tests might be a good idea for those who are at an elevated risk for diabetes.
- Scott
Posted by linkadge on July 20, 2009, at 9:11:59
In reply to Re: nortriptyline + diabetes, posted by SLS on July 20, 2009, at 5:36:00
Well, I am a little concerned. There are molecules related to the TCA's which have proven diabetogenic effects. Cyproheptadine and seroquel come to mind.
5-ht2 blockade in the pancreas is supposedly not good.
On a side note, I am also concerned about the issue of sudden cardiac death on TCA's. That doesn't have a good ring to it.
Linkadge
Posted by Phillipa on July 20, 2009, at 19:49:05
In reply to Re: nortriptyline + diabetes, posted by linkadge on July 20, 2009, at 9:11:59
Link yes that is also a side effect hence the use of the ssri's and snri's. Safer meds for various reasons. Phillipa
Posted by bulldog2 on July 21, 2009, at 10:01:11
In reply to Re: nortriptyline + diabetes » linkadge, posted by Phillipa on July 20, 2009, at 19:49:05
> Link yes that is also a side effect hence the use of the ssri's and snri's. Safer meds for various reasons. Phillipa
Im confused. You indescrimnately took dangerous hormones that cause cancer in animal studies and yet still fear meds that are far safer than these very dangerous hormones. All kinds of cancers in mouse and animal studies.
Posted by Phillipa on July 21, 2009, at 21:35:05
In reply to Re: nortriptyline + diabetes, posted by bulldog2 on July 21, 2009, at 10:01:11
Back on target thread on nortriptyline and diabetes. Might want to start a new thread? Phillipa
Posted by bulldog2 on July 22, 2009, at 15:18:08
In reply to Re: nortriptyline + diabetes » bulldog2, posted by Phillipa on July 21, 2009, at 21:35:05
> Back on target thread on nortriptyline and diabetes. Might want to start a new thread? Phillipa
Is Jade still on the parnate?
Posted by Phillipa on July 22, 2009, at 22:16:54
In reply to Re: nortriptyline + diabetes, posted by bulldog2 on July 22, 2009, at 15:18:08
No idea long gone???? Why did you hear from her? Phillipa
Posted by bulldog2 on July 30, 2009, at 18:49:52
In reply to Re: nortriptyline + diabetes » bulldog2, posted by Phillipa on July 22, 2009, at 22:16:54
> No idea long gone???? Why did you hear from her? Phillipa
Yes still on parnate and still in remission. I thought you were in remission with the hormones?
Did you do something to offend her?
Posted by Phillipa on July 30, 2009, at 21:28:30
In reply to Re: nortriptyline + diabetes, posted by bulldog2 on July 30, 2009, at 18:49:52
How could I without contact. Get thread back on track and babblemail me this is distracting for the initial poster. Sorry about this. Phillipa
Posted by bulldog2 on August 1, 2009, at 18:53:17
In reply to Re: nortriptyline + diabetes » bulldog2, posted by Phillipa on July 30, 2009, at 21:28:30
> How could I without contact. Get thread back on track and babblemail me this is distracting for the initial poster. Sorry about this. Phillipa
well you had coffee and a corn muffin with her at the White Tower!
Posted by Sigismund on August 3, 2009, at 23:09:08
In reply to Re: nortriptyline + diabetes, posted by bulldog2 on August 1, 2009, at 18:53:17
So this is where all the fun is?
This is the end of the thread.
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