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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by katekite on July 20, 2002, at 12:23:53
Can anyone who's taken trimipramine say how they felt it compared with benadryl as far as the anti-histamine effect goes: was it somewhat drying? Did you notice dry eyes at all? Gummy mouth?
If so did that effect go away or not?
Thanks -- Kate
Posted by may-b on July 20, 2002, at 16:51:53
In reply to trimipramine, posted by katekite on July 20, 2002, at 12:23:53
Hi Kate
About 11 years ago I was on trimiprimine (10-25 mg) -- used it on and off (mostly on) with an equal amount of imiprimine for 5 years. Never got any better re anticholinergic effects.
Helped with sleep, tho.
best wishes,
may-b
Posted by fachad on July 20, 2002, at 17:07:44
In reply to trimipramine, posted by katekite on July 20, 2002, at 12:23:53
Both Trimipramine and Benadryl have anti-histamine and anti-cholinergic properties.
The anti-histamine effects cause drowsiness, improved sleep, reduced allergic reaction.
The anti-cholinergic effects cause drying, dry mouth, dry eyes, constipation.
Most anti-histamines also have anti-cholinergic effects, so people tend to think of anti-histamines as drying. But they are only drying to the extent that they have anti-cholinergic effects.
For example, Remeron is an extremely potent anti-histamine, with a binding affinity of 700, but with little to no anti-cholinergic activity. It is extremely sedating, but not drying.
Just to give a scale, Benadryl histamine binding affinity is about 7. It's 100 times less potent than Remeron. But it has enough anti-cholinergic activity to be very drying.
Trimipramine has an histamine affinity of 370.
> Can anyone who's taken trimipramine say how they felt it compared with Benadryl as far as the anti-histamine effect goes: was it somewhat drying? Did you notice dry eyes at all? Gummy mouth?
>
> If so did that effect go away or not?
>
> Thanks -- Kate
Posted by katekite on July 20, 2002, at 17:58:04
In reply to trimipramine (anti-histamine vs. anti-cholenergic) » katekite, posted by fachad on July 20, 2002, at 17:07:44
Thanks fachad for clarifying. That sounds familiar. Some of my memory is currently inaccessible.
I must be particular sensitive to anti-cholinergic effects -- I will have to watch out for that in the future.
Thanks -- kate
Posted by katekite on July 20, 2002, at 18:08:35
In reply to Re: trimipramine, posted by may-b on July 20, 2002, at 16:51:53
Posted by Shawn. T. on July 20, 2002, at 23:50:46
In reply to trimipramine (anti-histamine vs. anti-cholenergic) » katekite, posted by fachad on July 20, 2002, at 17:07:44
Note that you'll lose the anti-histamine
side effects after a couple weeks. Your body develops a tolerance over the course of a couple weeks I believe. Note that these binding values are not in vivo.SSRI histamine (H1) binding values:
Prozac: 470
Zoloft: 53,000
Paxil: 66,000
Fluvox: 2,900
Celexa: 220SSRI acetylcholine binding values:
Prozac: 445
Zoloft: 5,800
Paxil: 720
Fluvox: 8,900
Celexa: 3,100http://www.erowid.org/chemicals/ssris/ssris_info1.shtml
Trimipramine is awful! Is it really worth the negative effects on learning to get to sleep when other sleep aids exist? I really can't present a more logical argument than what follows. I just don't understand why people don't care. An antidepressant should show cognitive benefits.
There is a "possible correlation between the reduction in LTP expression and learning deficits produced by chronic administration of trimipramine."http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8476377&dopt=Abstract
"Taken together the present data suggest that the loss of LTP maintenance in TRIM-treated animals is more likely the result of the disruption by trimipramine of cellular processes that follow LTP induction. In addition, the results provide evidence for a possible correlation between the reduction in LTP expression and learning deficits produced by chronic administration of trimipramine."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8476377&dopt=Abstract
"Whereas the binding characteristics of various agonist and antagonist ligands to the N-methyl-D-aspartate and the AMPA receptors were not modified by trimipramine treatment, there was a significant reduction in the increase in 3H-AMPA binding elicited by PLA2 treatment. Since activation of PLA2 has been reported to play a critical role in the formation of long-term potentiation, possibly mediated through a modification of the AMPA receptors, the results strengthen the hypothesis that PLA2-induced modification of 3H-AMPA binding is an important component of synaptic plasticity."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7912839&dopt=Abstract
Posted by fachad on July 21, 2002, at 9:57:32
In reply to Trimipramine=bad; SSRI receptor affinity values, posted by Shawn. T. on July 20, 2002, at 23:50:46
> Note that you'll lose the anti-histamine
> side effects after a couple weeks.That's not always true. My wife has been taking Elavil (amitriptyline) for over 8 years, and she still falls asleep hard and sleeps very soundly from it.
> Trimipramine is awful! Is it really worth the negative effects on learning to get to sleep when other sleep aids exist?
What other sleep aids do you think are a good idea?
What would you recommend to someone with chronic insomnia?
If your first choice is a proprietary med, what would you recommend as an alternate if their insurance does not cover brand meds and they cannot afford brand name meds? (That consideration would exclude both Remeron and Surmontil = trimipramine).
Would your second line sleep med be a benzo, or a TCA?
And if they could not tolerate you second line med, would you have another choice?
Don't forget that insominia has adverse effects on learning and memory if left untreated.
And regarding the effects on learning, I still think you are extrapolating unrealistically from those studies. The minute effects that can be measured in a laboratory do not usually translate into gross effects in human life in the real world.
Posted by katekite on July 21, 2002, at 19:11:00
In reply to Anti-Histamines, Questions about Sleep Meds » Shawn. T., posted by fachad on July 21, 2002, at 9:57:32
I'm just hoping that by the time I try all these meds for insomnia and reject them one by one for whatever side effect happens to get to me, that my system will be so screwed up that it will forget not to sleep well.
Posted by Shawn. T. on July 22, 2002, at 2:33:15
In reply to Anti-Histamines, Questions about Sleep Meds » Shawn. T., posted by fachad on July 21, 2002, at 9:57:32
> > Note that you'll lose the anti-histamine
> > side effects after a couple weeks.
>
> That's not always true. My wife has been >taking Elavil (amitriptyline) for over 8 years, >and she still falls asleep hard and sleeps very >soundly from it.You are right. I doubt it's possible to avoid the sedation from the histaminic actions of Remeron and Elavil. I really hate the thought of someone being on amitriptyline for any reason. It just has so many side effects; I can't name any other antidepressant that has more. I like the idea that it is a pharmacy in a pill.
http://www.preskorn.com/columns/9803.html
> > Trimipramine is awful! Is it really worth >the negative effects on learning to get to sleep >when other sleep aids exist?
>
> What other sleep aids do you think are a good >idea?
>Remeron
> What would you recommend to someone with >chronic insomnia?
>
> If your first choice is a proprietary med, what >would you recommend as an alternate if their >insurance does not cover brand meds and they >cannot afford brand name meds? (That >consideration would exclude both Remeron and >Surmontil = trimipramine).
>
> Would your second line sleep med be a benzo, or >a TCA?Neither. Ask your doctor about taking .5 to 1 mg of melatonin to help with insomnia.
http://www.gnc.com/health_notes/Concern/Insomnia.htm
http://www.gnc.com/health_notes/Supp/Melatonin.htm
> And if they could not tolerate you second line >med, would you have another choice?
I normally wouldn't suggest this to anyone, but you might talk to your doctor about trazadone (Desyrel). I'd say start at 25mg/day and don't go over 50mg/day. I've heard bad things about taking too much trazadone.http://www.fpnotebook.com/PSY169.htm
> Don't forget that insominia has adverse effects >on learning and memory if left untreated.
>True.
> And regarding the effects on learning, I still >think you are extrapolating unrealistically from >those studies. The minute effects that can be >measured in a laboratory do not usually >translate into gross effects in human life in >the real world.Trimipramine has moderate anticholinergic effects. That's not acceptable. Amitryptiline has rather strong anticholinergic effects. I should have mentioned that Benadryl is an unadvisable sleep aid because of its anticholinergic effects. Anticholinergic drugs have negative effects on learning in humans. You just can't dispute that. I disagree with your statement that I am extrapolating unrealistically from those studies. The prevention of the formation of long term potentiation in the hippocampus is not a "minute effect." Long term potentiation is perhaps the most important factor in the creation of memories. Your memories and experiences lead to the expression of your individuality. That's why this issue matters so much to me. The tricyclics are horrible drugs IMO. I'm always glad to try to convince someone that hasn't been convinced yet.
http://www.fpnotebook.com/NEU162.htm
http://www.fpnotebook.com/PSY173.htmShawn
Posted by fachad on July 22, 2002, at 21:23:39
In reply to Re: Anti-Histamines, Questions about Sleep Meds » fachad, posted by Shawn. T. on July 22, 2002, at 2:33:15
>I really hate the thought of someone being on Amitriptyline for any reason. It just has so many side effects; I can't name any other antidepressant that has more.
Yep, I think Elavil is the king of side effects. It is the only thing that works my wife, and she prefers the side effects to the IBS.
>...Ask your doctor about taking .5 to 1 mg of melatonin to help with insomnia.
Melatonin does not work for me at all. It makes me feel anxious.
> I normally wouldn't suggest this to anyone, but you might talk to your doctor about trazadone (Desyrel). I'd say start at 25mg/day and don't go over 50mg/day. I've heard bad things about taking too much trazadone.
Trazodone doesn’t' work for me either. I wake up after a few hours with a headache.
> Trimipramine has moderate anticholinergic effects. That's not acceptable.
"Not Acceptable" is a pretty strong statement. Very undesirable, yes, unpleasant also, but not unacceptable.
>Amitriptyline has rather strong anticholinergic effects.
Amitriptyline’s anticholinergic effects are not acceptable to me at this time for this indication. If I had something worse going on, and I was responding only to Amitriptyline, I'd reconsider at that point.
>I should have mentioned that Benadryl is an unadvisable sleep aid because of its anticholinergic effects.
They are pretty moderate compared to most TCAs.
>Anticholinergic drugs have negative effects on learning in humans. You just can't dispute that.
That statement is very general. I'm sure high doses of atropine would result in performance declines on human memory tests of random number recall.
But would those effects persist after the atropine wore off? How much would performance be impaired? Would subjects who were atropine naive be severely affected and subjects who were atropine experienced by mildly affected? Are the effects cumulative, as you are insinuating, or are they acute only? I think you can see what I mean about that being too general a statement to be meaningful.
>I disagree with your statement that I am extrapolating unrealistically from those studies.
What I am saying is that while those studies provide meaningful information, the kind of information they produce is not directly translatable to everyday human experience.
Neuroanatomy and neurochemistry have come along way, but they still have a long way to go. The nervous system has a remarkable ability to establish equilibrium against our best efforts to manipulate it. That's why people "lose response" to ADs. Their brain just says, "you give me more serotonin, fine, I'll give you less receptors. you sensitize my receptors, fine, I'll turn down the signal"...and on and on, for more levels than we have found.
>The prevention of the formation of long term potentiation in the hippocampus is not a "minute effect." Long term potentiation is perhaps the most important factor in the creation of memories. Your memories and experiences lead to the expression of your individuality. That's why this issue matters so much to me.
That's EXACTLY the type of extrapolating that I think is flawed. It goes way beyond the evidence. You are starting out with neuroanatomical microstructures, and are suddenly talking about personal identity and individuality. That's a very big leap.
>The tricyclics are horrible drugs IMO. I'm always glad to try to convince someone that hasn't been convinced yet.
Well, I'll agree with you there. But they do help people, and often the benefit they bring outweighs the harm they cause. In a way, I almost think it's a bit of a good thing, because they deter over usage of ADs. SSRI's look so harmless and easy to tolerate (at least on first glance, and compared to TCAs) that people think of them as "chicken soup" - can't hurt, might help. Well as you know, they can hurt, in more subtle ways than the immediate misery caused by TCAs.
Posted by 122296 on July 22, 2002, at 22:42:41
In reply to trimipramine, posted by katekite on July 20, 2002, at 12:23:53
Hi,
I read your message to Deli. I would like to know what is premature menopause? Who diagnosed it for you? I am 31, also. I am fatigue all the time and have occasional moodswings. I've never seen a psychiatrist, just the family doctor. Although, I have made an appointment to see one in the future. What are BC pills? It was 5 years ago that I mentioned my symptoms to the family doctor and she gave me zoloft. I take the minimum and have never increased my dosage. However, I'm not sure what is wrong with me. She never told me and I never asked. I guess I was ashamed. I just continued taking the medicine because it helped. Now I find that some of the symptoms are coming back and that is why I'm going to a psych. I thank you for sharing your info. with Deli. It might help me also.
Posted by katekite on July 23, 2002, at 9:21:03
In reply to Re: trimipramine, posted by 122296 on July 22, 2002, at 22:42:41
http://www.dr-bob.org/babble/20020709/msgs/112658.html
That link is to a message where I described things in more detail.
BC pill is 'birth control' pill.Before a woman goes through menopause itself she may have years (usually 3-5 years) of symptoms without having her periods change much. Fatigue, worsening of pre-existing psychological problems is common.
I think the best person to see just to ask about it would be a gynecologist. We should see one once a year anyhow.
Take care,
kate
Posted by Shawn. T. on July 23, 2002, at 19:27:51
In reply to Re: Anti-Histamines, Questions about Sleep Meds » Shawn. T., posted by fachad on July 22, 2002, at 21:23:39
OK what do you think of Valerian? I know it doesn't help me, but have you thought about trying that? I'll leave both of our comments alone unless you really want a reply; it's probably best to let people decide on their own what to believe in this situation.
Shawn
Posted by Shawn. T. on July 23, 2002, at 19:31:34
In reply to Re: trimipramine » 122296, posted by katekite on July 23, 2002, at 9:21:03
High levels of prolactin can result in a loss of periods aka amenorrhoea (why do I know this stuff?).
Shawn
This is the end of the thread.
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