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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by 4WD on May 10, 2005, at 17:50:00
I'm taking nortriptyline in the hope it will help with my anxiety (ssri's/ don't, snri's quit). I've only been on it a week and I"m still having bad anxiety. I don't want to take a benzo (I have issues) if I can help it. My pdoc has now prescribed Inderal (10 mg t.i.d.) to try and help with the anxiety.
Here's my question. I read that Inderal blocks norepinephrine receptors in the brain. So won't the Inderal and the nortriptyline be at odds with each other? Won't the Inderal cancel out whatever NE action the nortriptyline is trying to effect?
Is my pdoc totally unaware????
Marsha
Posted by linkadge on May 10, 2005, at 18:31:18
In reply to Urgent question: Inderal cancels nortriptyline?, posted by 4WD on May 10, 2005, at 17:50:00
Not necessarily. The inderal will only block one subtype of norepinephrine receptor. There will still be other receptors that receive serotonin.
I am not sure about the net effect, but it will not completely block the effects of the antidepressant.
The inderal should block cardiovascular effects of norepinephrine.
Linkadge
Posted by Phillipa on May 10, 2005, at 18:44:25
In reply to Re: Urgent question: Inderal cancels nortriptyline?, posted by linkadge on May 10, 2005, at 18:31:18
Link, What about l0mg of paxil and 25mg of lopressor? Fondly, Phillipa
Posted by tygereyes on May 10, 2005, at 19:28:09
In reply to Re: Urgent question: Inderal cancels nortriptyline? » linkadge, posted by Phillipa on May 10, 2005, at 18:44:25
Be careful - Propanolol has been known to cause depression. There are only TWO beta blockers that do NOT cross the blood brain barrier and therefore do not cause depression - Atenolol is one of them, can't remember the other.
Posted by linkadge on May 10, 2005, at 20:17:51
In reply to Re: Urgent question: Inderal cancels nortriptyline?, posted by tygereyes on May 10, 2005, at 19:28:09
Not everybody has depression as a side effect from beta blocker use. I think the incidence of it is less than assumed. It is someting to watch out for, but I do believe that there will stil be a net effect.
I took effexor and a beta blocker, and noticed that it was still much different than a SSRI.
Linkadge
Posted by 4WD on May 11, 2005, at 10:47:55
In reply to Re: Urgent question: Inderal cancels nortriptyline?, posted by linkadge on May 10, 2005, at 20:17:51
I just don't understand why the pdoc would prescribe a drug that he surely must know would cancel out the effect of my AD to some degree. I mean, the reason I'm taking nortriptyline specifically is because of the anxiety. And since I'm just starting it, I can't afford to diminish its efficacy.
Is there any reason Inderal in particular would be better for anxiety than another beta blocker? I want to call and ask this stuff but he doesn't take phone calls.
I don't even know if this is that big a deal. When you're this anxious, everything feels like the end of the world and of major significance?
Marsha
Posted by tygereyes on May 11, 2005, at 19:33:04
In reply to Is this really that major? Too scared to think., posted by 4WD on May 11, 2005, at 10:47:55
Call your doctor and ask.
All I know is that my cardiologist refuses to prescribe Propanolol & other beta blockers to individuals with known psychiatric histories because (as he says) he has seen SO many cases of worsening or returning depression due to this med. He instead prescribes 2 other beta blockeres that do NOT cross the blood brain barrier, of which Atenolol is one.
Posted by 4WD on May 11, 2005, at 22:06:08
In reply to Re: Is this really that major? Too scared to think., posted by tygereyes on May 11, 2005, at 19:33:04
> Call your doctor and ask.
>
> All I know is that my cardiologist refuses to prescribe Propanolol & other beta blockers to individuals with known psychiatric histories because (as he says) he has seen SO many cases of worsening or returning depression due to this med. He instead prescribes 2 other beta blockeres that do NOT cross the blood brain barrier, of which Atenolol is one.
Ha! My doctor does not accept phone calls or messages. I went in person today to ask,(35 miles) was told I could ask at an appointment and the earliest available was May 24. Whereupon my anxiety peaked, I had a major meltdown in his reception area, and was told "the doctor knows all about medicines and we're sure it must be fine." I guess next step is look for a new doctor. I don't know if I can face it.Marsha
Posted by ed_uk on May 12, 2005, at 5:46:16
In reply to Re: Is this really that major? Too scared to think., posted by tygereyes on May 11, 2005, at 19:33:04
>He instead prescribes 2 other beta blockeres that do NOT cross the blood brain barrier, of which Atenolol is one.
There's also nadolol (Corgard).
Ed.
Posted by Bill LL on May 12, 2005, at 11:05:15
In reply to Urgent question: Inderal cancels nortriptyline?, posted by 4WD on May 10, 2005, at 17:50:00
I think that your doctor made a good choice. Inderal is very effective at reducing the physicial symptoms of anxiety. The 2 drugs will probably not cancel each other out to any real extent. Although they both affect norepinephrine, they do so in different ways in different organs of the body.
I would definitely try Inderal at this point in time for your situation.
> I'm taking nortriptyline in the hope it will help with my anxiety (ssri's/ don't, snri's quit). I've only been on it a week and I"m still having bad anxiety. I don't want to take a benzo (I have issues) if I can help it. My pdoc has now prescribed Inderal (10 mg t.i.d.) to try and help with the anxiety.
>
> Here's my question. I read that Inderal blocks norepinephrine receptors in the brain. So won't the Inderal and the nortriptyline be at odds with each other? Won't the Inderal cancel out whatever NE action the nortriptyline is trying to effect?
>
> Is my pdoc totally unaware????
>
> Marsha
Posted by tygereyes on May 12, 2005, at 22:22:45
In reply to Re: Is this really that major? Too scared to think., posted by 4WD on May 11, 2005, at 22:06:08
Sounds like it's time for a new doctor!
You can always try taking the Inderal, and if you notice worsening depression, discontinue it and try to find another beta blocker ... just an idea, as it does not affect ALL people in this way.
> > Call your doctor and ask.
> >
> > All I know is that my cardiologist refuses to prescribe Propanolol & other beta blockers to individuals with known psychiatric histories because (as he says) he has seen SO many cases of worsening or returning depression due to this med. He instead prescribes 2 other beta blockeres that do NOT cross the blood brain barrier, of which Atenolol is one.
>
>
> Ha! My doctor does not accept phone calls or messages. I went in person today to ask,(35 miles) was told I could ask at an appointment and the earliest available was May 24. Whereupon my anxiety peaked, I had a major meltdown in his reception area, and was told "the doctor knows all about medicines and we're sure it must be fine." I guess next step is look for a new doctor. I don't know if I can face it.
>
> Marsha
>
This is the end of the thread.
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