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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 25 to 49 of 49. Go back in thread:
Posted by Phillipa on July 25, 2005, at 18:22:54
In reply to Re: Can stopping a TCA cause palpitations? » med_empowered, posted by Phillipa on July 24, 2005, at 19:21:05
Ed, I knew it! I thought it had to be a TCA. Amiltriptaline was popular then. Was the other drug/ the European version? Fondly, PJ O
Posted by med_empowered on July 25, 2005, at 19:55:43
In reply to Re: Can stopping a TCA cause palpitations? » Phillipa, posted by Phillipa on July 25, 2005, at 18:22:54
It certainly is quite possible that it was Triavil, the perphenazine+Elavil combo ed_uk wrote about. The other "combo" antidepressant was Limbitrol, librium+Elavil. The Triavil "idea" was to calm people down with the antipsychotic while treating the depression...I think the aim was to make people placid and happy. It was also used for psychotic depression, schizophrenia, and "agitated depression," which is now usually understood to be a bipolar mixed-state. It is possible that you were given Dexamyl...amphetamines were still really popular in the 1970s, and barbiturates were still being used a good bit. I dont think Dexamyl was taken off the market until the very late 70s, maybe sometime into the 1980s, so thats a possibility.
Posted by Phillipa on July 25, 2005, at 21:47:03
In reply to hey Philiipa!, posted by med_empowered on July 25, 2005, at 19:55:43
Med, getting confused again! I always thought elavil sounded like an upper downer by it's name. So maybe TCA's are no no's for me? He finally gave me valium and meprobomate 450mg. He also was a believer of placidyl for sleep along with a good red, expensive wine. And he didn't have a problem with this when I was pregnant! I put myself into the hospital when my baby was sent to Yale University for failure to thrive and severe hyperactivity. I left the same day with dire threats by the nurses that I would develop seizures with abrupt withdrawal of meds. Well after thinking I was walking on a ship for two weeks, and lying on the couch all day. I allowed myself 5mg of valium and felt okay. The pdoc called and said I didn't need to see him anymore. I had an openended Rx for valium for years until one day they told me he had lost his license. I just don't have luck with picking good pdocs. Fondly, Phillipa
Posted by KaraS on July 25, 2005, at 23:42:20
In reply to Re: hey Philiipa! » med_empowered, posted by Phillipa on July 25, 2005, at 21:47:03
> Med, getting confused again! I always thought elavil sounded like an upper downer by it's name. So maybe TCA's are no no's for me? He finally gave me valium and meprobomate 450mg. He also was a believer of placidyl for sleep along with a good red, expensive wine. And he didn't have a problem with this when I was pregnant! I put myself into the hospital when my baby was sent to Yale University for failure to thrive and severe hyperactivity. I left the same day with dire threats by the nurses that I would develop seizures with abrupt withdrawal of meds. Well after thinking I was walking on a ship for two weeks, and lying on the couch all day. I allowed myself 5mg of valium and felt okay. The pdoc called and said I didn't need to see him anymore. I had an openended Rx for valium for years until one day they told me he had lost his license. I just don't have luck with picking good pdocs. Fondly, Phillipa
Phillipa,It's hard to imagine Elavil (amitriptyline) causing anxiety. It's one of them most sedating drugs ever. My guess is that the offending agent was the other medication, perphenazine. Some of the other TCAs might cause some anxiety but amitriptyline and doxepin work incredibly well to prevent anxiety.
K
Posted by KaraS on July 26, 2005, at 1:33:58
In reply to Re: Can stopping a TCA cause palpitations? » KaraS, posted by ed_uk on July 25, 2005, at 16:29:43
Hi Ed!
>>My mood also goes up as dose increases which is something to take into account.......
>What's the highest dose you've tried? How did it affect you?
It was over 20 years ago so I don't remember all that well. I think the highest dose I took was 75 mg. It got me back on my feet and functioning again. I had the usual TCA side effects but nothing I couldn't manage at the time. I have no doubt that if I increased up to 75 mg. or more of the doxepin now that my mood wood lift. It might not be very good for my ADD ... but if it isn't that anticholinergic (as you say below), then maybe it wouldn't be that bad. It does seem like it slows me down a bit physically and mentally though.
>>The other TCAs that aren't as anticholinergic, give me tachycardia.
>Anticholinergic drugs *cause* tachycardia. The reason low-dose doxepin doesn't cause much tachycardia is because it's only a 'weak' norepinephrine reuptake inhibitor. It's also quite sedating.
Oh, ok. I think I've been told that but forgot it (maybe because I think of anticholinergics in terms of slowing me down mentally?). I probably have this wrong but I thought that desipramine wasn't supposed to be very anticholinergic... yet it's most likely of all of the TCAs to cause tachycardia?
>Btw, trimipramine (Surmontil) is a strange TCA which doesn't inhibit the reuptake of anything! Larry Hoover takes it.
Well if Larry Hoover takes it, then it must be good! :-) Actually I've been curious about that one. It behaves more like an AP doesn't it?
>>Also I think he feels that I could benefit from the mood stabilization effects of the Klonopin.
>What does he mean by 'mood stabilization'? If it helped your depression that would be fantastic! Very high doses of clonazepam can be useful as an adjunct to other meds in the treatment of acute mania. I wouldn't really call clonazepam a mood stabiliser though.
I can't say for sure but I think he's thinking that it might help my depression because of it's mild mood stabilization properties. I think he talked about it more in those terms rather than actually calling it a mood stabilizer.
>Does your doc believe that Dex will improve your depression or just your ADD?
He definitely believes that it can help with both the depression and the ADD. He doesn't think I need any serotonin - just NE or DA. I am inclined to agree with him somewhat because of my experience on the SSRIs. Yet, how would he explain that doxepin lifts my mood as well as Effexor at only 75-150 mg. (with minimal NE in that range)? I'll have to ask him about that.
>Am I right in thinking that he suggested Lamictal as an AD?
Yes, Lamictal was also one of the things he thought would be good for me. I think he might want to add it in to the mix if necessary once I'm established on the K and the Dex. Actually he mentioned Lamictal or Topomax. He didn't mention Trileptal though - not sure if that was an oversight or intentional. I will ask him about that later.
>>My pulse rate shoots up very quickly and stays there a while at the slightest provocation - either from something emotional or from medications so I think the combination may be more dangerous for me than for most.
>Perhaps........ but isn't your pulse actually quite low on doxepin?
It is usually in the 70's. It can easily go up into the 80s though. With just a little bit of stress it goes up to the upper 80's and stays there a long time. BTW, I know that Dex can cause increased blood pressure. Does it (and other meds) do this directly or do they do it by increasing the pulse rate?
>>I read in the archives about a couple of people who said that the apathy/depression set in on the K for them around the 4 week mark.
>Perhaps they increased the dose over the first few weeks?
That's a good point but there's a good chance I would be increasing the dose along the way as well, no?
>>If that were to happen to me, then I'd already be on it long enough to have a sustained tapering, don't you think?
>If you'd been on clonazepam for 4 weeks, I expect you'd need to taper over a few weeks or so. It might be quite unpleasant but I expect you'd make it!
The tapering of the Ativan wasn't that bad because of the doxepin and because I did it very slowly. In this case it would also mean losing many weeks of time in getting well that I wouldn't have needed to experience.
>>I took Ativan for three weeks at night to sleep many years ago. Then I stopped it abruptly and all hell broke loose.
>Clonazepam's withdrawal symptoms are almost identical to those of Ativan. They should be somewhat less intense though, due to clonazepam's longer half-life.
Good to know that it's at least a little less intense so I could probably go a little faster than I did with the Ativan. OTOH, I was only on a very small amount of Ativan to begin with.
>>Fortunately then I was able to start on doxepin and taper off of the Ativan very slowly.
>Doxepin could help you get off clonazepam too.
Yes, if I'm not on Dex. Maybe it makes sense to stay on the Klonopin for a good 4 weeks at required dosage before deciding whether to keep it and before even attempting to start on the Dex. That way I won't have the possibility of having to go off of two of them at or around the same time which could cumulatively have a really horrible effect on me. I'd also be certain I could use doxepin to rid me of the K. Does that make sense to you or am I being much too cautious and wasting time that could get me feeling better sooner?
>>I may not be able to take doxepin in order to stop the K (because of the dex), then how would I cope with the anxiety?????
You could always try Surmontil. It's anxiolytic like doxepin but it's not at all noradrenergic.
That's a really good idea! Does it not have the electrical conduction issues the other TCAs have? Would the DA antagonism be a problem at all? Does it have the risks of akathisia? I'm quite certain it has a very small risk of TD. In fact, it might be a good substitute for the Klonopin to begin with - although maybe the DA antagonism would be counterproductive?
Thanks again, Ed. Anyone ever tell you you're a peach? :-)
Kara
xxx
Posted by MidnightBlue on July 26, 2005, at 11:33:46
In reply to Re: hey Philiipa! » Phillipa, posted by KaraS on July 25, 2005, at 23:42:20
I was very anxious on elavil. It made me feel jumpy and I had terrible pins and needle feelings in my arms and legs. I was trying to take it for migraine headaches. The doc put me on Triavil which I took for a while, but I didn't feel so good on it and it did NOT help my headaches. That was many years ago........
MB
Posted by ed_uk on July 26, 2005, at 13:35:50
In reply to Re: hey Philiipa! » med_empowered, posted by Phillipa on July 25, 2005, at 21:47:03
Hi!
I don't think it was amitriptyline. Amitriptyline doesn't usually cause anxiety. In fact, it often reduces anxiety.
I expect you were given a combination pill containing amitriptyline *and* perphenazine. Perphenazine can cause severe restlessness. What was the nature of your reaction to the 'upper downer'?
>So maybe TCA's are no no's for me?
No, I don't think so.
>Dexamyl
I doubt it was Dexamyl. Dexamyl contains a barbiturate and an amphetamine. The barbiturate is generally quite sedating. The amphetamine is a stimulant and appetite suppressant. I know you've taken 'diet pills' in the past and not reacted badly. 'Diet pills' are stimulants.
~ed
Posted by ed_uk on July 26, 2005, at 14:08:33
In reply to Re: Can stopping a TCA cause palpitations? » ed_uk, posted by KaraS on July 26, 2005, at 1:33:58
Hi K!
>It might not be very good for my ADD ... but if it isn't that anticholinergic (as you say below), then maybe it wouldn't be that bad.
Doxepin actually is quite anticholinergic. I was just saying that it's unlikely to cause as much tachycardia as nortriptyline because it's only a 'weak' NE reuptake inhibitor.
>I probably have this wrong but I thought that desipramine wasn't supposed to be very anticholinergic... yet it's most likely of all of the TCAs to cause tachycardia?
Norepinephrine reuptake inhibition is probably the major cause of TCA-induced tachycardia. Although desipramine is only weakly anticholinergic, it's a very potent NE reuptake inhibitor.
>It behaves more like an AP doesn't it?
It's a very 'weak' dopamine antagonist. 'Weaker' than any of the antipsychotics AFAIK.
>I can't say for sure but I think he's thinking that it might help my depression because of it's mild mood stabilization properties.
Japanese psychiatrists believe that clonazepam can be used to augment an antidepressant. I'm not convinced though. IMO, it's just an anxiolytic.
>Yet, how would he explain that doxepin lifts my mood as well as Effexor at only 75-150 mg. (with minimal NE in that range)?
Perhaps a little bit of NE reuptake inhibition is all you need to lift you depression? Desipramine or nortriptyline might be helpful at a very low dose. I guess you could take doxepin 20mg + a little bit of desipramine.
>Actually he mentioned Lamictal or Topomax.
I'd be inclined to try Lamictal first - due to it's known antidepressant properties.
>It is usually in the 70's.
Normal :-)
>It can easily go up into the 80s though.
Still normal :-)
>BTW, I know that Dex can cause increased blood pressure. Does it (and other meds) do this directly or do they do it by increasing the pulse rate?
It's partly because it's a vasoconstrictor. When the blood vessels are narrower (due to muscle contraction of the blood vessel wall) the pressure increases.
>That's a good point but there's a good chance I would be increasing the dose along the way as well, no?
You could increase the dose every 7 days or so - just a suggestion.
>Does that make sense to you or am I being much too cautious and wasting time that could get me feeling better sooner?
Well....... you definitely need to start clonazepam and doxepin several weeks apart. You need to be able to fully evaluate the effect of each medication. If you start them at the same time you won't know what's doing what! Too confusing :-S
>Does it not have the electrical conduction issues the other TCAs have?
Same as doxepin.
>Would the DA antagonism be a problem at all?
I think it's very unlikely. I expect you'd be taking a very low dose.
>Does it have the risks of akathisia?
Perhaps a very low risk.....
>In fact, it might be a good substitute for the Klonopin to begin with - although maybe the DA antagonism would be counterproductive?
To help you withdraw from clonazepam while still taking Dex?
Ed xx
Posted by Phillipa on July 26, 2005, at 14:29:14
In reply to Re: hey Philiipa! » Phillipa, posted by ed_uk on July 26, 2005, at 13:35:50
Ed, When I was 22 I took something OBGYN said would help me lose wt,so I guess they were diet pills. Now I know they were stimulants but at the time I didn't. I also didn't have a problem with anxiety. That came about 2 years later so I guess I was 24. But the diet pills I only took every other day and couldn't sit still. At the end of 30day rx I was starting to have trouble sleeping. Never a problem then. The other med that was an upper-downer I only took once the side effects were so horrible. I don't remember all of it it was so long ago. I've just always wanted to know what that pill was. See the valium and mephrobomate did the trick at the time. And I've lived a life so full of stress that I don't think the average person could take it. So now after all these years i wonder why I don't react to meds. I just live in fear. Fondly, PJ O
Posted by KaraS on July 26, 2005, at 15:25:34
In reply to Re: hey Philiipa! » KaraS, posted by MidnightBlue on July 26, 2005, at 11:33:46
> I was very anxious on elavil. It made me feel jumpy and I had terrible pins and needle feelings in my arms and legs. I was trying to take it for migraine headaches. The doc put me on Triavil which I took for a while, but I didn't feel so good on it and it did NOT help my headaches. That was many years ago........
>
> MB
No kidding! You're the first person I've ever heard of who was anxious on Elavil. I guess we can just never know how we're going to react!K
Posted by ed_uk on July 28, 2005, at 17:30:20
In reply to Re: Elavil » MidnightBlue, posted by KaraS on July 26, 2005, at 15:25:34
Hi K!
Did you see my post to you above?
Ed xxx
Posted by KaraS on July 28, 2005, at 22:27:46
In reply to Re: Elavil » KaraS, posted by ed_uk on July 28, 2005, at 17:30:20
> Hi K!
>
> Did you see my post to you above?
>
> Ed xxx
You mean the one where you called me a peach?k
Posted by KaraS on July 28, 2005, at 23:55:47
In reply to Re: Can stopping a TCA cause palpitations? » KaraS, posted by ed_uk on July 26, 2005, at 14:08:33
> Hi Ed!
I did read this one but I forgot to respond. Sorry.
> >It might not be very good for my ADD ... but if it isn't that anticholinergic (as you say below), then maybe it wouldn't be that bad.
>
> Doxepin actually is quite anticholinergic. I was just saying that it's unlikely to cause as much tachycardia as nortriptyline because it's only a 'weak' NE reuptake inhibitor.
Ok. I understand.
> >I probably have this wrong but I thought that desipramine wasn't supposed to be very anticholinergic... yet it's most likely of all of the TCAs to cause tachycardia?
>
> Norepinephrine reuptake inhibition is probably the major cause of TCA-induced tachycardia. Although desipramine is only weakly anticholinergic, it's a very potent NE reuptake inhibitor.
Yes, I thought the NE reuptake was responsible for the tachycardia. I got confused above when I thought you were saying that the anticholinergic effects were causing the tachycardia.
> >It behaves more like an AP doesn't it?
>
> It's a very 'weak' dopamine antagonist. 'Weaker' than any of the antipsychotics AFAIK.
I wonder if it would be an ok med to take for someone who is very low dopamine to begin with.
Maybe it's too weak to make any kind of a difference. OTOH, if it's that weak why would it be used as an AP?
> >I can't say for sure but I think he's thinking that it might help my depression because of it's mild mood stabilization properties.
>
> Japanese psychiatrists believe that clonazepam can be used to augment an antidepressant. I'm not convinced though. IMO, it's just an anxiolytic.
Besides, fish oil has mild mood stabilizing properties too. I could take that instead.
> >Yet, how would he explain that doxepin lifts my mood as well as Effexor at only 75-150 mg. (with minimal NE in that range)?
>
> Perhaps a little bit of NE reuptake inhibition is all you need to lift you depression? Desipramine or nortriptyline might be helpful at a very low dose. I guess you could take doxepin 20mg + a little bit of desipramine.
I was on that combo many years ago. It wasn't enough unfortunately. The scary part was that when I took that first desipramine pill, my heart felt like it was going to leap out of my chest. I thought for sure I was having a heart attack. The following days when I would take the desipramine I didn't have that happen. I still had tachycardia but not that initial horrible feeling. Isn't that weird?
> >Actually he mentioned Lamictal or Topomax.
>
> I'd be inclined to try Lamictal first - due to it's known antidepressant properties.
I'll have to see if he just mentioned those two as an example of meds that could provide mood stabilization or if he only meant those two. I'd prefer to try lithium orotate or even small amounts of lithium carbonate. Lamictal and trileptal are so expensive here if you don't have health insurance plus if I did get SJ, then I'd probably need to be hospitalized. That would end up putting me in so much debt. I'd never be able to recover from it.
> >It is usually in the 70's.
>
> Normal :-)
Yes
> >It can easily go up into the 80s though.
>
> Still normal :-)
High side of normal perhaps. Dr. E. wanted to put me on a beta blocker because he thought that was my normal rate. He claims he has had success using them to stop some people's anxiety and that is has stopped their depression as well.
> >BTW, I know that Dex can cause increased blood pressure. Does it (and other meds) do this directly or do they do it by increasing the pulse rate?
>
> It's partly because it's a vasoconstrictor. When the blood vessels are narrower (due to muscle contraction of the blood vessel wall) the pressure increases.
Makes sense. Thanks. Beta blockers are vasoconstrictors too, right?
> You could increase the dose every 7 days or so - just a suggestion.
Right now I've only taken that one quarter of a .5 mg. pill of Klonopin one time. It grogged me out for 3-4 days. I'm only now starting to feel not drugged. I did take it with 6 mg. of doxepin though, but still. I'll try it again tonight without the doxepin. I've taken Valium, Xanax and Ativan before without a problem. I expected that this might make me a little bit groggy, but not this much. It's tough because I live alone and there's no one to take care of me. I have to do my own grocery shopping and drive myself to take care of other things. I can't be grogged out for weeks while I build up on this stuff.
> >Does that make sense to you or am I being much too cautious and wasting time that could get me feeling better sooner?
>
> Well....... you definitely need to start clonazepam and doxepin several weeks apart. You need to be able to fully evaluate the effect of each medication. If you start them at the same time you won't know what's doing what! Too confusing :-S
Agreed. (I'm assuming you meant Dex instead of doxepin above.)
> >Does it not have the electrical conduction issues the other TCAs have?
>
> Same as doxepin.
Then the point of switching to trimipramine would be because of less NE reuptake?
> >Does it have the risks of akathisia?
>
> Perhaps a very low risk.....
>
> >In fact, it might be a good substitute for the Klonopin to begin with - although maybe the DA antagonism would be counterproductive?
>
> To help you withdraw from clonazepam while still taking Dex?
So you're saying that it's not a good substitute for the Klonopin now but rather just something to keep in mind if I'm on the Dex and wanting to withdraw from the Klonopin?
Kara
xxx
Posted by ed_uk on July 29, 2005, at 15:01:19
In reply to Re: Ed, you must have been referring to this post. » ed_uk, posted by KaraS on July 28, 2005, at 23:55:47
Hi K!
>OTOH, if it's that weak why would it be used as an AP?
Trimipramine's activity as an AP has been disputed - it's a bit dubious. I don't think you'll need to take trimipramine though, doxepin is ok!
>Beta blockers are vasoconstrictors too, right?
Cardioselective beta blockers only weakly constrict peripheral arterioles. They occasionally cause cold hands. I have a friend who take atenolol + Ritalin with no problems.
>I expected that this might make me a little bit groggy, but not this much.
If you really do want to take a benzo, perhaps you could take Valium or Librium instead. I'm still not convinced that you need a benzo though! Doxepin is dealing with your anxiety :-)
>Then the point of switching to trimipramine would be because of less NE reuptake?
Yes, although I doubt it would be necessary. I expect you'd be ok combining doxepin with dex... you'd have to start with a very low dose of dex though and increase the dose gradually with careful monitoring of BP and pulse.
Ed xx
Posted by KaraS on July 29, 2005, at 16:02:14
In reply to Re: Ed, you must have been referring to this post. » KaraS, posted by ed_uk on July 29, 2005, at 15:01:19
> Hi Ed!
>
> If you really do want to take a benzo, perhaps you could take Valium or Librium instead. I'm still not convinced that you need a benzo though! Doxepin is dealing with your anxiety :-)
>
> >Then the point of switching to trimipramine would be because of less NE reuptake?
>
> Yes, although I doubt it would be necessary. I expect you'd be ok combining doxepin with dex... you'd have to start with a very low dose of dex though and increase the dose gradually with careful monitoring of BP and pulse.
I think I'll get a blood pressure monitor soon and test out a very samll amount of Dex while I'm on 12.5 mg. of doxepin and see what happens.Thanks, Ed.
K
xxx
Posted by ed_uk on July 30, 2005, at 3:05:19
In reply to Re: Ed, you must have been referring to this post. » ed_uk, posted by KaraS on July 29, 2005, at 16:02:14
Hi K,
You could start by taking 1/4 of a 5mg tablet as a test dose. Next you could take 1/2 a tab..... then a full tab and go from there. Dex frequently increases BP, hopefully not too much. What is your current BP?
Doxepin sometimes reduces BP. Does it reduce your BP?
~Ed x
Posted by KaraS on July 30, 2005, at 14:26:03
In reply to Re: Ed, you must have been referring to this post. » KaraS, posted by ed_uk on July 30, 2005, at 3:05:19
> Hi K,
>
> You could start by taking 1/4 of a 5mg tablet as a test dose. Next you could take 1/2 a tab..... then a full tab and go from there. Dex frequently increases BP, hopefully not too much. What is your current BP?
>
> Doxepin sometimes reduces BP. Does it reduce your BP?
>
> ~Ed xHi Ed,
The Dex I have is sustained release spansules which is great because I can open up the capsule and take very small amounts to begin with.
So if doxepin also reduces bp, then why is it contraindicated with Dex? Does it have something to do with it's electrical conduction effects?
I'm not sure what my bp is because it has changed so much every time I've been at the clinic in the last 6 months. One time the systolic pressure was 90. The last time I went the systolic pressure was in the upper 120s according to the automatic tester. I was concerned about that reading as it has never been that high so less than 5 minutes later the doctor took it manually and it was 110. Basically, I haven't had much of a problem with bp yet but my father died of a heart attack at age 45 so I'm very concerned about anything that effects the heart.
k
xx
Posted by ed_uk on July 30, 2005, at 15:25:48
In reply to Re: Ed, you must have been referring to this post. » ed_uk, posted by KaraS on July 30, 2005, at 14:26:03
Hi K,
>So if doxepin also reduces bp, then why is it contraindicated with Dex?
I've never read that it was contra-indicated, just that one should be cautious. Although TCAs can reduce BP, they can also increase BP!
>I was concerned about that reading as it has never been that high so less than 5 minutes later the doctor took it manually and it was 110.
Manual measurements are supposedly more accurate. Once you get a BP monitor you can measure it regularly.
~Ed x
Posted by KaraS on July 30, 2005, at 15:58:15
In reply to Re: Ed, you must have been referring to this post. » KaraS, posted by ed_uk on July 30, 2005, at 15:25:48
> Hi K,
>
> >So if doxepin also reduces bp, then why is it contraindicated with Dex?
>
> I've never read that it was contra-indicated, just that one should be cautious. Although TCAs can reduce BP, they can also increase BP!So maybe that caution is really more directed more towards TCAs like desipramine?
>
> >I was concerned about that reading as it has never been that high so less than 5 minutes later the doctor took it manually and it was 110.
>
> Manual measurements are supposedly more accurate. Once you get a BP monitor you can measure it regularly.I was thinking of getting an automatic one. The manuals are much harder to manage when using them on yourself. But maybe I should go for the manual if it's more accurate? I was going to read about them in Consumer Reports first anyway so maybe that will help me make up my mind.
k
xx
Posted by ed_uk on July 30, 2005, at 16:51:14
In reply to Re: Ed, you must have been referring to this post. » ed_uk, posted by KaraS on July 30, 2005, at 15:58:15
Hi K,
>So maybe that caution is really more directed more towards TCAs like desipramine?
I agree. I think it's probably more relevant to the potent NE reuptake inhibitors.
>But maybe I should go for the manual if it's more accurate?
Ixus uses one - he takes Parnate.
Ed xxx
Posted by Phillipa on July 30, 2005, at 17:24:03
In reply to Re: Ed, you must have been referring to this post. » KaraS, posted by ed_uk on July 30, 2005, at 16:51:14
Kara, a manual one isn't hard to take. Just have someone wrap it around your arm. Then get a stethoscope and place flat circular end to your inner arm. Blow up the cuff nice and tight. Not over your clothes. Then put other end in your ears. Slowly let the air out of the cuff while listening. The first sound you hear is your systolic and the point where you stop hearing anything is your diastolic. Diastolic is the most important number. Fondly, Phillipa
Posted by KaraS on July 31, 2005, at 2:08:32
In reply to Re: Ed, you must have been referring to this post. » KaraS, posted by ed_uk on July 30, 2005, at 16:51:14
Posted by KaraS on July 31, 2005, at 2:10:17
In reply to Re: Ed, you must have been referring to this post., posted by Phillipa on July 30, 2005, at 17:24:03
> Kara, a manual one isn't hard to take. Just have someone wrap it around your arm. Then get a stethoscope and place flat circular end to your inner arm. Blow up the cuff nice and tight. Not over your clothes. Then put other end in your ears. Slowly let the air out of the cuff while listening. The first sound you hear is your systolic and the point where you stop hearing anything is your diastolic. Diastolic is the most important number. Fondly, Phillipa
Hi Phillipa,The problem is that I live alone so I don't have anyone to help me wrap it around my arm.
k
Posted by Phillipa on July 31, 2005, at 18:13:00
In reply to Re: Ed, you must have been referring to this post. » Phillipa, posted by KaraS on July 31, 2005, at 2:10:17
Kara, if you try real hard you can do it yourself. i used to do this all the time when I was working. Fondly, Phillipa
Posted by KaraS on July 31, 2005, at 22:50:43
In reply to Re: Ed, you must have been referring to this post. » KaraS, posted by Phillipa on July 31, 2005, at 18:13:00
This is the end of the thread.
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