Posted by SLS on February 17, 2009, at 14:19:07
In reply to Re: Tricyclic least likely to mess with the heart?, posted by Incubusfan on February 17, 2009, at 12:46:38
> > Maybe trimipramine.
> >
> >
> > - Scott
>
> How about desipramine? I've read the anti-cholinergic properties can contribute to the heart rate issues. Desipramine doesn't seem to have anti-cholinergic issues.Desipramine does have a mild muscarinic cholinergic receptor binding affinity. However, I don't know how important that is to the overall set of side effects.
Anticholinergic effects will certainly contribute to cardiac effects of drugs. However, the NE reuptake inhibition of desipramine is so potent, that most people notice an accelerated heart rate. Remember, there is a balance between sympathetic (NE) and parasympathetic (ACh) autonomic nervous systems. Too much NE or not enough ACh produce very similar symptoms: tachycardia, palpitations, dry mouth, sweating, mydriasis, blurred vision, urinary retention, etc. I found imipramine to be worse, which, of course, makes sense, as it does have the additional anticholinergic properties.
http://www.drugs.com/sfx/desipramine-side-effects.html
Personally, I have no fear of any of the tricyclics except for, perhaps, protriptyline. It is extremely anticholinergic along with NE reuptake inhibition.
> BTW, have you hit 300mg yet? Hope you're doing well.
Thanks for asking. No, I am still stuck at 250mg, and I continue to deteriorate. This was unexpected. I would have thought that being so close to my therapeutic dosage that I would have at least maintained some sort of plateau. Now, I can't help but to have some trepidation that even 300mg won't do it. I still think it's the right drug for me, though. I guess we will know better in 2 weeks.
Take care and be well.
- Scott
poster:SLS
thread:880691
URL: http://www.dr-bob.org/babble/20090213/msgs/880718.html