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Tricyclic antidepressants

Discussion in 'Physical & Sexual Health' started by Pseudojim, Oct 31, 2012.

  1. Pseudojim

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    Hi All

    So, i have a friend who has been on a tricyclic antidepressant for quite some time. She has been through a lot of shit the last year or so. Despite being on this drug (i don't know which one it is), she can get extremely down from time to time, out of the blue. A lot of the time she feels fine. But some days for no apparent reason she will feel so down in the dumps that nothing can cheer her up. I have comforted her a few times when this mood has hit. Could this be a side effect of the tricyclics? I have known her for a long time, she was a bubbly, happy-go-lucky person who never had a bad mood in her youth. She laments how "wussy" she has become (her word not mine).
     
  2. cult logic

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    Be careful when it comes to tricyclics they are very dangerous if you od on them. I'm curious as to why they were prescribed in the first place.
     
  3. Pseudojim

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    Yes i was too. Apparently she had adverse reactions to all other medications her psychiatrist prescribed to her, and so tricyclics were somewhat of a last resort.
     
  4. J Snow

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    You say she was a bubbly, happy-go-lucky person, but she must have been suffering from depression to get on the drugs in the first place wasn't she? It doesn't sound like the tricyclics are helping though. SSRI's are more commonly prescribed today because they have fewer side effects, but its possible she didn't respond well to them or couldn't take them for other reasons. Either way, the standard method is for a doctor to prescribe an antidepressant for 4-6 weeks, and if there isn't a beneficial effects by that time, then they move on to a different drug.

    If she isn't being helped by the tricyclics then it might be a good idea for her to talk to her doctor about trying an MAO or SSRI antidepressant. Or if her doctor isn't keen to that idea she could always get a second opinion.
    Also, I'm curious as to how long your definition of quite some time is, because antidepressants often take up to eight weeks to have a positive effect.
     
  5. Pseudojim

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    You say she was a bubbly, happy-go-lucky person, but yes, she has had the year from hell. More than a year, about 18 months now. Unfortunate things have happened in her life that i won't go into, but which have made her depressed for a long time.

    She didn't respond well to the first, second, third, fourth, fifth.... etc etc drugs that her doctor initially prescribed. The tricyclic was well down on the list of resorts and it apparently was better indicated, but i wonder if it is actually having adverse effects.

    She has been on the tricyclic for at least several months, probably more like a year and a half, i am not entirely certain.
     
  6. J Snow

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    Well, this really sounds more like a decision that should be made between your friend and her doctor, but here is a list of potential side effects of tricyclic antidepressants since you are intersted.


    Drowsiness
    Dry mouth
    Blurred vision
    Constipation
    Urinary retention
    Dizziness
    Delayed orgasm and low sex drive, particularly in men
    Increased heart rate
    Disorientation or confusion
    Low blood pressure, which can cause lightheadedness
    Increased appetite
    Weight gain
    Fatigue
    Headache
    Sensitivity to sunlight
    Nausea
    Seizures (particularly with maprotiline)
     
  7. Chip

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    I think a bunch of those also apply to SSRIs :slight_smile:
     
  8. J Snow

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    This is true, but my understanding from my psych classes that I have always been given is that SSRI's tend to "less" side effects compared to tricyclic and MAO antidepressants, and that's why they are usually tried out first. They all are going to have some side effects though.
     
  9. KaraBulut

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    There's a difference between a situational depression from having a shitty year to a chronic depression that requires medication.

    It sounds like your friend may have both going on.

    The thing for her to do is to talk to the physician who prescribed the tricyclic and to let him/her know that she's having these periods of feeling down and what has happened in her life that has made her feel down. Together they can decide whether she might want to try a different med or whether more traditional psychotherapy might work for her.

    You know- something that we forget is that depression and highs/lows are normal in response to major stress - like losing a loved one, the end of a relationship or employment change. It seems like our first response is to medicate away normal emotions. Lots of animals besides humans grieve- it is a natural and healthy response.

    What makes this a unique situation for friend is that she has a history of depression that she's been prescribed a long-term medication for. Even in someone who is being successfully treated for chronic depression, a life-changing event can put them into another depression. It takes a discussion with their physician to determine whether it's just a normal response to a bad situation or whether it's really something that needs to be aggressively treated.
     
    #9 KaraBulut, Oct 31, 2012
    Last edited: Oct 31, 2012
  10. alwayshope11

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    It may be a side affect of them, but like everyone else said..she needs to talk to her doc and/or therapist to help
     
  11. Pseudojim

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    Yes, i wasn't going to suggest anything but talking to her psychiatrist to her, i'm not a doctor and neither is the internet, i just thought some people on here might have some experience with tricyclics to relate.

    Thanks all for your input.
     
  12. alwayshope11

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    I take a ssri and it works wonders...stinks that didnt work for her :frowning2:
     
  13. mattloveshugs92

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    psychiatry to me is utter bull crap, it never helped me infact i almost died several times from it, and therefore i think it is a fake science thta they diuaagnoses by observation and not sceintific proof. ide say this be there for her hug her, most medicines cn infact do the opposite of the intention, have her look at her choices, to get off the meds,exersize eaat healthy, and tell her to try omega 3 and maybe magnesium if her doctor permits, and she wants to. also suggest to her, to use her creative talents, and fine a physical, spiritual, mental, and expressive/cretive and emotionl set of outlets, try suggesting cognative behavioral therapy, it shows how to turn negatives in life into a posotive by simple exersizes in work books. meds can either work or fail, i have seen more failure but she cn do wht she wants, mayabe tell her som of these suggestions.
     
  14. J Snow

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    Well, actually antidepressant medication has been shown to be effective in about 2/3 of patients. So to act like its quackery is just not true. Eatching health and excercize does help with mood though.
     
  15. Chip

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    While I don't agree that psychiatry is bullcrap, I do believe that many psychiatrists are limited in the time they can spend with patients (than you, managed care!) and so will often just prescribe something rather than take the time necessary to really delve in depth and understand what's going on.

    That said, psychiatry, and psychotropic medications do serve a useful and valuable purpose, and, while the jury is still out somewhat on the value of SSRIs or any other antidepressants, particularly when you consider that the difference between placebo and active response is only about 25%, they do work for some people.

    There's also some data that a number of things, including the things you've suggested, that can be helpful. I always believe that it makes sense to work with your doctor to find out if there are non-drug alternatives that can be tried, particularly since overmedication is an enormous problem in the US. But in this particular case, it sounds like the psychiatrist has tried a number of different combinations of things without success, so my guess is this is likely a more serious situation where the ordinary non-drug interventions may not work.
     
  16. J Snow

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    Fixed my awful typos.

    I'm sorry, I don't mean to spam, wish I could just edit typos, but that was really bugging me seeing all those blatant errors in my post. I didn't get much sleep last night and my brain is elsewhere it seems.

    On a side note, yes placebo effects are shown to be common in cases of moderate depression, but often people with severe depression get more depressed slightly after administration because of the lack of results in the early weeks of treatment. That's why its incredibly important for doctors to explain to patients that it takes some time to work so that they don't have unrealistic expectations and then have it push them over the edge when they aren't met.

    On a side note, my doctor just prescribed me Zoloft (an SSRI) yesterday, I didn't sleep well and have been feeling pretty awful today so, I can vouch for side effects at least early on...
     
  17. mattloveshugs92

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    the problem is the work for some but for many they dont, it is not devoloped enough, genetic psychiatry is a new science, but they include, herbs, pills, vitamins and personalized exersize nd diet programs, with therapies, but it is not common enough. i have seen more doctors overperscibe meds and give a slap on diagnosis than anything else. it needs reform which is why atm i think it is quackry until it can be reformed it seems waste of time, treat the person, treat the heart, heal the wounds. love people. i have seen more hate than love in america from families, to friends, and it ends people up on meds.
     
  18. mattloveshugs92

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    CBT and DBT have been known to be more effective, as it helps the mind think happier, some times the side effects seem worse than the benefits. i have met many people worse off on medicine than with out medicine, they became like vegetables. i have noticed a trend, 10-20 years ago the divorce rate was lower, as it has raised, i have more children and adults have been put on medication. i have been reading about it. i spend up to 4 hours a day reading since i do not go to school at the moment. medicine, is actually designed to get an individual to a point to work through the problems to get off the the person off the medication, at least nurses told me that, but i have seen the opposite. i can say this from expierence, if any one is depressed perhaps do not get stuck in the trap of being trapped in it by listneing to sad songs, and wearing dark things, because it can just make it worse. (*hug*)
     
  19. BudderMC

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    Well the thing is, a lot of what you're describing isn't an issue with psychiatry, it's an issue with society. If people are having other issues that are leading them to need medication, that's not the psychiatrist's fault. You may have had bad experiences with it, but to say that it's worse for more people than not would be incorrect.

    Though I will say, like anything else regarding depression, it requires some effort. The moment you give up, the worse things get. Medication may not be for you, but to write if off just because it didn't work the first time might not be wise.

    We live in a society that self medicates. Again, not the psychiatrist's fault, but society's fault. Regardless, there are people who legitimately have chemical imbalances and may require medications to help correct those, and no amount of raw willpower will substitute.
     
  20. J Snow

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    Well the antidepressants are supposed to be used along side therapy. And yes, it is ideal to get people back off these medications if they don't need to be on them, but some people really are severely depressed as the result of a chemical imbalance and need them. Is there over medication going on? Probably. But that doesn't mean that they are not useful for some people.