todd@uhccux.UUCP (Todd Ogasawara) (03/30/88)
In article <758@spdcc.COM> dyer@spdcc.COM (Steve Dyer) writes: ]In article <2216@phoenix.Princeton.EDU], amlovell@phoenix.Princeton.EDU (Anthony M Lovell) writes: ]] Someone earlier posted a note expressing concern over Imipramine's (Tofranil) ]] potential long-term unpleasantness. I've never heard any mention of doubt ]] that this drug was safe (beyond the mild side-effects while ON the drug) ]] Does anyone KNOW what these effects MIGHT be? Are any of these unlikely to ]] stop with the cessation of medication? ] ]I don't know of any such long-term side-effects. Like 90% of the stuff which ]gets asserted here, any claim that imipramine has long-term dangers is bogus. At correctly prescribed dosages there are no long term dangers (that I know of) associated with Imipramine except for dependency. The reason that people often drop out of Imipramine treatment are due to side-effects that are considered uncomfortable. These side-effects include fatigue, constipation, dry-mouth, and palpitations. The palpitation problem can be worrisome to those experiencing it. These palpitations "may" be due to the effect that Imipramine (like all tricylics) has on the norepinephrine and acetycholine synapses which affect the cardiovascular system. -- Todd Ogasawara, U. of Hawaii Faculty Development Program UUCP: {ihnp4,uunet,ucbvax,dcdwest}!ucsd!nosc!uhccux!todd ARPA: uhccux!todd@nosc.MIL BITNET: todd@uhccux INTERNET: todd@uhccux.UHCC.HAWAII.EDU
dyer@spdcc.COM (Steve Dyer) (03/30/88)
In article <1710@uhccux.UUCP>, todd@uhccux.UUCP (Todd Ogasawara) writes: > At correctly prescribed dosages there are no long term dangers (that I know > of) associated with Imipramine except for dependency. Imipramine does not cause dependence, if "dependence" means "produces drug-seeking behavior" upon cessation of long-term administration. Imipramine has well-known characteristic side-effects, whose strength and unpleasantness varies greatly depending on the individual. However, none of these are associated with "long term dangers". -- Steve Dyer dyer@harvard.harvard.edu dyer@spdcc.COM aka {ihnp4,harvard,husc6,linus,ima,bbn,m2c}!spdcc!dyer
dwc@homxc.UUCP (Malaclypse the Elder) (03/31/88)
< < At correctly prescribed dosages there are no long term dangers (that I know < of) associated with Imipramine except for dependency. The reason that < people often drop out of Imipramine treatment are due to side-effects < that are considered uncomfortable. These side-effects include fatigue, < constipation, dry-mouth, and palpitations. The palpitation problem can < be worrisome to those experiencing it. These palpitations "may" be due < to the effect that Imipramine (like all tricylics) has on the < norepinephrine and acetycholine synapses which affect the < cardiovascular system. < my psychiatrist told me that the fatigue factor can usually be eliminated by HIGHER doses of imipramine. in fact, now that i am off the medication, i feel a little more fatigued. it may have something to do with this flu that i have caught though... danny chen homxc!dwc
hadj@sbcs.sunysb.edu (Michael Hadjimichael) (03/31/88)
In article <1710@uhccux.UUCP>, todd@uhccux.UUCP (Todd Ogasawara) writes: > .... These side-effects include fatigue, > constipation, dry-mouth, and palpitations. The palpitation problem can > be worrisome to those experiencing it. These palpitations "may" be due > to the effect that Imipramine (like all tricylics) has on the > norepinephrine and acetycholine synapses which affect the > cardiovascular system. and from Steve Dyer (dyer@harvard.harvard.edu) ] Imipramine has well-known characteristic side-effects, whose strength ] and unpleasantness varies greatly depending on the individual. However, ] none of these are associated with "long term dangers". Does anyone know if tricyclics (Desipramine/ Norpramine) have any other effects on the nervous system, such as trembling (hands) ?? Also, if tricyclics are prescribed for ~6 months, what are the chances that a patient will need to take the medication again later in life ? -mike hadjimichael. -- { "We are creatures of love..." - Talking Heads } { } { hadj@sbcs.sunysb.edu {philabs, allegra}!sbcs!hadj hadj@suny-sb } { departmentofcomputersciencesunystonybrookstonybrooknyoneonesevenninefour }
dyer@spdcc.COM (Steve Dyer) (04/03/88)
In article <1105@sbcs.sunysb.edu>, hadj@sbcs.sunysb.edu (Michael Hadjimichael) writes: > Does anyone know if tricyclics (Desipramine/ Norpramine) have any other > effects on the nervous system, such as trembling (hands) ?? Also, if > tricyclics are prescribed for ~6 months, what are the chances that a > patient will need to take the medication again later in life ? There have been occasional reports of tremor in people taking tricyclic antidepressants, but it is not a hallmark side-effect of this class of drugs. A fine tremor is more frequently reported in patients taking lithium. When prescribing an antidepressant agent for the first time, one common schedule is to choose a drug, and if it is effective, to maintain the patient on it for approximately 6 months, at which time the dose is slowly reduced, keeping an eye out for relapses. I don't have hard numbers at hand on the percentage of patients who relapse; I do know that treatment for less than 4 months is associated with higher rates of relapse than longer periods. Long-term drug therapy (at the lowest effective dose) is fairly common. A lot of this depends on the person, his family history, etc. -- Steve Dyer dyer@harvard.harvard.edu dyer@spdcc.COM aka {ihnp4,harvard,husc6,linus,ima,bbn,m2c}!spdcc!dyer
stevew@iscuva.ISCS.COM (Steve Walton) (04/05/88)
I have been taking Imipramine for over six months. Its effects have been extremely beneficial. I have experienced most of the more common side-effects (cotton-mouth, low tolerance of heat and sunlight, low tolerance of caffeine and chocolate, as well as the uncomfortable side-effects of palpitations and some problems, as Mel Brooks said in "High Anxiety", with the wee-wee. Luckily for me (or unluckily, some might say) my father is a psychiatrist, and prescribes tricyclics frequently. So, when my own physician was unavailable, or obscure in his reply, I would call my father with questions. The prescribed duration of anti-depressant medication is usually 6-9 months *after* the medication has shown a theraputic effect. Other than weaning the patient off of the medication rather than stopping abruptly, there is no cause for concern about lasting side effects. I will be sure to let you know in the next 2-3 months, when I come off of Imipramine, how well that advice holds up. By the way, tricyclic anti-depressants are usually used to treat depression, in my case a bout with Epstein-Barr, and/or panic disorders, as well as "obsessive-compulsive behavior". Imipramine does not work for everyone. In my case, it has restored me to a normal life from almost complete debilitation. later, Steve Walton
todd@uhccux.UUCP (Todd Ogasawara) (04/07/88)
In article <759@spdcc.COM> dyer@spdcc.COM (Steve Dyer) writes: ]In article <1710@uhccux.UUCP>, todd@uhccux.UUCP (Todd Ogasawara) writes: ]] At correctly prescribed dosages there are no long term dangers (that I know ]] of) associated with Imipramine except for dependency. ] ]Imipramine does not cause dependence, if "dependence" means "produces ]drug-seeking behavior" upon cessation of long-term administration. ]Imipramine has well-known characteristic side-effects, whose strength My apologies for not being clearer. I should have said something more like: Due to the lag between the first administration of Imipramine and the time it first takes effect, it is often difficult to tell whether an improvement in the patient's condition is due to the effect of the drug or some maturation effect (changes that took place with the passage of time rather than being caused by the drug). This might mean that a person would be taking Imipramine when he or she may not need it anymore. This leads to a situation similar to the old story of the group of people who continued to pray for the sun to rise each morning because they feared that if they stopped the sun would not come up and they would all die. I admit that my usage of the word "dependence" was inappropriate. ..todd -- Todd Ogasawara, U. of Hawaii Faculty Development Program UUCP: {ihnp4,uunet,ucbvax,dcdwest}!ucsd!nosc!uhccux!todd ARPA: uhccux!todd@nosc.MIL BITNET: todd@uhccux INTERNET: todd@uhccux.UHCC.HAWAII.EDU
dyer@spdcc.COM (Steve Dyer) (04/08/88)
In article <1734@uhccux.UUCP>, todd@uhccux.UUCP (Todd Ogasawara) writes: > My apologies for not being clearer. I should have said something more > like: Due to the lag between the first administration of Imipramine and the > time it first takes effect, it is often difficult to tell whether an > improvement in the patient's condition is due to the effect of the drug or > some maturation effect (changes that took place with the passage of time > rather than being caused by the drug). This might mean that a person would > be taking Imipramine when he or she may not need it anymore. Three weeks is typical for the lag time between first administration of a tricyclic and a well-defined beneficial effect, although people who respond best often show a more rapid response and it is unlikely that an individual drug will be of benefit if the person has not demonstrated some improvement by three weeks. Antidepresssants are not prescribed for short-term depressive episodes which are part of a normal life and whose duration is so short that one could "mature" out of them in a matter of weeks. As has been mentioned before, it is common to keep someone on drug therapy for 6 to 9 months, and then to gradually taper the dose with the goal of stopping treatment. This is backed by studies which show that relapses are more frequent in people who have been treated with antidepressants for fewer than 6 continuous months. The success or failure of tapering or eliminating the drug will become evident over the succeeding weeks and months. If the depression recurs, it can generally be controlled by reintroducing the antidepressant. -- Steve Dyer dyer@harvard.harvard.edu dyer@spdcc.COM aka {ihnp4,harvard,husc6,linus,ima,bbn,m2c}!spdcc!dyer