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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by wishingstar on March 5, 2007, at 19:57:51
I was hospitalized this past weekend for suicidal thoughts and depression. They started me on desipramine 25mg, taken before bed. The first day on the medication (the day after the pill) everything was fine. The second day however my blood pressure was low (around 90/50 or so) and my pulse was high (137 right after getting out of bed, down to about 105 later on). By the evening, it was all close to normal (pulse in the 90s). I do typically have low blood pressure, but not that low, and my heart rate is usually more like 80. The third day (today), I woke up and my blood pressure was at 78/44, and my pulse at 145. They gave me an ativan to slow my pulse down. They had planned to release me this morning, and decided to do so, even with this issue going on. They never checked my pulse/bp again after giving me the ativan and I was released around 11am. One additional symptom has been bugging me ever since the second morning... my pupils are significantly dialated. I'm having a little bit of trouble focusing in on small print, like in a novel - I can do it, but its harder.
I'm leaning towards not taking the medication tonight. Each morning so far my bp and pulse have been more "off", and now that I'm not in the hospital, there is no one checking it or here to help if it gets too far off. Besides this, I'm only taking 25mg, and my understanding is that 75mg is generally the lowest level dose found to be effective. I cant imagine that I'll be able to tolerate triple what I'm currently taking, even if I move it up slowly.
My next appt with my pdoc is not for 7 weeks. I'm going to try and move it up, but in the past that has been very hard to do, even for emergencies.
Does anyone have any thoughts on this? Should I keep taking it or discontinue it? I was surprised that the doctor at the hospital told me to keep taking it, but I dont respect him for several other reasons anyway. I dont think he's the greatest doctor. I'd love to hear your thoughts. Thanks!
Posted by Phillipa on March 5, 2007, at 21:39:20
In reply to desipramine - weird side effects, posted by wishingstar on March 5, 2007, at 19:57:51
Well usually your gut instincts are right. I had one in the hospital put me into withdrawal and had to see a neurologist after discharge who added back in the drug they took away and said to find another pdoc. Love Phillipa ps I'm still sure yous will see you.
Posted by stargazer on March 5, 2007, at 21:54:20
In reply to desipramine - weird side effects, posted by wishingstar on March 5, 2007, at 19:57:51
Wishingstar..
I don't think that's a good reaction for you to have. As your BP drops and your pulse increases, that's the same reaction someone has going into shock so I would be quite concerned about continuing to take the med, despite what the doc says. Before your next dose, count your pulse for a minute, if it continues to be more than 110-120, I would call the doc and tell him. Something is wrong there, whether or not they want to believe it. I wouldn't continue to take it myself. I guess that is how I've managed to stay out of the hospitals. Once my pdoc told me to continue to take Zoloft as I got more and more suicidal...I listened to myself and stopped it, the suicidal effect vanished. So the docs are often times wrong.
You could also buy a BP cuff to monitor your pressure. It should never be under 80/40 unless you are being monitored. Aren't you incredibly light headed or fainting yet? Drink plenty of fluids.
What other meds are you on? I sure wouldn't risk ending up back in the hospital again and that is what is going to happen if you continue to take the med with those values, normal pulse is 60 to 100. Tachycardia is greater than 100, consistent tachycardia can be very dangerous, leading to cardiac arrthymias.
Stay well.
Stargazer
Posted by wishingstar on March 5, 2007, at 22:14:14
In reply to Re: desipramine - weird side effects/wishingstar, posted by stargazer on March 5, 2007, at 21:54:20
Thanks for your response.
I'm not on any other meds right now. I was previously on adderall but stopped it last Tues. I had been getting dizzy some, especially when standing up and in the earlier part of the day, but I havent gotten close to fainting yet. The scary part is that even when my heart is beating that fast, I dont FEEL it pounding at all (like you might after running a mile). It feels totally normal.
I've decided to just not take the med tonight. In the hospital, they can monitor me and take action if something goes haywire. But at home, especially while Im asleep, anything could happen, and it's just not worth the risk.
I'm going to call my pdoc in the morning and ask for the earliest possible appointment, but past experience suggests that it will be at least 3 or 4 weeks away. It makes me so angry... I went into the hospital with the hope that at LEAST I'd get my meds stabalized, if nothing else. Now I'm stuck where I was before - no meds and no appt in the coming weeks. But I will call and try my best. Maybe I should switch doctors, but I hate to do that. Mine really is very good (he is not the one I saw in the hospital).
Posted by linkadge on March 6, 2007, at 13:06:34
In reply to Re: desipramine - weird side effects/wishingstar » stargazer, posted by wishingstar on March 5, 2007, at 22:14:14
Was there any particular reason that desipramine was chosen? It can be very stimulating. The potent noradrenaline reuptake inhibition can elevate heart rate, so this side effect is not just in your head.
Linkadge
Posted by wishingstar on March 6, 2007, at 16:15:42
In reply to Re: desipramine - weird side effects/wishingstar, posted by linkadge on March 6, 2007, at 13:06:34
I've tried all the SSRIs and related drugs, so we decided it was time for something outside of that category. As for why my pdoc chose desipramine over another tricyclic, he said that many of the others are more likely to be sedating and cause more side effects. I'm generally very sensitive to ADs (I've had to stop several due to side effects) and already have very low energy and fatigue, so I didnt want to feel any more sedated than I already do. That was the reasoning he shared with me. If there were other additional reasons, he didnt say.
I have stopped it now. My therapist was unhappy with me and didnt seem to understand, but it just felt unsafe and dangerous for me physically. It's not worth that.
I called and rescheduled my pdoc appt from April 23 to March 30, but March 30 is the earliest they can possibly get me in.
Posted by Phillipa on March 6, 2007, at 19:26:19
In reply to Re: desipramine - weird side effects/wishingstar » linkadge, posted by wishingstar on March 6, 2007, at 16:15:42
Well you did the right thing as it would not be safe for you to be alone. And I hate to say the joke that docs are "practicing medicine". But it's true. And I would call the hospital and report the condition you were in when they sent you home. There will be no discharge vital signs unless someone made them up. Love Phillipa feel better
Posted by linkadge on March 6, 2007, at 21:00:12
In reply to Re: desipramine - weird side effects/wishingstar » linkadge, posted by wishingstar on March 6, 2007, at 16:15:42
I think it was probably a good move. You don't want to mess with the heart for sure.
Desipramine has been used for an secondary treatment for ADHD. Its use was discouraged in Europe however because of the death of some kids related to its cardiac effects.
Thats not to say it might not be effective for some, but you are right, some of the TCA's can sure get the ticker going.
Linkadge
Posted by psychobot5000 on March 9, 2007, at 10:07:50
In reply to Re: desipramine - weird side effects/wishingstar, posted by linkadge on March 6, 2007, at 21:00:12
Hi,
Thought you might want to know that I had a similar experience with nortriptyline, a tricyclic like desipramine that's similar in that it's a powerful inhibitor of norepinephrine reuptake--and so can effect the heart. It caused greatly increased heart-rate (around 100, resting), but my doc basically told me that it was okay to have elevated heart-rate for a few weeks while my body adjusted to the drug. I think that might have been their rationale in your case. As for me, eventually I had to go off it (after several months), because my heart-rate did not go back to normal. But I gather that it often does normalize in a few weeks.
That said, if you find in the future that low blood pressure is a problem with meds, you can always try 1-2 grams of table salt (or pills, whatever), twice a day with extra fluids, as an antidote. That is often enough to take care of dizziness, and make you functional. But I suppose in this case it's moot.
Best of luck,
P-bot
Posted by Iansf on March 9, 2007, at 17:30:30
In reply to desipramine - weird side effects, posted by wishingstar on March 5, 2007, at 19:57:51
Have you considered reducing the dose? Some people take longer to adapt to a particular medication, and it may be that your metabolism requires to you to build to an effective dose at a much slower rate than the average person. Why not try half, or even a quarter, of the 25mg pill for several days, then move up in steps. If you still have problems, then it may not be the right med for your system.
This is the end of the thread.
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