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Amitriptyline only antidepressant that really works on PN?

Some new information on why Amitriptyline works:

http://psychcentral.com/news/2009/06...tors/6761.html

Quote:

Doctors also prescribe amitriptyline for chronic pain such as migraine headaches or the nerve damage caused by diabetes, he notes.

In laboratory tests, amitriptyline could protect neurons from oxygen and glucose deprivation or the toxin kainic acid. Only amitriptyline, and not other antidepressants, could duplicate NGF’s ability to stimulate neurons to send out “neurites,” small projections thought to be the beginnings of connections to other neurons.

Amitriptyline directly binds TrkA and a related molecule called TrkB, the authors found. Amitriptyline could also bring together a mismatched pair of TrkA and TrkB — a phenomenon not seen before, Ye says.

Also surprising was the finding that other tricyclic antidepressants — even those with a similar molecular structure such as imipramine — could not match amitriptyline’s ability to stimulate cells through TrkA.

In a model of antidepressant function called a “forced swim test,” amitriptyline’s effects do not depend on TrkA, because it still works on mice with modified TrkA genes, the authors found.

The results are published online and appear in the June 26 issue of the journal Chemistry & Biology.

So it looks here like Elavil (amitriptyline) is the drug of choice now.

Quote:

Originally Posted by mrsD (Post 529063)

Some new information on why Amitriptyline works:

http://psychcentral.com/news/2009/06...tors/6761.html

So it looks here like Elavil (amitriptyline) is the drug of choice now.

It seems many get relief from this drug. I don't understand why my heart is so sensitive to this drug and other antidepressants. It skips, flips and races like crazy. :(

Hope my heart does the same thing. I just tried nortriptyline and my heart raced. Doc is trying desipramine next for me.

This was awful made me jumpy and really nervous,but works for others or
at least I; m told.... echhhh Blessings to all Sue

Quote:

Originally Posted by Shelley (Post 529286)

Hope my heart does the same thing. I just tried nortriptyline and my heart raced. Doc is trying desipramine next for me.

Really? I guess that I am not alone then. I'll keep my fingers crossed that the desipramine works for you Shelley....

If you get ANY cardiac effects from low dose TCAs....I would insist on an EKG and look for QT prolongation.

These drugs cause this in sensitive people. And it is very dangerous, and should be evaluated. If you have this reaction,
I'd stay away from this family of drugs. And make sure your
potassium and magnesium levels are kept optimum. Low electrolytes will cause a cardiac event!

http://www.azcert.org/

Check out these lists!

Quote:

Originally Posted by mrsD (Post 529503)

Wow MrsD, thank you for the lists and advice. I don't have OT prolongation, but I do have heart rhythm problems leaving my heart very sensitive to certain drugs. I just cannot take any antidepressants as I do not tolerate them well at all. Even when I took hydralazine for blood pressure for a brief period of time, it made my heart race. All I know is if heart rhythm problems are listed as a side effect on any drug, then I know I can't take it ususally. I am actually going for a blood test on Monday to check my electrolytes.

Drugs that cause vasodilation like hydralazine, will cause a compensatory increase in heart rate.

This includes calcium channel blockers like Procardia. I tried
Procardia years ago and it made my heart race too.

Nitrates will do it as well.
So will alcohol in some people.

This effect is not the drug working on the heart directly, it is the body trying to keep blood flow going in the arteries that are
suddenly dilated.

It has been thought that TCAs like Elavil were working centrally to moderate pain in diabetic neuropathies. This new paper is showing that it works in the periphery to help the nerves as well. That is the new information.

Mrs. D, I haven't been visiting neurotalk for awhile & just today I return & see your post on elavil! This very morning I was actually recalling fondly the time I was on it (6 or 7 years ago) when the only sx I disliked was brain fog. I've been on Lyrica for the past 2 weeks and am not happy w/ its many sx. The doc says to try it for at least a month. I'm leaning towards ditching it & going back on elavil. It was great for getting 6 hours of uninterrupted sleep & providing many hours of pain relief. Not the case with Lyrica as yet.

Many thanks for the update!

Mrsd can a prolonged Qt syndrome only be seen when you start one of these drugs or will a doc that mentioned it before. I have had EKG's done and they have alsys said its fine.

Not sure if this racing hart is from possible gerd or if it is from the antidepressant. I only tried the new one last night. Have not been on the other one for a week and a half now and that was only on it for 3 days.

I will call the heart doc on monday and ask to come in. I am seeing the gastro doc too.