Opinions - Nortryptaline (TCA) Adverse Reaction. Please offer any advice AT ALL!!!!

[Boca Bitch]

Damn it to hell... I think just spent the last two hours freaking out over nothing.


I'd been warned by my psychiatrist that TCAs can have an adverse, 'electrifying' effect upon people. They're anticholinergic, meaning they have the exact opposite effect of nicotine... this tends to have a heavy sedating effect.. if you've ever taken Benedryl or Tylenol Simply Sleep, you're familiar with this feeling. I'm an insomniac.. so they really have little effect on me, sedation-wise. They also inhibit the re-uptake of norepinephrine and serotonin to a lesser extent. Now through some mechanism of action that I don't understand in the least increasing the levels of the primary stress neurotransmitter actually has anxiolytic effects with continued therapy.

I'm supposed to take them right before I'm ready to pass out.. tonight I took it WAY too early. The mild sedation kicked in.. and then anxiety FLEW through the roof!!!! It felt more difficult to breathe.. I was convinced I was having an allergic reaction. But if that were true (which I now realize is really physically impossible), I couldn't take Benedryl, because it would have synergistic (additive) effects... as it's also anticholinergic... in addition to antihistamine. I wasn't sure if it was something to wake the rents over.

After reviewing Nortriptyline and TCAs in general in my HUGE pharmacology book, I decided Benedryl would be the worst thing I could do... taking ibuprofen (Advil) for general inflamation couldn't be of any harm.. just in case.
And I just took 2mgs. alprazolam Rx and 1.35g [whole ground] valerian root for anxiety.


I now realize what happened:

1) I had a panic attack, not an allergic reaction, while under the influence of a drug that causes confusion in general.
2) I drank alcohol. Ethanol has nonspecific GABAergic-related effects on the CNS. It pronounced the sedatory effects temporarily.. and stopped or partially inhibited the norepinephrine from being released... thus reducing general re-uptake inhibiton. Once the alcohol was metabolized, and no longer psychoactive (about two hours after two glasses of wine), the Nortriptyline's norepinephrine re-uptake inhibition kicked through the roof... resulting in panic.
Alcohol's psychological withdrawal can [rarely] result in acute mania... meaning temporary EXTREME anxiety/mild insanity. Alprazolam is used to treat alcohol withdrawal anyway.. so I killed two birds with one stone.


Does this sound like a valid assessment of the situation? Or do you think it might be something I should bring up with my psych?... discontinue the nortriptyline???

Thank you for your input!!!!! And thank you for having the patience for reading my story.

Reputation Comments on this post:

	This post is very well written, presented knowledgably, and centers around and abnormal topic for discussion. Good post!
	Read the rules about self incrimination. Even though it's legal where you are, nortryptaline could be illegal elsewhere....