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Thread: Quick question

  1. #1
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    Quick question

    Doctor is wondering if maybe amitrip would be a better option. My concerns are the positive RA factor and ana. Has anyone had this issue with the medication? My biggest fear in life is autoimmune and cancer.
    Sorry if I have been a little crazy lately guys and women. You have all been of great help.
    Its that drug or another one I am not familiar with imipramine.
    Last edited by SEANML; 16-12-20 at 11:16.

  2. #2
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    Re: Quick question

    Quote Originally Posted by SEANML View Post
    Doctor is wondering if maybe amitrip would be a better option. My concerns are the positive RA factor and ana. Has anyone had this issue with the medication? My biggest fear in life is autoimmune and cancer.
    Amitriptyline wouldn't be the most prescribed pain med for rheumatoid arthritis if there was a significant risk. Nor is there much evidence that it causes, or exacerbates cancer. If you go looking for reasons not to take a med you will almost always find at least one online. The best option is to avoid checking up on meds, especially with HA. An anxious mind it very capable of creating the full range of severe side-effects if given half a chance.

    BTW-anxiety and depression are themselves arguably symptoms of an autoimmune disorder.

    Its that drug or another one I am not familiar with imipramine.
    Imipramine is a more potent TCA than amitriptyline. It was the AD that pulled me out of my first panic spiral. I had few problems with it even though I was always on very higher doses, mostly 300mg and 350mg for some months. Few doctors would prescribe doses that high these days, but the bloke that developed it took up to 1,000 mg for a while during the initial safety testing (back in those days the drug company chemists were also the guinea pigs).

    Either med would be a good choice, but given the HA, I suggest amitriptyline as it generally causes slightly fewer initial side-effects. You could switch to imipramine later if amitriptyline proved inadequate.
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  3. #3
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    Re: Quick question

    I am trying to get out of the ha worry of amitrip. I took it years ago on low doses and it was nice. Only reason I like imipramine is that there is no "ana" or "RF" wich ever med I do choose it will be for my mental problems but also to help me sleep (it will be used to replace mirtazapine) which was an amazing drug but the eating is way out of hand lol.

    Thanks for talking with me and helping me decide. I am still not sure wich is best (
    imipramine or ami). All I know if I hope they will be sedative like mirtazapine was. I need to loose the weight I gained from mirtazapine as well (also on olanzapine lol )

    *Also I have memory issues (due to a head trauma) so I need to make sure the new meds do not alter my memory. Havent asked or looked into that. Just kinda started panic on the Rheumatoid and ana bit lol.
    *Never knew it was prescribed for rheumatoid. And thankfully I havent seen any cancer risk for the 2 drugs. I saw a risk for a separate drug he had offered though.
    **Also what is this dementia risk I heard about for amitriptiline? Is
    imipramine the same for that risk? I already have memory issues lol
    Last edited by SEANML; 16-12-20 at 13:32.

  4. #4
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    Re: Quick question

    Quote Originally Posted by SEANML View Post
    I am trying to get out of the ha worry of amitrip. I took it years ago on low doses and it was nice.
    There is no reason it should be any different at the higher doses for anxiety.

    Only reason I like imipramine is that there is no "ana" or "RF"
    Why are antinuclear antibody and rheumatoid factor such a concern for you?

    wich ever med I do choose it will be for my mental problems but also to help me sleep (it will be used to replace mirtazapine) which was an amazing drug but the eating is way out of hand lol.
    Mirtazapine is more a very sedating antihistamine than antidepressant. It is a more potent antihistamine than most of the meds marketed as antihistamines. It is the inhibition of histamine receptors which mostly causes sedation. Amitriptyline blocks histamine receptors to a lesser degree so probably won't be as sedating, but that also means it is also less likely to trigger the powerful carbohydrate cravings that mirtazapine does. Imipramine is usually significantly less sedating that amitriptyline.

    Thanks for talking with me and helping me decide. I am still not sure wich is best imipramine or ami. All I know if I hope they will be sedative like mirtazapine was. I need to loose the weight I gained from mirtazapine as well (also on olanzapine lol
    Unfortunately, there is no way of knowing which will be the more effective med for you other than by trying them.

    *Also I have memory issues (due to a head trauma) so I need to make sure the new meds do not alter my memory. Havent asked or looked into that.
    You probably have memory issues because of the anxiety too. Anxiety and depression are the emotional symptoms of atrophy of the twin hippocampal regions of the brain caused by high brain stress hormone levels killing hippocampal cells and inhibiting the growth of new ones. ADs work by stimulating the growth of hippocampal neurons. It is the new cells and the connections they form which produce the therapeutic response. Btw - therapy works the same way. The hippocampi are critical to the conversion of short-term to long-term memory.

    Just kinda started panic on the Rheumatoid and ana bit lol.
    What have you been reading?

    *Never knew it was prescribed for rheumatoid.
    To be clear, amitriptyline isn't prescribed to treat rheumatroid arthritis, but to alleviate the pain it causes. It is prescribed for many other conditions which produce neuropathic (nerve) pain, including fibromyalgia, diabetes and some cancers.

    And thankfully I havent seen any cancer risk for the 2 drugs.
    There are cancer risks in just about everything. One of the leading causes is anxiety/stress. Indeed, anxiety/stress is the leading cause of premature death overall because it often sets in train the circumstances which produce the main diseases of humanity so doing nothing about HA is itself not risk free.

    To be blunt, none of us get out of this alive. Imho, quality of life is far more important than longevity. To quote one of my inspirations, Hunter S. Thompson:

    "Life should not be a journey to the grave with the intention of arriving safely in a pretty and well preserved body, but rather to skid in broadside in a cloud of smoke, thoroughly used up, totally worn out, and loudly proclaiming "Wow! What a ride!"

    Also what is this dementia risk I heard about for amitriptiline?
    I assume what you've heard relates to meds that block acetylcholine receptors which according to a recent study increases the risk of dementia. It is always a good idea to treat a single study finding with scepticism as they don't always survive scrutiny and that may be even wiser for this study as there is considerable evidence pointing to TCAs either having no added risk, or significantly reducing dementia risk [1]. Anxiety/depression is itself a major risk factor for dementia.

    Fwiw, I've been on very high doses of TCAs almost continually since early 1987. So far my brain hasn't turned to mush and most mornings I can still remember my name. On the days this alludes me it isn't because of dementia!!

    Is imipramine the same for that risk? I already have memory issues lol
    Amitriptyline is a more potent acetylcholine blocker than imipramine.



    [1]
    Bartels C, Belz M, Vogelgsang J, et al. (2020)
    To Be Continued? Long-Term Treatment Effects of Antidepressant Drug Classes and Individual Antidepressants on the Risk of Developing Dementia: A German Case-Control Study.
    J Clin Psychiatry. 2020 Aug 25;81(5):19m13205 [Abstract]

    Leng Y, Diem SJ, Stone KL, Yaffe K. (2018)
    Antidepressant Use and Cognitive Outcomes in Very Old Women.
    J Gerontol A Biol Sci Med Sci. 2018 Sep 11;73(10):1390-1395 [Abstract]

    Lee CW, Lin CL, Lin PY, et al. (2017)
    Antidepressants and risk of dementia in migraine patients: A population-based case-control study.
    Prog Neuropsychopharmacol Biol Psychiatry. 2017 Jul 3;77:83-89 [Abstract]

    Lee CW, Lin CL, Sung FC, et al. (2016)
    Antidepressant treatment and risk of dementia: a population-based, retrospective case-control study.
    J Clin Psychiatry. 2016 Jan;77(1):117-22 [Abstract]

    Kessing LV, Forman JL, Andersen PK. (2007)
    Do continued antidepressants protect against dementia in patients with severe depressive disorder?
    Int Clin Psychopharmacol. 2011 Nov;26(6):316-22 [Abstract]
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  5. #5
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    Re: Quick question

    I panic about ana and rheumatoid arthritis because they are just a big fear. I dont want a auto immune. Especially rheumatoid. I already am positive for ana and rheumatoid factor. Did the test last year with no follow ups required.
    In your opinion which one is more sedating?
    A part of me thinks imipramine might be better due to my panic of rheumatoid and auto immune. I was on ami for 2 weeks last year, got off it when I tested positive.
    Ami was nice and euphoric and got rid of my fibro pain. Is imaprimine similar? Thanks for the chat, you are going to help me to decide. You are mellowing me out with your great responses and facts.

    My memory is faulty from a traumatic brain injury coma 10 years back. So I have hard times talking. I hope you understand me well.
    I just need a good sedative, and if it kills my pains and depression as an add on wicked! Lol. So from your opinion dementia is a low risk possibly with tcas. Hows your hair? I read it can cause hair loss too.

    More concerned about auto immune. I'd take ami if it wasn't for the auto immune and rheumatoid. That's a nasty disease And treatments kill your immune system (so cancer can happen in theory)

    I get all the side effects from a drugs.com site
    Last edited by SEANML; 17-12-20 at 18:52.

  6. #6
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    Re: Quick question

    Quote Originally Posted by SEANML View Post
    I panic about ana and rheumatoid arthritis because they are just a big fear. I dont want a auto immune. Especially rheumatoid. I already am positive for ana and rheumatoid factor. Did the test last year with no follow ups required.
    Which suggests your GP doesn't think the test results were significant. A single test positive doesn't necessarily mean you're at risk. You might have been positive for any number of reasons.

    In your opinion which one is more sedating?
    Amitriptyline is a far more potent blocker of histamine H1 receptors than imipramine so is likely to be considerably more sedating, however, as with all things antidepressant, YMMV. It all comes down to how the meds mesh with your individual biology.

    A part of me thinks imipramine might be better due to my panic of rheumatoid and auto immune. I was on ami for 2 weeks last year, got off it when I tested positive.
    Who's idea was that, you or your GP's?

    Ami was nice and euphoric and got rid of my fibro pain. Is imaprimine similar?
    Neither should be producing euphoria. You just may have been feeling extra good because the pain had eased/stopped.

    I just need a good sedative, and if it kills my pains and depression as an add on wicked! Lol. So from your opinion dementia is a low risk possibly with tcas. Hows your hair? I read it can cause hair loss too.
    The evidence shows that TCAs may reduce the dementia risk. No hair loss so far and I'm over 70 yo. Just about any med can trigger hair loss, but anxiety/stress is probably a greater risk.

    More concerned about auto immune. I'd take ami if it wasn't for the auto immune and rheumatoid. That's a nasty disease And treatments kill your immune system (so cancer can happen in theory)

    I get all the side effects from a drugs.com site
    Just because something is listed as a potential side-effect doesn't mean the med is thought to cause it. Side-effects lists are based on reports during the trials of the med and detail everything reported irrespective of whether the maker believes it was caused by the med. This is why some contagious diseases are listed as a potential side-effect of some SSRIs. If this were true then it would mean our understanding of infectious disease was seriously flawed.

    I've managed to track down the case which seems to have been responsible for ANA being on the side-effects list (PDF, page 14):

    Immunological

    Positive antinuclear antibodies and elevated immunoglobulin levels were noted in one patient with amiodarone induced pulmonary fibrosis.
    As you can see it doesn't claim amitriptyline was the cause, but states what was likely responsible as elevated antibodies, including ANA are common with pulmonary (lung) fibrosis, as is PRF. Also note that unlike Drug.com it doesn't list PRF as a side-effect.

    There is only one study in the medical literature involving amitriptyline and positive antinuclear antibodies and another listing both the AD and positive rheumatoid factor. Neither claims amitriptyline as the cause, in the PRF case amitriptyline was prescribed as one of the treatments!

    If amitriptyline was a risk factor then it wouldn't be one of the most prescribed pain meds for autoimmune disorders. You are stressing about nothing. My advice, stop looking up side-effects and trust your GP knows what he/she is doing. They are likely to know much more about what you can and cannot take than Drugs.com.
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  7. #7
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    Re: Quick question

    Hair loss scares me. I was thinning previously so I'm growing my hair out. I read tcas are toxic to hair.

    You are being a great help in my decision. Ana and auto immune is scary. Dr said amitriptyline cause I used it before
    He suggested imaprimine and anafril as alternatives.

  8. #8
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    Re: Quick question

    Quote Originally Posted by SEANML View Post
    Hair loss scares me. I was thinning previously so I'm growing my hair out. I read tcas are toxic to hair.
    Temporary hair loss is an uncommon side-effect of most ADs (and many other meds). The TCAs are no more likely to cause it than the other classes. The hair will usually grow back when the ADs is discontinued so in the unlikely event this becomes a problem for you switching to another AD, including even another TCA, should resolve it.

    As I wrote previously, if you go looking for reasons not to take a med you will inevitably find them online. You need to decide which is worse for you, living with anxiety or putting up with some, usually short-term, side-effects. Plus, this is not a zero sum situation, anxiety/stress itself carries considerable serious health risks.

    Ana and auto immune is scary.
    Then isn't it fortunate that not only do the ADs suggested by your GP not cause autoimmune issues, but may actually reduce the risk of you developing them?

    Dr said amitriptyline cause I used it before
    He suggested imaprimine and anafril as alternatives.
    Any of them would be a good choice. Personally, I'd lean toward Anafranil (clomipramine), because it has a superior OCD track record (HA is on the OCD spectrum). However, given you've taken amitriptyline before that would probably be the better option for you psychologically.

    If you decide to have a go then discuss and get the okay from your GP to start on a low dose, half a 25mg tablet for the first week, then 25mg for the next, ramping it up 25mg at weekly intervals until you reach the initial target dose, usually 75mg for amitriptyline and imipramine, 100mg for clomipramine. You may need to go higher later to achieve optimum results.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  9. #9
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    Re: Quick question

    Anafril is a no because I had saw a side effect I did not want to risk. I will stop looking things up. But it has a risk of onocological. A cancer on drugs.com I am trying to get comfy with risking amitriptyline. I do have OCD and anxiety. Anafril is just a no go even though it's a small rare risk. Breast fibrodenosis I think was the cancer risk. I just have to think hard. Hair loss, ana, rheumatoid are scary but you are giving me some positive advice on everything . Thx again my friend. Also a good point on the ana and maybe being prevented with tcas thanks again you are truly helping me out here
    Last edited by SEANML; 19-12-20 at 19:12.

  10. #10
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    Re: Quick question

    Quote Originally Posted by SEANML View Post
    Anafril is a no because I had saw a side effect I did not want to risk. But it has a risk of onocological. A cancer on drugs.com I am trying to get comfy with risking amitriptyline. I do have OCD and anxiety. Anafril is just a no go even though it's a small rare risk. Breast fibrodenosis I think was the cancer risk.
    Sigh! Breast fibroadenoma is a benign, non cancerous tumour, i.e. fibrose lumps that form in breast tissue which are fairly common in females aged 30+, but very, very rare in males. Are you female? If so, do you take oral contraception? They are far more likely to cause such lumps.

    I will stop looking things up.
    That would be very wise because your efforts to date are not helping you. You don't seem to have the knowledge to evaluate what you're reading and just needlessly scaring yourself.

    I just have to think hard.
    No, stop thinking because overthinking everything seems to be stopping you from getting treated. Time to do. If not meds then therapy. But do something. As per my last post, doing nothing is by far the worst of the options available to you.

    Hair loss, ana, rheumatoid are scary but you are giving me some positive advice on everything .
    The only one that may impact you is hair loss and even this would only be a temporary side-effect.
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