advertisement

Anxiety-Panic Community

Bookmark and Share

Learn about the benefits, side-effects and disadvantages of tricyclic antidepressants (Tofranil, Pamelor, Norpramin) for treatment of anxiety and panic attacks.

A. Tricyclic Antidepressants (TCAs)

Physicians use tricyclic antidepressants in the treatment of severe depression or depression that occurs with anxiety. Several also have broad anti-obsessional and anti-panic effects.

Learn about the benefits, side-effects and disadvantages of tricyclic antidepressants (Tofranil, Pamelor, Norpramin) for treatment of anxiety and panic attacks.Possible Benefits. Often effective in reducing panic attacks and elevating depressed mood. Well researched. Usually a single daily dose. Some generics available, which reduces cost. Tolerance does not develop. Non-addicting.. Often effective in reducing panic attacks and elevating depressed mood. Well researched. Usually a single daily dose. Some generics available, which reduces cost. Tolerance does not develop. Non-addicting.

Possible Disadvantages. Delayed onset (take from 4-12 weeks). Anticholinergic effects. Postural hypotension. Possible side effects initially (including insomnia, tremor, or both) may last up to the first two to three weeks of treatment. Weight gain can be as much as one pound per month with about 25% of patients gaining 20 pounds or more. Dangerous in overdose. Should not be used by patients with narrow-angle glaucoma or certain heart abnormalities. Men with an enlarged prostate should avoid certain antidepressants. Delayed onset (take from 4-12 weeks). Anticholinergic effects. Postural hypotension. Possible side effects initially (including insomnia, tremor, or both) may last up to the first two to three weeks of treatment. Weight gain can be as much as one pound per month with about 25% of patients gaining 20 pounds or more. Dangerous in overdose. Should not be used by patients with narrow-angle glaucoma or certain heart abnormalities. Men with an enlarged prostate should avoid certain antidepressants.

Possible Side Effects. The anticholinergic effects of dry mouth, blurred vision, constipation, and difficulty in urination; postural hypotension; tachycardia, loss of sex drive; erectile failure; increased sensitivity to the sun; weight gain; sedation (sleepiness); increased sweating. Some of these side effects will disappear with the passage of time or with a decrease in the dosage. Some people may experience side effects on dosages as low as 10 mg per day: jitteriness, irritation, unusual energy, and difficulty falling or staying asleep.. The anticholinergic effects of dry mouth, blurred vision, constipation, and difficulty in urination; postural hypotension; tachycardia, loss of sex drive; erectile failure; increased sensitivity to the sun; weight gain; sedation (sleepiness); increased sweating. Some of these side effects will disappear with the passage of time or with a decrease in the dosage. Some people may experience side effects on dosages as low as 10 mg per day: jitteriness, irritation, unusual energy, and difficulty falling or staying asleep.

Dosages Recommended by Investigators. One-third of panic-prone individuals become jittery and actually experience more anxiety symptoms for the first two to three weeks. For this reason, the medication trial should probably be initiated with a very low dose -- as little as 10 to 25 milligrams (mg) per day of imipramine, for example. If uncomfortable side effects appear, one approach is to wait two to three weeks for them to diminish before increasing to the next higher dose. If the patient adjusts to the side effects, the physician increases the dosage every two or more days until the patient is taking the preferred dosage. . One-third of panic-prone individuals become jittery and actually experience more anxiety symptoms for the first two to three weeks. For this reason, the medication trial should probably be initiated with a very low dose -- as little as 10 to 25 milligrams (mg) per day of imipramine, for example. If uncomfortable side effects appear, one approach is to wait two to three weeks for them to diminish before increasing to the next higher dose. If the patient adjusts to the side effects, the physician increases the dosage every two or more days until the patient is taking the preferred dosage.

If daytime sedation or other side effects are bothersome to the patient, the physician may suggest taking the full dosage at night before bed.