Are you or someone you know being treated for bipolar disorder? If so, it's important to be aware of the different types of medications that are prescribed for it. Because some medications are not suitable for this condition, and some should be used with great caution. Today we're talking about one such, somewhat older, but still used for various conditions, class of medications called tricyclic antidepressants .
First, let's see, what are these tricyclic antidepressants (TCAs)?
Simply put, these are a type of medication that is a bit older than the ones used to treat depression. There are chemicals in our brain that transmit messages between nerves (neurotransmitters). What these drugs do is increase the activity of two of these chemicals called serotonin and norepinephrine . Scientists believe that these two chemicals are very important for the brain circuits that control our mood.
However, these medications have more side effects than newer medications. Also, these medications are now being prescribed by doctors for other conditions besides depression. For example:
- Neuropathic Pain
- To prevent migraines
- Insomnia
- Some intestinal complications ( Irritable Bowel Syndrome )
Several other medications belonging to this class of medications are listed in the table below.
| Name of the medicine type | Common Brand Names |
|---|---|
| amitriptyline | Elavil |
| imipramine | Tofranil |
| nortriptyline | Pamelor |
| desipramine | Norpramin or Pertofrane |
Why do you need to be very careful when giving this medication to someone with bipolar disorder?
This is the most important part of this article. Bipolar disorder is a state of mood swings, where you experience periods of extreme depression and periods of unusually high levels of activity and excitement, called mania.
These tricyclic (TCA) medications are used to treat depression. So if a bipolar patient is given these medications alone for their depressive state, there is a high chance that their mood will shift to the other extreme, that is, mania. Also, a condition called rapid cycling, where they switch back and forth between depressive and manic states, can occur.
Imagine that someone with bipolar disorder is just started on a medication like this for depression. If, within a few days, they suddenly lose all sleep, talk excessively, spend excessively, do extravagant things, and are unusually happy, that could be a manic episode. This is due to the effects of the medication.
So what is the solution to this?
To reduce this risk, doctors recommend a mood stabilizer at the same time as an antidepressant like this for bipolar patients, especially those with bipolar I.
Experts believe that these tricyclic medications should not be given alone to bipolar patients without a mood stabilizer, such as lithium or divalproex.
Other risks and things to consider
In addition to the risk of inducing mania, there are several other things we need to be aware of about these medications.
1. Heart disease risk: This medication may cause or worsen heart rhythm problems in some people. If you have a heart condition, you should definitely tell your doctor about this.
2. Overdose is very dangerous: This is the biggest danger of these drugs. Compared to newer drugs, even a small overdose of tricyclic (TCA) drugs can be life-threatening. Therefore, if you are using these drugs, do not take more than the dose prescribed by the doctor for any reason. Also, keep these completely away from small children in the house and keep them in a safe place. If you suspect that someone has accidentally taken too much of this drug, immediately take them to the Emergency Treatment Unit (ETU) of the nearest hospital . If necessary, you can also call the National Poison Information Center at the Colombo National Hospital for advice.
3. More side effects: These are more likely to cause side effects such as drowsiness, dry mouth, blurred vision, constipation, and difficulty urinating than newer medications.
For these reasons, doctors prescribe these medications very sparingly and with great caution when treating bipolar patients.
Take-Home Message
- Tricyclic antidepressants (TCAs) are an old class of medications used to treat depression. They are now also used to treat other conditions.
- Giving this medication alone to bipolar patients greatly increases the risk of the disease progressing to the other extreme, mania.
- Therefore, if this type of medication is given, it is essential to take a mood stabilizer at the same time.
- Overdosing on these medications is very dangerous, so it is important to follow medical advice and keep your medications safe.
- Never start, stop, or change the dosage of any medication without your doctor's advice. Talk to your doctor about any questions or concerns you may have.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න