Doctor insights on:
Surmontil Tertiary Amine Tricyclic
Supportive Treatment: Whenever someone intentionally or unintentionally overdoses with any medication, it is an emergency. The individual should be brought to the emergency room immediately. Life support measures are given as necessary. Side effects are treated and managed until they resolve. Then a psychiatric eval once medical stability achieved. If suicidal involuntary hospitalization. If accidental determine cause. ...Read more
Unknown: We can neither endorse nor prohibit it during pregnancy. Some similar medicines have been studied, but the results are inconclusive. There may be an increase in risk; on the other hand, if it is helpful to the mother, there may be an increase in risk without it. Consider dosage, trimester, risks and benefits, and involvement of the father and obstetrician, in deciding. ...Read more
Caution advised: The combination together has an increased risk of low blood pressure episodes, seizures, central nervous system depression, psychomotor impairment, and risk of serotonin syndrome. You should discuss this with your physician and as long as you agree to accept the risk, there is no absolute contraindication to taking them together. ...Read more
I don't feel the same after taking generic surmontil (trimipramine). I feel more depressed and anxious. Is this normal? Been on generic about a week.
Brand before?: Answer depends on whether you have been taking brand surmontil (trimipramine) previously. But not a pharm answer! the placebo effect is powerful, both positive and negative, it's possible that your worry about generic being less effective is causing you serious anxiety. It's too soon for a pharm effect, if there were one (unlikely). Give it some time--and do some reading on placebo, it will really be helpful. ...Read more
Been on surmontil (trimipramine) 50 mg. For 12 yrs. Now generic doesn't seem as effective. Is generic the same formulation?
Yes and no: Generics must contain the same active ingredient as the branded product, but other ingredients (fillers) or delivery system (capsule vs pill vs gelcap vs specialized release system) may be different. Generics from other countries may not be tested as thoroughly to make certain dose of active ingredient is consistent. Discuss concerns with fp/doc &/or pharmacist. ...Read more
Neurotransmitters: Tricyclic antidepressants are probably the most effective antidepressants we have. They affect a number of neurotransmitters and multiple circuits in the brain, alleviating depression, anxiety, migraines, and various pain syndromes. The down side to them is side effects and potential for stopping the heart in overdose. The serotonin-norepinephrine antidepressants are much safer. ...Read more
Rings: The designation refers to the chemical structure. Monocyclic antidepressants, such as bupropion or fluvoxamine, have a molecular structure with only one ring of atoms whereas tricyclic antidepressants, such as Imipramine and desipramine, have three rings of atoms in their structure. ...Read more
Certain ones: In my practice and with my patients with various anxiety disorders, i often find the tricyclic antidepressant nortriptyline to be quite beneficial. Some doctors who did not receive their training until the 90s, may not feel comfortable prescribing some of the older medications. ...Read moreSee 1 more doctor answer
I took Dur amine 40mg can't sleep having trouble breathing is this normal does it pass please advise, what to do?
Can i experience antidepressant withdrawal when transitioning from a tricyclic to an ssri? If so, what are some of the symptoms?
Yes: Symptoms of gastrointestinal and somatic distress, sleep disturbance, and movement disorders and mania have been temporally linked to withdrawal of tcas. Cholinergic and adrenergic overdrive after tca discontinuation have been suggested as the proposed mechanism for this syndrome. Reported symptoms may be psychosomatic or related to underlying mental illness. www.ncbi.nlm.nih.gov/pubmed/8219442. ...Read more
SSRI's vs Tricyclics: The ssri's focus on blocking serotonin reuptake, and the tricyclics are non-selective in their receptor activity. Histamine blockade and others in tca's causes more sedation; there can also be postural hypotension with tca's. Ssri's may be safer in overdose, less likely to cause arrhythmia -- could be important in patients w/heart disease. Ssri's have their own side effect profile though. ...Read moreSee 1 more doctor answer