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bethanechol for TCA-induced cognitive impairment?

Posted by tom2228 on April 6, 2014, at 21:35:16

I've been taking nortriptyline for almost a week now, titrating to 75mg tonight, and am pleased with the therapeutic results so far (!!).

However, I prize my intellect and need a clear mind to succeed in school, and it seems nortriptyline is doing a number on my cognitive abilities. I understand it's early in my trial and that things may improve, but I do not necessarily like the idea of getting "used to" or acclimating to this state of cognitive functioning. I need as much clarity as I can get.

So, I understand the negative effect on cognition stems in part from the nortriptyline's antihistamine and from its antimuscarinic effect.

I have heard of bethanechol (urecoline), a muscarinic agonist, as being helpful for antimuscarinic effects such as urinary retention and dry mouth, but what about for cognitive impairment?

I saw somewhere that it may not be helpful as it is does not cross the blood-brain barrier, but am interested in your thoughts and experiences.

Otherwise if notrtrip doesn't work out I was thinking desipramine might be better in the sense that the lower potency for muscarinic and histamine receptors would confer an advantage for cognition.

Thanks


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poster:tom2228 thread:1063760
URL: http://www.dr-bob.org/babble/20140328/msgs/1063760.html