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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by bubblegumchewer on July 29, 2002, at 13:02:55
Hi there; I seem to remember that you are a pharmacist. I described my problem in more (unsavory) detail in "let's play pick-a-med," but I'm looking for some clarification from you, if you can help me.
I've been taking nortriptyline for almost a year but I can't stand it anymore because it is just so "constipating." I put that word in quotes because I think the real problem is that, from what I've read, the medication relaxes the muscles or nerves of the gut so well that nothing moves along as it should. I have to admit I am afraid of some catastrophe like "paralytic ileus." I eat and drink well but just don't have to go for up to a week and a half or two weeks, and my doctors don't care about this side effect. From what I understand, the problem is not one that can be fixed with fiber or colace (it makes no difference whether I take those or not) and in fact it may be inadvisable to keep throwing more bulk at a gut that is not moving at all. My stop-gap measure right now is to stop taking the medication once a week just so I can use the bathroom. Ridiculous, huh? I'm looking for some backing from you that I am understanding the problem correctly. I mean, I could try eating nothing but prunes and metamucil but I don't think that's a healthy way to eat and I'm not sure it would "fix" the problem which is obviously caused by the med. Within 12 hours of my missed dose of the med I am completely and utterly normal again, at least bowel-wise.
Am I understanding this correctly? I want your opinion so that next time I see the doc and he starts reciting, "colace, prunes," etc. I can tell him to stick it. I am looking for a replacement medication for anxious depression/ panic attacks. Thanks very much for your input.
Posted by bubblegumchewer on July 30, 2002, at 17:25:23
In reply to Question for Sunnelly, posted by bubblegumchewer on July 29, 2002, at 13:02:55
Remember me, Cam? Grapebubblegum? I have to admit now that I don't chew gum very often at all, and when I do it is not usually bubblegum. I couldn't retrieve that name - lost the password.
Posted by CamW. on July 30, 2002, at 18:16:24
In reply to Question for Sunnelly, posted by bubblegumchewer on July 29, 2002, at 13:02:55
GBG - I seem to remember that Aventyl™ (nortriptyline) is a potent blocker of the muscarinic-M1 receptor. This would be the cause of your constipation. Do you also suffer from a dry mouth, and possibly dry eyes?
If so, it sounds like you are sensitive to the antimuscarinic effects of nortriptyline. God (or some other perceived higher power that can be used as an explicative) help you if you ever have to start taking Clozaril™ (clozapine); we would have to hand you a mallet and chisel.
Seriously, if the med is working, it would be a shame to have to stop it. Ask your doctor about lactulose syrup (Chronulac™ or Laxilose™- a generic). It is the laxative we give to people taking Clozaril, as well as the elderly who are having problems on their tea and toast diets. Lactulose is a sugar and is fairly safe, and may prevent paralytic ileus. Don't let the sugar part fool you; I had one person describ the taste as "liquid death". I don't think that it is that bad, but I haven't tried it.
I hope that you can glean something from this (outside of a hard time). - Cam
Posted by bubblegumchewer on July 31, 2002, at 12:34:39
In reply to Re: Question for Sunnelly » bubblegumchewer, posted by CamW. on July 30, 2002, at 18:16:24
Hey, thanks! I'll look into that "liquid death" stuff. Incidentally, dry mouth is not much of a problem and dry eyes is not... I think I just tend on the slow side, bowel wise. Thanks for the suggestion.
This is the end of the thread.
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