WarmWaterDiver
Contributor
Lloyd:
I thought high PO2 levels in and of themselves are well documented to have high risks of inducing seizures - my profiles are to avoid high PO2 levels in the first place.
Amitriptyline for pain?
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I thought high PO2 levels in and of themselves are well documented to have high risks of inducing seizures - my profiles are to avoid high PO2 levels in the first place.
H2Andy
Contributor
i think lloyd means that even within recreational PO2 levels (i.e. below 1.4-1.6) there
is an increased risk of toxicity and/or seizures if you are on certain meds.
there was a thread about this somewhere, but i can't find it right now.
is an increased risk of toxicity and/or seizures if you are on certain meds.
there was a thread about this somewhere, but i can't find it right now.
WarmWaterDiver
Contributor
Hmmm - I didn't see anything in the DAN links regarding additional risk of seizure associated with this medication and increased PO2 levels, beyond what risks already exist at increased PO2 levels. My dive physician isn't aware of such a link either - but it does demonstrate how non-quantified words like 'high' and speculation can grow things on their own. And, using sense and training (those PO2 levels were set based on scientific evidence and history going back to cassion workers) really appears to mitigate the issue, based on available published work. Medical opinion is opinion, and I welcome any links to study data for this medication and increased PO2 levels and risks that are magnified. I'm open to reviewing data.
H2Andy
Contributor
ok, this is not the one i was looking for, but, for example, Sudafed has been linked
to seizures at higher P02's:
http://www.scubaboard.com/showthread.php?t=63586&page=1&pp=10
i've never heard of amitryptoline being linked to PO2 problems; was just saying some meds have been.
to seizures at higher P02's:
http://www.scubaboard.com/showthread.php?t=63586&page=1&pp=10
i've never heard of amitryptoline being linked to PO2 problems; was just saying some meds have been.
WarmWaterDiver
Contributor
Thought the title of thread was specific on which medication . . .
H2Andy
Contributor
you're welcome
WarmWaterDiver
Contributor
Thanks for being back on topic - and I didn't see anything relating amitriptyline to increased risks at increased PO2's in Doc Vikingo's article the link in post #5 on this thread takes one to - I've seen the article before in links in posts made by Doc V. here. Doc does briefly discuss theoretical potential of increased suceptibility to HPNS (not O2 toxicity) for SSRI's (not tricyclics) near the bottom of Page 5 of the article the link in post #5 takes one to, but then also states the postulated link for caffiene and O2 toxicity was found to be exactly opposite expected when tested on rats.
I'm still open to data - but Doc V.'s article shows only Dramaine has had such testing, and it was for relationship to partial pressures of nitrogen, at the time the article was published.
My position is I review medications prescribed to me with my physician - and think this is appropriate for anyone.
I'm still open to data - but Doc V.'s article shows only Dramaine has had such testing, and it was for relationship to partial pressures of nitrogen, at the time the article was published.
My position is I review medications prescribed to me with my physician - and think this is appropriate for anyone.
derwoodwithasherwood
Contributor
buddyfan:
Disclaimer: I am not a doctor, nurse, pharmacist or any other professional qualified to give any advice in this field. Normally I would not think to offer any advice about a drug, but in the case of amitriptyline...
SWMBO was prescribed amitriptyline at a very low dose (10mg/day) for post-op pain a few years ago. And it seemed to work. A few months later she started to have vivid daydreams. We discussed it with the doctor and he did check the medical references to see if it could be the amitriptyline (among many other possibilities). Things continued to deteriorate and the daydreams turned into hallucinations. A psychiatrist was brought into the picture (who dismissed 10mg as a "baby dose" not worthy of consideration) and various anti-psychotics were tried with limited to no effect. Our lives were hell.
I started some intense research of my own. It piqued my interest to note that, of all the drugs she was taking, amitriptyline was known for interactions with other drugs. I was shocked to discover that the "long term" tests of amitriptyline were merely 6 weeks in duration, and that it was only ever tested for interactions with ONE other drug at a time (I read all the studies and monographs). No one knows what could happen if it is taken along with two or more other drugs, they just assume that if it's statistically safe for 6 weeks with drug A and also statistically safe for 6 weeks with drug B, then it's fine to take it indefinitely with A and B together. She was on a couple of other prescriptions associated with her underlying condition and then the psychoactive drugs made things even worse. To make a long story short, we stopped the amitriptyline and suddenly things started to get better. She's now about fully recovered.
SWMBO's case is undoubtedly unusual. Still, I would be very cautious about partaking in any activity where judgement could be impaired (like, say, nitrogen narcosis) especially if you are taking any other drugs alongside that amitriptyline. 60' below the surface is not a good place to start racing emus and chipmunks.
derwoodwithasherwood:
Welcome to drug safety testing. That's why postmarketing surveillance is so important.
It's unreasonable to expect pharmaceutical companies to test every new drug with every drug combination possible. That's why it's important for physicians to have a reasonable understanding of pharmcokinetics & drug metabolism, so that when rare occurences like the one you experienced happen, you have the greatest chance of logically deducing the culprit. Of course, some side effects just happen "unexpectedly," and those really should be reported to FDA.
Jim
WarmWaterDiver
Contributor
My daydreams involve becoming independantly wealthy, leaving work behind, and buying my own private warm water area island, catching lobster for supper in warm clear water. I'll leave the emus and chipmunks to others - to each his own tastes.
FYI, the DAN links do list, in DAN's own print,
"Possible side effects that may be adverse to diving:"
I'm not a physician either, but I certainly wouldn't want to be on a public road in my vehicle with someone else in their vehicle behind the wheel while they're hallucinating racing emus and chipmunks - the statistical data and law of conservation of momentum would indicate this to be a more likely and more damage potential scenario, given the population distribution of drivers vs. divers.
FYI, the DAN links do list, in DAN's own print,
"Possible side effects that may be adverse to diving:"
I'm not a physician either, but I certainly wouldn't want to be on a public road in my vehicle with someone else in their vehicle behind the wheel while they're hallucinating racing emus and chipmunks - the statistical data and law of conservation of momentum would indicate this to be a more likely and more damage potential scenario, given the population distribution of drivers vs. divers.
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