Confusion from TCAs

Sedation and dry mouth are the most common adverse reactions seen with the use of TCAs. Tolerance to these effects develops with continued use. Orthostatic hypotension can occur with the administration of the TCAs. Orthostatic hypotension is a drop in blood pressure of 20 to 30 points when a person changes position, such as going from a lying position to a standing position. Mental confusion, lethargy, disorientation, rash, nausea, vomiting, constipation, urinary retention, visual disturbances, photosensitivity, and nasal congestion also may be seen. Sexual dysfunction may occur with administration of clomipramine. 

Adverse effects of the TCAs on the brain include confusion, impaired memory and cognition and occasionally delirium some of these effects have been reported to occur in up to 30% of patients over the age of 50. These effects may occasionally be confused with a recurrence of the s)nnptoms of depression and are probably due to the central antimuscarinic activity of these drugs. Tremor also occurs frequently, particularly in the elderly, and may be controlled by the concurrent administration of propranolol. Neuroleptics are normally not recommended to be used in combination with TCAs as they are liable to accentuate the side effects of the latter drugs. The risk of seizures, and the switch from depression to mania in bipolar patients, has also been reported following TCA administration. 

Because anticonvulsants calm the activity of the brain, they often produce unwanted side effects such as drowsiness, sedation, dizziness, confusion, loss of coordination, and slurred speech. Some anticonvulsants can produce other side effects, such as nausea, vomiting, constipation, double vision, and even abnormal hair growth. As with TCAs, people suffering from chronic pain often have to try several different anticonvulsants before they find the one that is most effective in relieving their pain while having the least amount of unwanted side effects. 

With both kits, the doctor adds TCA to the base solution to activate the peel the quantity of TCA to be added to the base solution may vary from coimtry to country and from kit to kit. To avoid any confusion, it is best to refer to the volumes that are clearly indicated on the inside cover of each kit. 

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