How to Coach Yourself and Others Coaching and Counseling in Difficult Circumstances | Page 44
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• With TCAs, overdose attempts are serious and often fatal due to cardiac complications. The symptoms of overdose
include: agitation, confusion, drowsiness, difficulty in breathing, convulsions, bowel and bladder paralysis, dilated
pupils, and disturbances with the regulation of blood pressure and temperature.
• Tranylcypromine (a MAOI) by virtue of its amphetamine-like properties has a high abuse potential. Take
extra care to ensure that the drug is given to, and taken by, the right patient.
• With MAOIs, dietary restrictions are necessary to prevent a tyramine-induced and potentially fatal
hypertensive crisis. Tyramine is found in many common foods. Patients should not take any other drug at all
(including over-the-counter cough and cold remedies) without consulting a doctor. If a throbbing headache
develops, medical attention should be sought immediately.
• Most people may need to continue taking antidepressants for at least 4 months and some may need to continue
for 12 months or more, especially if they have been depressed more than once, to reduce the chance of
relapse.
• Antidepressants should not be stopped suddenly, even if the patient feels better. Their depression may return.
In addition, they may experience ‘discontinuation’ symptoms. At worst, these could include headache,
restlessness, diarrhoea, nausea, ’flu-like symptoms, lethargy, abdominal cramps, sleep disturbance and mild
movement disorders. These are usually short lived and can even occur with missed doses.
• Despite the discontinuation symptoms, antidepressants are not addictive because they do not produce craving
for the drug, or tolerance (ie needing more of the drug to get the same effect).
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