1979: Tedral Related Depression?

I wrote about my experience with Tedral and Tedral Side Effects. I have come up with another side effect that I think might have been related to Tedral: Depression.

I remember the first time I experienced it was in 1976 when my grandpa Howard died. He was my Great Grandfather, and he was 82-years-old. I did not know him very well, although I did visit him a few times with grandma at the nursing home, and maybe the occasional Christmas party at grandma's house.

So, in November of 1976, he died. And I remember getting severely depressed. It lasted for quite some time. I remember feeling like I wanted to cry even in the days leading up to, and the days following the funeral.

In fact, I remember the class singing "You Light Up My Life" in music, and I had to work hard not to cry.

The same thing happened in 1977. It happened again in 1978. My Aunt Mary worked at K-Mart. They had a special "Blue Light Special" day where those who worked at K-Mart could invite their friends and relatives to this special day where they would have all sorts of deals.

I remember being severely depressed every year this happened. And one year I won a radio. And that sort of ended the depression for a little while. But then it came back.

I learned to dread November. I learned to dread the day of the K-Mart special party because I knew I'd get depressed.

And then, one year, I think it was 1983 or 1984, the depression didn't come. I kept thinking it would, and it didn't. I remember concentrating on not letting the depression come, and it didn't. I prayed. I was so happy when it stopped.

I have, to the best of my knowledge, not been depressed in November ever since.

Mom said that when I was a kid I used to pace the living room for hours. She said she knew I was depressed. I do not ever remember her acknowledging it. I don't ever remember being treated for it until 1985 when I was at the asthma hospital.

Recently, however, as I was thinking about this, and about Tedral, a thought occurred to me: what if I was going through withdrawal symptoms?

I only took Tedral during allergy season, and then I was told (or my mom was told) to stop taking it or to have me quit. See? I probably became addicted to it over the summer. And when they took me off, probably near the end of October or early November, I went through withdrawal symptoms.

No one ever noticed.

Tedral contained theophylline, which is a xanthine just like caffeine. Like caffeine, you can develop both a psychological and a physical addiction to it.

I think it ended because my asthma got so bad that I ended up taking theophylline year round. My doctor switched me to Theovent at some point. I probably only took it in the summer at first. But, by 1984, my asthma was so bad he just kept me on it year round.

So, the depressions ended. They ended because my body developed a tolerance to it. My body expected it to always be there. It expected me to continue putting it into my body. And when I quit, my body had to readjust, hence the withdrawal symptoms; hence the depression.

I know that when I forgot to take my theophylline over the years, it resulted in severe asthma episodes. So, I never experienced depression because, I think, asthma hit before the depression ever did.

Anyway, this is just me thinking here. I could be wrong. There's really no way of knowing.

1979: Tedral Side Effects?

I got to thinking about the horrible side effects of Tedral described by other people my age who used it as a kid to control their allergies/ asthma. Many of them described having hallucinations. At first, I figured these descriptions of side effects were probably just exaggerations. However, there were a few events that occurred in my childhood that make me wonder if I had these side effects too, just blamed them on something else.

Actually, these descriptions were by people older than me. I was just a little kid when I took the medicine, and thankfully it was no longer used by the time I was ten. However, I was unfortunate (or fortunate, depending on how you look at it) enough to get to experience the tail end of its run as a top line allergy/ asthma treatment.

Here is one of the comments (unedited from medschat.com)

I took tedral in the 60's and another drug which was a smaller pill with a brown coating. I suffered mostly unpleasant hallucinations when I was small and they were not always when I was sick. I no longer have the life threating athsma as I did when I was a child. Over time my inquiries about the hallucinations were never answered. So it is interesting to read about others experiences here. I always thought it was a combination of the drugs and the reduced oxygen and air in my body. I think tedral probably saved my life also. The halluncinations very occasionally revisit me as I am falling asleep and if i am becoming ill.

Here's another:

I also took tedral on the late 50's for asthma and experienced similar side effects including hallucinations, but without the medication I'm not sure I would've lived. Our family doctor still made house calls and I can remember her coming to our house at all hours of the night to save my life. She was something else. I think the Tedral was the reinforcement if the adrenalin wasn't able to restore normal breathing.

And another:

Wow!!!!! I have always wondered why I would see the spiders on the ceiling's and what happened to them. I too remember taking the thick yellow asthma medicine (how I googled and ended up here) I used to surround myself with Teddy Bears to protect me. I never knew it was the medicine. I used it as a child 4 years old 1960''s to 1970's when primitine mist came on the market. I now know where my restlessness, inability to sleep and over abundance of energy /hallucinations came from and that I wasn't a bad child just effects of the medicine that I hated to take. Preferred the eperine shot in the arm even as a child.

And...

I thought i was mentally unbalanced. Seeing enlargements of real life in front of me. Increased hearing sensitivity. Shrinking rooms in front of me own eyes. For years thinking it was me. An unbalanced. Self. It all stopped as i got older until one day I was having an asthmatic condition and took the medicine the doctor had me take 3 times a day! Tedral!. The truck in front of my eyes, as i worked on the engine, seemed to shrink like what happened 5 ears previously. when I was taken tedral regularly. I wasn't crazy after all--- It was the medicine! Anyone else experience shrinking heads, feelings of speed' before the term existed? Why was it taken off the market? Everyone have these problems? It would be nice to hear from others about their Tedral experience. This occurred 1952 ...

That's how often I took it, sometimes.

 I don't want to dwell on this, but I do remember hallucinating at nighttime. I remember dreading going to bed sometimes. This was because, just after I was relaxed on the bed, shortly after I closed my eyes, I would still be wide awake but not be able to move. I would become completely paralyzed. These episodes would last several long moments. I would become very panicky, as you might imagine.

I swear I was not dreaming when these occurred. As I noted above, I would dread even attempting to sleep because I was afraid I would have one of these paralytic episodes. I was afraid that the next one might be the one that never went away.

I remember waking up and not wanting to even try going back asleep. I would be wired. I would read a book. I would write. I would even look at my homework and consider doing even that. That's how desperate I was not to go back to sleep.

So, I would finally get tired and would eventually fall asleep. Then I'd have these horrible dreams that I still remember to this day. I remember having this recurring dream about how this monkey would come through my window (even though it was closed) and would try to convince me to go with it. He would be wily and goofy, as monkeys can be. He would tell me how good it was. I would be scared to death of this monkey. I would try to get away. I would look at my door. But, as so often occurred in such dreams, the monkey had the power to paralyze me. I was unable to move for the door.

I would wake up horrified. My heart would be racing. I would go and open the door. I would turn on the light -- but the light would not come on. Sometimes the light came on and popped off, as though the monkey had used his power to make the light bulb burn out. I wanted so bad in these moments to wake mom up. But, they happened so often, that I had better not.

Then, the next morning, the light would work fine.

So, were these events hallucinations due to Tedral?

There were also moments I would be home with the flu. I always thought it was a treat to get to lie in mom's bed, and that's what I got to do when I was sick. However, I remember being so sick on these days that I didn't really get to enjoy it. Not only would I be extremely nauseated, I would also have a headache so horribly bad that I felt my head was going to explode. I would feel so miserable that I would cry. I know mom felt bad for me, but there was nothing she could do. These episodes would last about one day. The next day I would be fine, and I was probably back at school.

Now, it's surely possible these episodes were caused by the flu. However, I have had the flu many times since then, but have never had it that bad. So, this makes me wonder: was it the Tedral? Was it an accidental Tedral overdose?"

I mean, none of these events may have been the medicine. However, considering similar stories I have now read about Tedral, one can't help but wonder.

Anyone out there have any Tedral experiences, please feel free to share your stories in the comments below.

1978: No antihistamines for this asthmatic

I remember my mom specifically telling me when I was a kid that I can't have antihistamines. She said they may cause bronchospasm, and that doctor said so. What my doctor prescribed for me instead was Tedral and salt water drops. That's it!

I remember many times when my nose was so plugged I couldn't sleep. I remember playing outside and my eyes would basically swell shut. Mom would have me lie on the couch, or on my bed, with a cold, wet rag over my eyes. Obviously, this affected my social life.

It also affected my asthma. 

My doctor, according to a 1978 notes my mom took while talking with my doctor on July 14, 1978, I was supposed to take Tedral three times a day, and rinse my nose with salt water drops four times every day. The medicine tasted terrible, and rinsing out my nose with salt water was torture. I hated both. 

It kind of reminds me of something Teddy Roosevelt wrote in his diary about growing up with asthma in the mid 19th century: "The medicine was often tortuous, and was often worse than the disease." I am paraphrasing it here, but that's pretty much what he was saying. I would have to say, that in the 1970s, asthma treatment wasn't much different. 

I can understand why my doctor would not prescribe for me a medicine that probably would have offered me some relief. It goes back to a myth in medicine during the 1950s and 60s that antihistamines, although they offered relief from allergies, dehydrated your lungs. This, it was believed, would cause bronchospasm and asthma.

I think it would have made more sense if they would have prescribed me an antihistamine, such as Marax (I am told it actually tasted good). I could have trialed it to see if it offered a benefit, If it didn't, or if my asthma got worse while taking it, I could have stopped. But this trial never happened. Instead, based on a myth, I suffered.

Now, by 1976, this myth was on the way out the door. The down side here is that most doctors were educated back in the 1950s, when the myth was taught in medical schools. Unless they kept up to date on their studies about asthma and allergies (and asthma was considered an allergic disease back then), doctors -- such as my doctor -- would have prevented themselves from prescribing antihistamines to asthmatic kids such as myself. 

An article in the January, 1968, edition of the Journal of the National Medical Association makes light of this myth. 

Antihistamines. The use of antihistamines in asthmatic children has been condemned in the past. In theory, they should be valuable in counteracting the effect of one of the principal allergic mediators-histamine. However, they do dry secretions and possibly, aggravate the patient with asthma. Practically speaking, some small children with pollen allergy do respond to antihistamine. But, generally, they are not effective in reversing bronchospasm. (1)

I did not start using antihistamines until I was over 18. They worked great, and have never induced asthma. I suppose I could hate my doctor and parents for not allowing me to have them, but I'm not. This is just one of those life lessons you learn as you grow older. You do the best you can with the wisdom you have today, and as you learn better you do better.

References:

1. LeNoir, Michael A., Lawrence D. Robinson, outpatient management of an asthmatic child, Journal of the National Medical Association, January, 1976, page 46-50, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2609533/pdf/jnma00473-0072.pdf, accessed 2/22/17

1978: Tedral and Brondecon

During the late 1970s, there was a medicine mom gave to me when I was having trouble breathing. I remember standing just inside the bathroom door watching mom opening the medicine cabinet above the sink, grabbing the bottle, pouring some of it on a teaspoon, and feeding it to me. I remember it tasted nasty.

I do not remember if it worked. I do not remember any side effects. However, it must have worked, because I do remember asking for it. I do remember my mom observing that I was sniffling, sneezing, and wheezing, and taking me to the bathroom to take my medicine. I do remember going on vacation and forgetting to take my medicine, and then having to deal with an asthma attack with nothing to take for it other than a cough drop.

I had been thinking of this medicine for a couple years. I asked my mom about it, and she has no memory of doing this, let alone what medicine it might have been. Ironically, a few days ago I was talking to one of my fellow-asthmatic co-workers about asthma medicines we took as a kid, and she said that she took a medicine called Tedral. She said it was nasty tasting, but it worked.

The next morning I woke up around 4 a.m. and an epiphany occurred to me that I should go into the basement and look at my asthma books mom put together for me. I just re-organized them about a year ago. The books mom put together were made of acid, and many of the papers and pictures she saved were no longer bound to the pages. So I bought an acid-free picture book and remedied the situation, saving what my mom worked so hard to put together for the future version of me (the me of today -- the nerdy amateur historian).

I opened up a green storage bin and was thrilled to find the picture book right on the top. I set it on the table, sat down, and began to flip through the pages. Only a few pages in I found what I was looking for: a note from my mom dated July 14, 1978.  As a bonus, a picture of me at that age was next to the date (you can see the note and a picture of me at age 8 below)

I had looked at it many times before, but never thought to actually read it until just now. My mom was a note taker. After my doctor's appointments, I would wait in the hallway while mom talked to my doctor in his office without me. Mom would take notes. Considering I was the sickly one in the family, this was probably necessary.

You can see the note below. Item #5: "I teaspoon Tedral or Brondecon 2 p.m., 6 p.m. and 10 p.m.to August 28th."

There are a four reasons why Dr. Gunderson ordered for me to stop taking it in August. First, Tedral was recommended for asthma and seasonal allergies. So, it must have been estimated that the pollen season (hay fever) was the cause of my asthma.

Second, asthma at this time was treated as bronchospasm, and the treatment was bronchodilators. The most common one to start with was theophylline. The products Dr. Gunderson was most comfortable prescribing to kids were Tedral and Brondecon. A medical journal from 1976 described asthma as follows:

"Asthma, as a pathologic process, involves change in the terminal bronchiole. Components of the disease include mucous plugging, mucosal edema, and bronchospasm... Bronchospasm is reflected by varying degrees of respiratory difficulty and wheezing. It is important to realize that significant bronchospasm must be present before respiratory difficulty or wheezing becomes clinically apparent." (1)

Third, asthma at this time was treated as an acute disease, meaning that it was only treated when symptoms were observed. Once symptoms went away, or when asthma went back into remission, treatment was stopped.

Fourth, asthma was considered an allergic disease. Note the following description from the same article referenced above:

IgE antibody develops in response to exposure to specific antigens in susceptible individuals... . Once the antibody forms, it circulates in the serum and ultimately finds its way to the surface of mast cells throughout the body. When the patient is subsequently exposed to the antigen, it combines with this IgE antibody. The reaction results in the release of allergic chemical mediators. These substances are released in various locations throughout the body causing vascular permeability, vasodilation and bronchospasm. When these reactions occur in the lungs in significant quantity, asthma results."

The authors of the article recommended starting with one bronchodilator, and usually with a theophylline product. There were various theophylline products on the market, with Tedral being one of the most popular. It was a combination drug that was available over the counter. It included theophylline, ephedrine, and phenobarbital.

Both theophylline and ephedrine were bronchodilators. While they worked to open airways, they also cause side effects, such excitement, hyperactivity, and insomnia. Phenobarbital was a sedative, added to the product in an effort to reverse some of the side effects of the other medicines.

As I searched the Internet, I found quite a few discussions about Tedral, including one at medchats.com.

As I noted earlier,  I was too young at this time to remember any adverse effects. However, I do remember being hyperactive, excitable and having trouble sleeping. I also remember having some horrible dreams. Whether these were a side effect to medicines I would have no idea, but one can't help but to assume that this is a strong possibility.

I thought it would be neat here to publish some of the comments noted by various people about taking Tedral. Here are some of the ones I found the most interesting.

1. When I was a kid I had asthma, and I had some yellow medicine that had a vaguely medicinal flavor, with a nasty alcohol kick, and the texture of snot, no kidding. I used to try to hide the wheezing to put off the moment when I'd have to take some Tedral. from 2001, 35 YO
2. It tasted like black licorice and was black and gross. It was a yellow elixir. Side effect is increased adrenaline. May cause excitability and trouble sleeping. Tremors are another side effect. Heart racing and nausea signs of side effects. I remember days when I would have horrible headaches and nausea, and I now wonder if I had overdosed on this medicine. possible. I gagged because of the horrible taste. "I felt like I had so much energy I couldn't sit still. Some people note hallucinations and confusion. Thick yellow asthma me
3. "I always wondered what happened to the spiders running around the ceiling when I was a child drinking thick yellow asthma m medicine. I thought it was only me and they were real. Used to use Teddy bears to protect me. Used from 4 years old until Primetine Mist came out
4. I had asthma as a child for several years...was allergic to a bunch of things...pollen, dust, citrus, horse hair etc...This would have been maybe from about 1959 to 1966. I had extreme agitation and felt so hyped up. I hated the feeling. Sometimes wasn't sure which was worse...the gasping and wheezing from the asthma or the "speed" like feeling from the Tedral...(Milky looking liquid...syrupy...tasted like licorice).
5. I took it in tablet form as a kid in the 50s and 60s. My mother, who also took 
it, described the taste of the tablet (if she didn't swallow it fast enough) as
a dirty streak across her tongue. I agreed then and can still remember it.
Yuck! And if it didn't work, there was always a doctor's visit (ah, those were
the days!) or a trip to ER.

These descriptions seem to fit my memories. Add in the note my mom put in my picture book, and my memory of taking a medicine that tasted horrible, and I bet Tedral was the medicine I remember. This might also explain why I abhor the taste of licorice.

Here are some descriptions from random people about taking Brondecon. 

1.  I remember "cherry flavoured Brondecon - a bronchitis medicine I used to have as a kid. My gawd..........it was one of those medicines that you used to still be able to taste hours afterward. I think it MAKES you get better by means of scaring you into 4 hourly rituals of tasting this horrid glomp."
2. When I was a lid my dad swore by Brondecon as a sure-fire remedy for a cough. We had a huge bottle of "Wild Cherry' flavoured hell on top of the fridge.

So, it was one of these medicines I took as a kid. As I noted earlier, I remember going on a vacation and forgetting my medicine. Considering how terrible it must have tasted, perhaps I forgot it on purpose.

As a side note here, I remember grimacing each time I was spoon fed this medicine. I remember one time mom was excited to tell me she got a different medicine. In retrospect, I bet it was Brondecon. It had a powerful taste. I remember grimacing and telling mom it was also terrible, like when we got a fluoride treatment at the dentist.

I also remember mom getting annoyed with me for saying this, and saying something like, "Well, these are the only options if you want to breathe."

"But it's nasty," I wined.

"Then I'll just get the other stuff, because it's cheaper!" she chimed.

This got me to thinking. I decided the new stuff, while nasty in and of itself, was better than the older stuff. So I decided to tolerate it. This strategy worked fine until, one day, she spoon-fed me the horrible stuff again. Needless to say, I was disappointed. I don't remember why she switched back, but at the time I figured it was because I complained. In reality, however, and knowing my mom's frugal (if not parsimonious) tendencies, I bet Tedral cost less.

Both Tedral and Brondecon were marketed by Warner-Chilcott. Both these medicines were available over the counter. Both were discontinued in 2010.

On the note you will also see # 6, which states, "Salt water nose drops 4 times daily to August 28." I hated doing that too. Can you imagine putting salt water up your nose? Yeah! Imagine being 8 YO and doing this, and not even feeling any different when you were done torturing yourself.

You can see advertising for both Tedral and Brondecon in this 1968 edition of "Diseases of the Chest." There is also an article called "Asthmatic Bronchitis" which lists various other theophylline products, including Marax, of which, I am told, tasted pretty good. 

When I showed this picture to my 8 YO daughter Laney, she said, "You look kind of nerdy in that picture." 

References:

1. LeNoir, Michael A., Lawrence D. Robinson, outpatient management of an asthmatic child, Journal of the National Medical Association, January, 1976, page 46-50, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2609533/pdf/jnma00473-0072.pdf, accessed 2/22/17
2. Official Publication of the College of Chest Physicians, Diseases of the Chest, vol. 53, No. 1., see advertisements for Brondecon and Tedral.