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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by vince on April 8, 2001, at 1:20:35
I've been taking Neurontin for about 2 1/2 months now. It has helped some. It mainly helps me with what I call psychological pain. (I think this pain may be what is technically labeled as dysphoria). But Neurontin doesn't help with all my symptoms of depression. So about three weeks ago my doc added in a combination of Prozac and nortriptyline because ssri/tca is one combination that I haven't tried. So now I’m taking Neurontin, Prozac and nortriptyline. I've found that the nortriptyline causes me to feel very sleepy and extremely lazy the next day. I just flop down anywhere and snooze. Even when I do wake up, I feel too tired to do anything. I don't remember being this tired on tca's in the past, but it’s been a long, long time since I've used them. Maybe when I was younger this symptom wasn’t so noticeable. I would like to give this combination a fair trial but I can’t tolerate this much somnolence.
Question: I have some adrafinil that I bought a couple of months ago but haven't tried yet. I'm hoping that it might remedy the somnolence caused by the nortriptyline. Does anyone have any idea as to whether there might be an adverse reaction between adrafinil and the ssri/tca mix? Would there be any undesirable overlap in brain chemistry between say the nortriptyline and the adrafinil, e.g. norepinephrine?
Another option might be switching the tca to desipramine, Is desipramine as sedating as nortiptyline?
Vince
Posted by SalArmy4me on April 8, 2001, at 3:21:01
In reply to Need help, medication advice, ssri/tca/adrafinil, posted by vince on April 8, 2001, at 1:20:35
I'm sure that everyone on this board will concur that desipramine has the least side-effects of the tricyclics.
Why not just try the Neurontin and Prozac together without the nortriptyline? How do you know that these two will not work by themselves?
Posted by vince on April 8, 2001, at 22:30:18
In reply to Re: Need help, medication advice, ssri/tca/adrafinil, posted by SalArmy4me on April 8, 2001, at 3:21:01
> I'm sure that everyone on this board will concur that desipramine has the least side-effects of the tricyclics.
SalArmy, thanks for the response I'll consider having my doctor switch me to desipramine. Right now I'm getting the best of both the ssri and tca worlds, sexual impotence and constipation.
I've read that Desipramine has fewer aniticholinergic side effects than other TCA's but what about weight gain and drowsiness?
>
> Why not just try the Neurontin and Prozac
together without the nortriptyline? How do you know that these two will not work by themselves?I know that, for me, Prozac alone is worthless - unless I decide to become a priest and need to live a celibate life. I've tried Prozac with Lamictal and Prozac with Risperdal without benefit.
The idea here is to combine an SSRI with a TCA to see if the combination does anything. My doctor wanted me to drop the Neurontin for our little ssri/tca experiment but I'm not willing to give up the only thing that has ever made a difference even if the Neurontin only helps partially. That is why the neurontin is in the mix.
Vince
Posted by SalArmy4me on April 9, 2001, at 8:28:03
In reply to Re: Need help, medication advice, ssri/tca/adrafinil, posted by vince on April 8, 2001, at 22:30:18
I was wondering if you had tried carbamazepine XR, because it has a tricyclic structure (that's why its contraindicated with MAOIs).
Posted by vince on April 9, 2001, at 23:19:13
In reply to Re: Need help, medication advice, ssri/tca/adrafinil, posted by SalArmy4me on April 9, 2001, at 8:28:03
> I was wondering if you had tried carbamazepine XR, because it has a tricyclic structure (that's why its contraindicated with MAOIs).
I tried a mood stablizer before lamictal. It was either carbamazepine or valproate. I can't remember which, because it was about two years ago. I was taking it with effexor. I'll have to ask my doctor what it was when I see him again in a couple of weeks.Vince
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