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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by JohnX2 on February 11, 2002, at 14:22:35
I'm thinking if I ever was to venture onto
a new anti depressant, I would try a tricyclic
and Nortyptyline would be the one based off the
trends of posts I have read on pbabble.So my question is, what are the trends in terms
of side effects? I know that I could experience
totally different effects, but I just want to get
a feeler for what other people have experienced.
I guess I kinda have stigmatized the tricyclics as
being evil thinking that there must be a good reason
that we came out with all these smart selective
reuptake inhibitors.Thnx for sharing your experiences.
-John
Posted by johnj on February 11, 2002, at 16:02:05
In reply to Nortryptyline experiences?, posted by JohnX2 on February 11, 2002, at 14:22:35
John,
I have been on nortryptyline for over 9 years at 50 mg. Anything above that and the side effects are terrible for me. I orginally started out at 100mg and was above the theraputic window. I also take lithium to boost the AD. IMO I would try something different like remeron or serzone. As of today I will take my first dose of remeron. I started having problems again and need something without the side effects. Overall, nortryptline has worked ok, but the dry mouth, weak urination, and constipation can be very bad. It has helped my anxiety too. I will chance the remeron because the weight gain is something I can control by limiting certain foods and excercise. I have never tried any SSRI's due to people saying they poop out a lot. Plus, I don't want any sexual side effects. I am not sure what is the best and I hate to be drug dependent, but I guess I have no choice. I wish they could clean up the TCA's since I believe they work pretty decent. I feel better at 75 mg, but the side effects are harsh. Again, that is me so you might want to give it a shot. I have heard good things about amitrypline too. Hope this gives you some idea of what that med is like.
take care
Posted by Bob on February 11, 2002, at 16:55:36
In reply to Re: Nortryptyline experiences?, posted by johnj on February 11, 2002, at 16:02:05
"I wish they could clean up the TCA's since I believe they work pretty decent."
I think that unfortunately this is a pipe dream. I don't think they've come out with a new tricyclic in a LONG time, and I'd be mighty surprised if anyone is doing research into them. I can't see the drug companies marketing a new one of them - they're perceived as especially evil now that SSRIs are here. Everything changes as time goes on. If they ever get a new "class" of drugs then SSRIs will look like crap.
Posted by JohnX2 on February 11, 2002, at 18:45:55
In reply to Re: Nortryptyline experiences?, posted by johnj on February 11, 2002, at 16:02:05
thnx for sharing your experience.
I really appreciate it.
I have tried Serzone in the past and also
Remeron. Basically I've done all the standard
ADs. If I retested a standard AD I probably would
go with Zoloft or Wellbutrin. These two meds were
very tolerable. The problem I had was that after
I got an anti-depressant response, the medication
would do weird things, poop out and trigger myofacial
pain. Since then I have been correctly diagnosed
as Bipolar and put on a good array of mood stabilzers
one of which cures my myofacial pain syndrome.
Anyways, thanks again for sharing the experience.
I hope you are doing well.Btw, is there a specific reason you recommend
Serzone or Remeron? Serzone wasn't too bad for me,
but it caused really bad cognitive problems. Again
if I tried it with my other meds I might get a new
response a 2nd time around. Remeron I tried with
my main mood stabilizer, but did not get an
anti-depressant boost.Regards,
John> John,
> I have been on nortryptyline for over 9 years at 50 mg. Anything above that and the side effects are terrible for me. I orginally started out at 100mg and was above the theraputic window. I also take lithium to boost the AD. IMO I would try something different like remeron or serzone. As of today I will take my first dose of remeron. I started having problems again and need something without the side effects. Overall, nortryptline has worked ok, but the dry mouth, weak urination, and constipation can be very bad. It has helped my anxiety too. I will chance the remeron because the weight gain is something I can control by limiting certain foods and excercise. I have never tried any SSRI's due to people saying they poop out a lot. Plus, I don't want any sexual side effects. I am not sure what is the best and I hate to be drug dependent, but I guess I have no choice. I wish they could clean up the TCA's since I believe they work pretty decent. I feel better at 75 mg, but the side effects are harsh. Again, that is me so you might want to give it a shot. I have heard good things about amitrypline too. Hope this gives you some idea of what that med is like.
> take care
Posted by spike4848 on February 11, 2002, at 19:06:04
In reply to Re: Nortryptyline experiences? » johnj, posted by Bob on February 11, 2002, at 16:55:36
> I think that unfortunately this is a pipe dream. I don't think they've come out with a new tricyclic in a LONG time, and I'd be mighty surprised if anyone is doing research into them. I can't see the drug companies marketing a new one of them - they're perceived as especially evil now that SSRIs are here. Everything changes as time goes on. If they ever get a new "class" of drugs then SSRIs will look like crap.I think alot of pdoc are swinging back to the TCAs for the large group of folk not responding to SSRI/effexor .... they can be remarkably effective for many patients .... and some will never give up their TCA med for a SSRI. They would rather have dry mouth, weight gain and constipation instead of insomnia, sexual dysfunction, nausea, diarrhea, anxiety.
Spike
Posted by Ritch on February 11, 2002, at 20:05:35
In reply to Nortryptyline experiences?, posted by JohnX2 on February 11, 2002, at 14:22:35
>
> I'm thinking if I ever was to venture onto
> a new anti depressant, I would try a tricyclic
> and Nortyptyline would be the one based off the
> trends of posts I have read on pbabble.
>
> So my question is, what are the trends in terms
> of side effects? I know that I could experience
> totally different effects, but I just want to get
> a feeler for what other people have experienced.
> I guess I kinda have stigmatized the tricyclics as
> being evil thinking that there must be a good reason
> that we came out with all these smart selective
> reuptake inhibitors.
>
> Thnx for sharing your experiences.
>
> -JohnIt was the easiest TCA for me to tolerate. The only one I could take during the day(and still think-have'nt tried protriptyline). Seemed to work best in combo with Wellbutrin or Celexa. In combo with Zoloft I got some pretty nasty headaches-but WOW did my attention improve. Also, simultaneously had an anxiolytic effect and BTW, it downregulates 5-HT receptor density, but isn't very serotonergic.
The big plus with it is much reduced orthostatic hypotension than the other TCA's.
Mitch
Posted by johnj on February 11, 2002, at 20:07:10
In reply to Re: Nortryptyline experiences? » johnj, posted by JohnX2 on February 11, 2002, at 18:45:55
The only reason I talk about Serzone and Remeron is that the research I have done and to the people I have talked to have me swayed a bit in their favor. One big attraction is the less harsher side effects. Who knows, maybe after I take remeron I will hate it and be back on a TCA. But, some people say the side effects are tolerable. Well, at 100 mg of nortryptline it felt as if I was crapping out a brick. I don't drink, smoke and RARELY eat junk food. I eat lots of fruit and veggies and still felt like I ate a pound of cheese. Plus, I had to have lithium added as a booster and they both cause weight gain so I might as well give remeron a chance. If I can get more energy out of a new one with less side effects I can excercise more to combat the weight gain. Serzone only scares me because of the possible liver problems.
For me, if I sleep I feel better plain and simple. If I don't sleep I am useless so remeron is what the doc suggested. Again some side effects disappear but mine would reoccur with vengence some times. When my urination time is twice that of the 70 year old guy next to me it is disturbing. I can't wait for the day things are more tailored for the person and I hope to see that in my lifetime. YOu might have already see it but the company that makes remeron (Organon) has some interesting info about what they are working on. Neurocrine has some good stuff too. What are you taking now?? Take care
john
Posted by Chloe on February 11, 2002, at 20:49:21
In reply to Nortryptyline experiences?, posted by JohnX2 on February 11, 2002, at 14:22:35
> I'm thinking if I ever was to venture onto
> a new anti depressant, I would try a tricyclic
> and Nortyptyline would be the one based off the
> trends of posts I have read on pbabble.
>
> So my question is, what are the trends in terms
> of side effects? I know that I could experience
> totally different effects, but I just want to get
> a feeler for what other people have experienced.
> I guess I kinda have stigmatized the tricyclics as
> being evil thinking that there must be a good reason
> that we came out with all these smart selective
> reuptake inhibitors.
>
> Thnx for sharing your experiences.
John,
I take 10-20 mgs of amitriptyline (nortrip is amitriptyline's metabolite. Hence nortrip. will have less side effects than ami..) hs. I love it. It really helps with anxiety, sleep and to my surprise depression at that low dose. I really don't notice any side effects. I think the TCA's are great as polytherapy. I know if I had to take the full dose of ami (150-300mgs), I would be plowed over by the anticholinergic side effects. I also take 1.5 mgs of celexa daily, which is all I can tolerate of the SSRI's...I am BP2So, IMHO, I think low dose or adjunct TCA therapy is underrated. You also mentioned you have some myofacial pain. Ami has helped alot with my neuropathic scalp pain. So these noradregenic meds be helpful to you in that area too.
Take care,
Chloe
Posted by Bob on February 11, 2002, at 23:04:49
In reply to Re: Nortryptyline experiences? » JohnX2, posted by Chloe on February 11, 2002, at 20:49:21
How do you manage to dose out Celexa at a 1.5mg level?
Posted by Bob on February 11, 2002, at 23:08:42
In reply to Re: Nortryptyline experiences? » Bob, posted by spike4848 on February 11, 2002, at 19:06:04
Don't the TCAs cause sexual dysfunction? I took Anafranil and it shut me down big time.
Posted by Chloe on February 12, 2002, at 18:01:21
In reply to Re: Nortryptyline experiences? » Chloe, posted by Bob on February 11, 2002, at 23:04:49
> How do you manage to dose out Celexa at a 1.5mg level?
Bob,
Celexa comes in an elixir form, too. 1cc of liquid is equal to 2 mgs. With a syringe, it's easy to measure out the proper amount.Chloe
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