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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by hansi555 on March 20, 2009, at 12:16:32
Hi
I am currently building up my Nortriptyline dosage from 85 mg to 125 mg.
Before that I was taking 20 mg Lexapro and 85 mg Nortriptyline resulting in a constant can-not-get-100%-happy-feeling, my PD said that Lexapro was to blame for this and we therefore decided to go for Nortriptyline on its own, tappering off Lexapro over a 7 week period.When tappering to around 8-12 mg Lexapro (and still 85 mg Nort) I was feeling quiet good for several weeks, I was my own real me.
After reaching around 3-4 mg Lex and below my mood has been more and more sad/depressed and its now 4 weeks since I took the last Lex pill.A blood test when taking 85 mg of Nort only showed a concentraion of 157 and the therapeutic window is 190 - 570. When I was on 20 mg Lex and 85 mg Nort the concentration was 292.
So the logic says something like 125 mg of Nort...
But I have this feeling Nort will not work properly on its own.
What are your experiences with Nort on its own?I know that Nort is weak in regards of Serotonin effect but what does this mean?
How long should I wait to see the full effect of Nortriptyline?
I have gone from 85 to 125 mg in 20 days, and so far it hs been more downs than ups..
I am also taking 15 mg Remeron at bed time for sleep.
I am stress burnt-out and have unipolar depression.All comments welcome
Posted by Phillipa on March 20, 2009, at 12:36:34
In reply to Nortriptyline on its own - what to expect?, posted by hansi555 on March 20, 2009, at 12:16:32
Is it possible that the low dose of lexapro combined with the dose nortriptyline you were taking when you felt good is a good combo for you that the lexapro SSRI was just the right combo for you? Phillipa
Posted by hansi555 on March 20, 2009, at 12:59:43
In reply to Re: Nortriptyline on its own - what to expect? » hansi555, posted by Phillipa on March 20, 2009, at 12:36:34
> Is it possible that the low dose of lexapro combined with the dose nortriptyline you were taking when you felt good is a good combo for you that the lexapro SSRI was just the right combo for you? Phillipa
Yes everything is possible. I am more curious to if the Nort can work on its own.
Nort could augment Lex - or is it the other way round?
Posted by mav27 on March 20, 2009, at 15:09:49
In reply to Nortriptyline on its own - what to expect?, posted by hansi555 on March 20, 2009, at 12:16:32
Well seratonin is usually regarded as being responsible for the sadness/depresion ect so ifyu are getting that back when lowering the lexapro then it seems like you may need some sort of seratonin drug. Nortriptyline which has very weak sertatonin efects as isprimarily noradrenaline is responsible for things like Energy. Nortriptyline on it's own made me quite agitated and didn't help the sadness. If the nortriptyline is having benifits though but you are feeling sad you could ask to change to amitriptyline which effects bother seratonin and noradrenaline (nortriptyline actually comes from amitriptyline as a metabolite) Amitriptyline has more side effects though typical of TCA's, making you sleep is one of the strong effects of it.
Posted by bleauberry on March 20, 2009, at 20:13:13
In reply to Nortriptyline on its own - what to expect?, posted by hansi555 on March 20, 2009, at 12:16:32
Maybe go up to 5mg Lex or 10mg Lex along with the Nortriptyline? That is a true SNRI, except you have the ability to finetune the NE and the 5HT components to your liking.
Check out Dr Gillman's writings at PsychoTropical Research. I think you'll be encouraged to know you were on the right track with the two meds combined, but maybe the Lex was too high, and now it is too low.
Posted by desolationrower on March 21, 2009, at 0:21:25
In reply to Re: Nortriptyline on its own - what to expect?, posted by bleauberry on March 20, 2009, at 20:13:13
it might just be the ssri withdrawal reaction, that fades with more time.
-d/r
Posted by hansi555 on March 21, 2009, at 5:26:56
In reply to Re: Nortriptyline on its own - what to expect?, posted by desolationrower on March 21, 2009, at 0:21:25
> it might just be the ssri withdrawal reaction, that fades with more time.
>
> -d/rWell, I have thought the same but how long should I expect then? It has been 5 weeks now without Lex.
Posted by hansi555 on March 21, 2009, at 8:37:03
In reply to Re: Nortriptyline on its own - what to expect?, posted by bleauberry on March 20, 2009, at 20:13:13
> Maybe go up to 5mg Lex or 10mg Lex along with the Nortriptyline? That is a true SNRI, except you have the ability to finetune the NE and the 5HT components to your liking.
>
> Check out Dr Gillman's writings at PsychoTropical Research. I think you'll be encouraged to know you were on the right track with the two meds combined, but maybe the Lex was too high, and now it is too low.Thanks a lot for that, a true gold mine of info this web site PsychoTropical.
When I took 85 mg Nort and 20 mg Lex combined, the concentration value for Nort was 297, with NO Lex dose it was 157, almost half, just by taking away Lex (the window is 190-570).
Now I am at 125 mg Nort, feeling slightly dizzy and tired, taking 80 mg at bed time and 45 mg in the morning. Some ups and downs almost everyday.
I am seriously considering adding Lex again as suggested, but I guess I have to wait some more to see how the Nort dosage suits me, also PD has to agree, question is how long?
Been on 125 mg for 3 days now and gone from 85 to this level during 2½ weeks.
Posted by desolationrower on March 21, 2009, at 14:45:33
In reply to Re: Nortriptyline on its own - what to expect?, posted by hansi555 on March 21, 2009, at 8:37:03
hm, it took me about that muhc time to wean from venlafaxing, so it might still be that. I think the first thing would be getting nort level back up to where it was before, or you won't know which one of the two meds it is that was helping. then at least you will have a clearer idea of what the cipralex was doing. trying to figure things out when changing two variables makes it much harder.
-d/r
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