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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Laney on November 24, 2010, at 16:07:24
I have been on Nortriptyline for a few months now and also on paxil. I'm on 50mg. Nort and 20mg. paxil. Should I increase the Nort? I just feel flat and uninterested in most things. So basically I'm still depressed. Was is Nort like when it's dosed higher?
Thanks!
Laney
Posted by SLS on November 24, 2010, at 17:21:20
In reply to Should I increase the Nortriptyline? From 50-75mg, posted by Laney on November 24, 2010, at 16:07:24
> I have been on Nortriptyline for a few months now and also on paxil. I'm on 50mg. Nort and 20mg. paxil. Should I increase the Nort?
Most people need 75mg. Rapid metabolizers need 150mg.
- Scott
Posted by Phillipa on November 24, 2010, at 20:05:05
In reply to Re: Should I increase the Nortriptyline? From 50-75mg » Laney, posted by SLS on November 24, 2010, at 17:21:20
Hi Laney sorry the combo is no longer working. Darn!!!! Phillipa
Posted by Laney on November 26, 2010, at 11:46:02
In reply to Re: Should I increase the Nortriptyline? From 50-75mg » Laney, posted by SLS on November 24, 2010, at 17:21:20
How would I know if I were??
Thanks!
Laney
Posted by ed_uk2010 on November 27, 2010, at 12:18:23
In reply to Scott: Rapid Metabolizer?, posted by Laney on November 26, 2010, at 11:46:02
> How would I know if I were??
You won't be while you're on Paxil.
Posted by SLS on November 27, 2010, at 14:43:08
In reply to Re: Scott: Rapid Metabolizer?, posted by ed_uk2010 on November 27, 2010, at 12:18:23
> > How would I know if I were??
>
> You won't be while you're on Paxil.I was once on Paxil plus desipramine. If I had to guess, I would say that I had to cut my dose of desipramine in half when I added Paxil.
- Scott
Posted by Phillipa on November 27, 2010, at 19:35:39
In reply to Re: Scott: Rapid Metabolizer?, posted by SLS on November 27, 2010, at 14:43:08
What does paxil do to cause not a rapid metabolizer? I took it first one two years? Phillipa
Posted by ed_uk2010 on November 28, 2010, at 7:33:16
In reply to Re: Scott: Rapid Metabolizer?, posted by Phillipa on November 27, 2010, at 19:35:39
> What does paxil do to cause not a rapid metabolizer? I took it first one two years? Phillipa
Paxil inhibits specific drug-metabolising enzymes in the liver.
NB. The effect stops when you come off Paxil.
Also, we're talking about the metabolism of drugs only, not food or anything else.
Posted by Phillipa on November 28, 2010, at 18:55:51
In reply to Re: Scott: Rapid Metabolizer?, posted by ed_uk2010 on November 28, 2010, at 7:33:16
Ed I don't understand what you mean are you saying paxil is different from other SSRI's? I didn't gain an ounce when on it. I understand the food part. PJx
Posted by Laney on November 29, 2010, at 10:56:07
In reply to Re: Scott: Rapid Metabolizer? » ed_uk2010, posted by Phillipa on November 28, 2010, at 18:55:51
Thanks for your responses and is paxil the only med or the only SSRI that does this?
Thanks!
Laney
Posted by ed_uk2010 on November 29, 2010, at 14:31:46
In reply to Re: Scott: Rapid Metabolizer? » ed_uk2010, posted by Phillipa on November 28, 2010, at 18:55:51
>Ed I don't understand what you mean are you saying Paxil is different from other SSRIs?
Paroxetine inhibits certain drug metabolising enzymes in the liver, as does fluoxetine. Citalopram and sertraline have much less effect on liver enzymes.
>I didn't gain an ounce when on it. I understand the food part.
I'm talking about drug metabolising enzymes, not metabolism of food.
Posted by ed_uk2010 on November 29, 2010, at 14:32:29
In reply to Re: Scott: Rapid Metabolizer?, posted by Laney on November 29, 2010, at 10:56:07
>Thanks for your responses and is paxil the only med or the only SSRI that does this?
No, fluoxetine also inhibits CYP2D6.
Posted by Conundrum on November 29, 2010, at 19:57:36
In reply to Re: Scott: Rapid Metabolizer?, posted by ed_uk2010 on November 29, 2010, at 14:32:29
> >Thanks for your responses and is paxil the only med or the only SSRI that does this?
>
> No, fluoxetine also inhibits CYP2D6.
>
>Also I think amitriptyline and imipramine have some liver interactions. I don't know for sure what enzymes, but you can ask your doctor, or look it up if interested.
This is the end of the thread.
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