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Re:TCA choice & Lamictal question

Posted by JohnL on October 17, 1999, at 7:03:20

In reply to To: JohnL re. TCA choice & Lamictal question, posted by Susan on October 17, 1999, at 6:26:30

> >
> Is there any reason for choosing Nortriptyline over Sinequan or Elavil which are also both quite sedating?

It's the one I know most about. And it, along with Desipramine, have the lowest side effects of TCAs. It isn't overly sedating. I actually don't sleep as sound or as long with it as with Remeron, but I think the sleep structure is much better because I awake feeling refreshed. That drugged hangover feeling goes away quicker in a.m. than Remeron for me.

> Also, have you ever heard of Lamictal causing severe nightmares? What dose/combo are you on?

One of Lamictal's possible side effects is disturbed sleep or insomnia, usually at higher doses though. Could certainly have contributed to the nightmares, though it is likely that could have subsided with time. Current dose is 125mg, still slowly working upward until I feel the onset of side effects. I especially like the way it quiets my tinnitus. Unbelievable. Also Prozac 30mg. Naltrexone 25mg. Remeron 7.5mg for sleep. I am considering lowering the Prozac down to 10mg and potentiating with Nortriptyline, ditching the Remeron. If Naltrexone hasn't provided much benefit in another couple weeks, I'll ditch it too. But I like Lamictal and from previous experience I liked the Nortriptyline.

The questions on this board are even a puzzle at times for the experts!

Yep! It really is an art sometimes. While an expert oil painter has an instinctive knack with colors and strokes, so does the expert doc with drugs and doses.




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