Posted by Sunnely on June 20, 2001, at 1:00:30
In reply to From Nortriptyline to Desipramine...?, posted by sl on June 19, 2001, at 21:56:21
Hi sl,
Three weeks is considered not long enough for an adequate antidepressant trial. If you are taking nortriptyline (Pamelor) as an antidepressant, the "therapeutic" dose is generally guided by the blood level. Nortriptyline as antidepressant has a "therapeutic window," the range in blood levels considered effective, which is between 50 to 150 ng/ml. Too low and you lose or do not achieve the antidepressant effect. Too high and you lose the antidepressant effect but increased side effects. So, before you give up on nortriptyline, have that blood level checked, and adjust the dose accordingly.
If you decide to switch from nortriptyline to desipramine (Norpramin), do the transition gradually to avoid anticholinergic toxicity.
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> Okay. This is wk 3 on Nortriptyline and all I feel is tired. Thought-patterns are bad, depression is bad, this should have kicked in by now, right?? Wk 1 was 25mg/day, wk 2 was 50mg/day, and this wk is 75mg/day. And it's DAMN-good I'm all but unemployed cuz I couldn't function in a workplace.
>
> SO, y'all told me it was likely if Nortrip didn't work, Desipramine would. So that's next on the list (obviously upon approval by my doc). So how do I go about getting from one to the other? Do I need to take 3 weeks to get back off Nortriptyline and then another 3 to get up to speed on Desipramine???
>
> The other thing: I'm going to try to talk them into a small dose of Zyprexa to control those nasty pervasive thoughts. Can this be combined with Nortrip and Desip (as I go from one to the other)?
>
> As always, any input is welcome....
> sl
poster:Sunnely
thread:67137
URL: http://www.dr-bob.org/babble/20010618/msgs/67162.html