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Re: nortryptline affect on anxiety » hildi

Posted by zeugma on May 17, 2003, at 18:15:38

In reply to nortryptline affect on anxiety, posted by hildi on May 17, 2003, at 10:11:59

> I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
>
> I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> Hildi


Hi Hildi,

Good to see you back here- I'm still taking nortriptyline, last week I took the HAM-D depression test and compared it with my scores from before I started the med- my depression was in total remission. The thing about nortriptyline is about dosage and metabolism. I read a study in which they monitored blood levels of nortriptyline and its metabolite, and they found that those with higher percentages of this metabolite had greater efficacy and fewer of the side effects johnj was talking about- like dry mouth and difficulty urinating. Here's an old Babble post about this: http://www.dr-bob.org/babble/20010530/msgs/65245.html
The trick is, you can't know in advance what your genomic status is so you'll have to see what kind of s/e you'll have. The side effects I have at this point (75 mg/day) are minimal. I just get tired at night a few hours after I take it, with the result that waking up in the morning is a lot easier.

And nortriptyline has a therapeutic window which may make a blood levels test necessary at some point- that was how I arrived at an optimal dose.

About the bipolar_ yes, I've heard that TCA's are not great for bipolars; are you currently taking a mood stabilizer or lithium? You could add on nortriptyline to that instead of an SSRI and see what happens.

I'd say nortriptyline is worth a try and it definitely has a different 'flavor' than the SSRI's. But a lot depends on factors about your metabolism you can't know in advance. In other words- you need some luck.

z


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URL: http://www.dr-bob.org/babble/20030514/msgs/227305.html