Posted by King Vultan on April 23, 2004, at 12:45:42
In reply to Re: Which AD's are most and least agitating, posted by SLS on April 23, 2004, at 11:18:40
> > Nortriptyline was by far the least activating of any of the drugs I've tried.
>
> I found it to be smooth as well, although it had a soporific effect on me when I first started it. Unfortunately, it doesn't appear that I have a therapeutic window for nortriptyline. 75mg was too little and 100mg was too much. The only times I felt improved were during the first 36 hours after a change in dosage, either up or down. There wasn't so much as a sliver of a dosage range at which the antidepressant effect would stabilize. This probably isn't so rare an event I imagine. For most people, the therapeutic window for nortriptyline lies with blood levels between 50-150 ng/ml. One of my doctors once told me that there is a tendency for an individual to respond to either desipramine or nortriptyline but not to both. I'm not sure how true this is.
>
>
> - Scott
Interesting, as I found desipramine to be relatively effective and the only AD I've been able to tolerate a full therapeutic dosage of up until now. Nortriptyline, OTOH, was only just barely tolerable, even at only 50 mg/day, which had some antidepressant effect--but not nearly enough--and was dreadfully sedating. When I went up to 75 mg/day, I experienced even worse sedation and drowsiness and was forced to go back down to 50 mg/day. I switched to desipramine soon after, which I was on for a few months before venturing on to other things.It would obviously be an impossibility for me to tolerate the parent molecule of nortriptyline, amitriptyline, but I get the feeling that I would be able to handle imipramine, which desipramine is a metabolite of. Perhaps a relationship similar to what you mentioned also exists between amitriptyline and imipramine.
Todd
poster:King Vultan
thread:339005
URL: http://www.dr-bob.org/babble/20040423/msgs/339167.html