Posted by zeugma on May 4, 2004, at 17:29:41
In reply to Re: which plan sounds more reasonable » Keith Talent, posted by Sad Panda on May 4, 2004, at 13:05:44
> > Why are you taking nortriptyline if you're taking atomoxetine (Strattera)? They both work by blocking the noradrenaline transporter, only atomoxetine is more potent. Do you need the histamine-1 antagonistic effect of nortriptyline for sleep? You'd be better off taking Ambien or triazolam (Halcion) for sleep.
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> Do you think Benzo style drugs are the way to go for sleep?
I think clomipramine would sedate me enough to sleep, and would be better than a benzo for this purpose. But obviously I am speculating about the sedative properties of clomipramine. What i actually need more urgently is relief of anxiety/depression than insomnia.
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> > By the way, clomipramine (and its metabolite desmethylclomipramine) kick nortriptyline's and atomoxetine's butts re noradrenaline reuptake inhibition.
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> Actually desmethyl-clomipramine, nortriptyline, & desipramine are all similar in strength as NRI's, they differ in a similar way to their parent drugs.Desipramine is a much more powerful NRI than nortriptyline; at least four times more powerful, and probably more. I don't know what the figures are for desmethylclomipramine but it probably has a higher potency for both 5-HT and NE transporters than nortriptyline. And it has a longer half life than atomoxetine, which is only about 5 hours.
I'm going to ask my pdoc to let me try a 25mg capsule of clomipramine with my two 25's of nortriptyline, and gradually taper from one to the other (as per my original plan last week). He hates dispensing benzodiazepines, but does not seem averse to TCA's, so i am hoping he will let me try my little experiment. The idea of adding Lexapro becomes less appealing with the thought that it might make dropping the nortriptyline more difficult, plus the SSRI's offer fewer opportunities for slow titration.
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> Cheers,
> Panda.Thanks to you both,
z
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poster:zeugma
thread:341936
URL: http://www.dr-bob.org/babble/20040429/msgs/343339.html