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Re: From desipramine to nortriptyline?

Posted by SLS on June 6, 2004, at 11:07:34

In reply to Re: From desipramine to nortriptyline? » EERRIICC, posted by Sad Panda on June 6, 2004, at 10:30:41

> > If a trial with desipramine fails does it make sense to try nortriptyline? What is the difference between these two drugs?

> Nortriptyline has nearly as much NRI ability as desipramine, but it also is mildy sedating, anxiolytic & carries more side effects. I would bet that it would have more of an antidepressant effect since it's parent Amitriptyline is still one of the best ever AD's.

I think you might be right about that. I found nortriptyline to produce a qualitatively better antidepressant response than did desipramine. Unforturnately, I found that establishing a therapeutic dosage of nortriptyline was problematic. There was no stable therapeutic window for me. No one dosage allowed me to feel better for than more than a few days after a dosage change. 75mg was too low and 100mg was too high. I would experience a transient improvement immediately after a change of dosage, either up or down. No amount of finessing helped. Although this type of response pattern is uncommon, I am not unique in this regard. 75mg is the right dosage for most people. Sometimes, people who don't respond to nortriptyline will respond to desipramine and vice-versa. The range for therapeutic blood levels for nortriptyine are well studied and determined to lie within the range of 50-150 ng/mL.


- Scott

 

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