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Re: nortriptyline + celexa (+ trazodone?) for ocd ibs zeugma

Posted by yeltom on July 20, 2004, at 12:10:07

In reply to Re: nortriptyline + celexa (+ trazodone?) for ocd ibs, posted by zeugma on July 20, 2004, at 12:00:27

I have noticed a sedative effect at 10 mg; it's just not enough to consistently put me to sleep. At this point, the question is whether I'm going to take 10 or 20 mg. 50 mg seems out of the question. I have a hard time getting out of bed in the morning with 20 mg, and when I do, I have a dull headache and dizziness. I'm worried about all the side effects of amitriptyline, and I'm very used to trazodone. That's why I'm wondering whether mixing trazodone with nortip would be a bad idea.

> Nortriptyline has no sedative effect below 50 mg. Bear in mind though that I was taking the nortriptyline alone. It is unlikely that Celexa would cause a dramatic rise in nortriptyline concentrations. However there is a lot of variation in intrinsic 2D6 activity due to genetic factors. I am a normal-to-fast metabolizer of nortriptyline, and 100 mg nortriptyline sends me to sleep in the range of 3-4 hours. 75 mg sent to sleep in about 6 hours. This is very far from what I understand about the sedative effect of trazodone, although in both cases patients are instructed to take at 'bedtime.' Of course, this is only my experience.
>
> Nortriptyline tends to be constipating. This side effect may diminish in time (it did for me) or it may not. The symptomology that I found nortriptyline most useful for in terms of IBS was upper GI tract pain and nausea. I found it to have analgesic and antinauseant effects at 20 mg.
>
> If you are interested in a combination sleep aid/IBS remedy, low dose amitriptyline might be more of what you're looking for. If you decide instead to stick with the nortrip, you should get a blood plasma level taken of nortriptyline once you get in the 50 mg range. This will help your doctor optimize the dose and ensure that levels are neither too high or too low.
>
>


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