Psycho-Babble Medication | about biological treatments | Framed
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Re: Question for Scott (if you have time)

Posted by SLS on July 13, 2005, at 16:18:36

In reply to Re: Question for Scott (if you have time) SLS, posted by TamaraJ on July 13, 2005, at 12:30:24

Regarding the combination of Zoloft + nortriptyline, I would use the full therapeutic dosages of both together as if you were taking each one separately. Zoloft can increase the blood level of nortriptyline slightly, so you might want to get a blood test at 75mg to see if it falls within the range of 50-150 ng/ml. Alternatively, you can start at 50mg and titrate the dosage upwards if necessary. It is difficult to guess which individuals will need to make an adjustment for the interaction. In the elderly, though, the increase in blood levels can be as much as 40%, so an allowance should be made in this population.

Bottom line: Your guess was right!

I would titrate the dosage of Zoloft and increase it as tolerated to as close to 200mg as possible. Expect transient headaches. They are not an indication of blood pressure. I would start the nortriptyline at 50mg and get a blood level once your Zoloft reaches 100mg after a week. I would then raise the dosage to 75mg if the blood test results in a level of less than 100 ng/ml.

I don't think there are any concerns in combining these drugs with respect to cardiac effects.

- Scott




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