Posted by SLS on January 30, 2007, at 6:01:38
In reply to Q for SLS, posted by UGottaHaveHope on January 30, 2007, at 2:14:43
> That was encouraging Scott to hear that your meds are doing well for you. I always meant to ask you: What is your diagnosis? Bipolar? Depression? Anxiety? If it's the latter two, I may try to copycat you with my pdoc. Thanks
As best as we can tell, I am bipolar. I have had occasional severe psychotic episodes as reactions to specific medications if administered a certain way. There are other attributes of my illness that are consistent with bipolar disorder, too.I know how compelling it is to try to reproduce a treatment that is found to be effective for someone else. Perhaps you would respond to the Nardil and nortriptyline without the need for the anticonvulsants and antipsychotic. It has been the traditional wisdom to start the tricyclic first. If you have never been on nortriptyline, it is worth trying as monotherapy, anyway. If this treatment is ineffective, you can then add the Nardil using a gradual titration. You must reach a minimum dosage of 60mg for the trial to be considered adequate.
1/2 pill - 3 days
15mg - 1 week
30mg - 1 week
45mg - 3 weeks
60mg - 3-6 weeks
75mg - 3-6 weeksI'm still in the middle of experimenting with my dosage of nortriptyline. I am very surprised to discover that I might need 200mg/day. I might be a rapid metabolizer. I'm not going to bother with blood levels, though. At this point, I'm so close, I'd rather do it clinically.
For you, I would recommend setting 75mg as your initial target dosage of nortriptyline. You might want to start at 25mg, though. It can be sedating in the beginning, so you might want to taking it at night. For me, this soporific (sleep-producing) effect disappeared completely. I now take it in the morning. After being at 75mg for 2 weeks, you might then want to get a blood level. Nortriptyline is a funny drug. You can respond to 75mg and then lose the response at 100mg. Blood levels help to guide you on finding the right dosage. The therapeutic range is considered to be 50-150ng/ml.
What do you think?
- Scott
> My goal is full remission. I think I may be lucky enough to have found my magic pills. We'll see.
>
> Currently:
>
> Nardil 75mg
> nortriptyline 150mg
> Lamictal 100mg
> Topamax 100mg
> Abilify 10mg
poster:SLS
thread:727990
URL: http://www.dr-bob.org/babble/20070125/msgs/727999.html