Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Re: Linkadge?

Posted by linkadge on June 4, 2008, at 8:37:22

In reply to Linkadge?, posted by torachan on June 3, 2008, at 20:31:11

>Yeah, I just got a script for Nortryptiline. I >was wondering if this med has strong enough 5HT2 >antagonism to counterbalance with the Effexor >for anxiety? I know you mentioned Doxepin and >amitryptiline, and I mentioned these to the >doctor, but he gave me Nortyptiline.

Nortryptaline can be a very effective antidepressant. According to the PDSP website it is actually a SNRI with stronger affinity for the norepinephrine reuptake pump (maybe 2:1 or less).

It does appear to be a fairly potent 5-ht2a/c antagonist but I'd have to look for more data.


>I checked out the Wiki page for this med, and it >states it's involved in the uptake inhibition of >norepinephrine. Wouldn't this be similar to >Remeron? Also, it stated that sleep would be >disrupted for a while until improvement appears.

It would be different from Remeron in a few ways. Remeron doesn't affect the reuptake of any monoamines. I personally didn't feel it had the same umph as the TCA's.

Some people find it activating and others find it sedating. This profile may change to a certain degree after a few weeks.

>How would you rate this TCA compared to the >others as an augmenting agent with Effexor for >the contribution of anxiolytic and hypnotic >effects?

It sounds promising. It is an effective AD and there is litureature for its use as an augmenting agent. There are a few questions (you may already have answered in previous posts i'm not sure). If you respond to effexor but only at higher doses (>75mg) then you may be benifitting from the norepinephrine reuptake inhibition. Since effexor has stronger affinity for serotonin, the combination for effexor and nortryptaline may allow you to fine tune an uptake ratio of serotonin/norepinephrine which helps you most. This may mean that lower doses of effexor are effective. For some people the norepinephrine reuptake may initially disrupt sleep but it may also improve sleep. I know a few posters who said the first dose knocked them out.

I think the key here is to take it slowly. You will likely get certain initial side effects that will fade with time. Does it come in 10mg? If so, I'd say start with 5mg on the first night, then slowly go up. You may only need 25mg for a good augmenting effect but play it by ear.

Take all your effexor in the morning if possable and the nortryptaline at night. When I added doxapin to celexa I noticed fairly soon that I needed less celexa. At this point lowering the celexa from 20 to 10mg actually led to clinical improvement. So, keep open to the possability that a lower dose of effexor may be more benificial (especially if the higher doses of the effexor caused apathy). The nortryptaline is *very* unlikely to cause or increase apathy (if this is a problem for you). In many cases it has been used effectively to reduce the apathy caused by SSRI's.

>PS. Read your above post in the Best TCA thread. >Very thorough. Do you by chance have an advanced >degree in neuroscience or do you just simply >read a lot on this subject?

No it's just been a personal interest for a while.

Take care and good luck over the next few days.

Linkadge


Share
Tweet  

Thread

 

Post a new follow-up

Your message only Include above post


Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.

 

Start a new thread

 
Google
dr-bob.org www
Search options and examples
[amazon] for
in

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:linkadge thread:832777
URL: http://www.dr-bob.org/babble/20080528/msgs/832846.html