Posted by tensor on December 8, 2009, at 13:18:54
In reply to Swapping Parnate for Effexor., posted by SLS on December 8, 2009, at 10:29:39
> Is this as good as it gets?
> I don't think so. I won't settle for being barely employable and doomed to live an empty life. I want more. Parnate is not making it happen for me. It was nice in the beginning. However, even with the lithium added, I'm stuck. I believe that a greater improvement in the quality of my life is there for me to be had. I am not looking for perfection. Complete remission may not be in my future. However, I do expect to feel greater than a 50% improvement. I am stuck at 35%. That sucks. However, if that indeed is as good as it gets, at least I will have tried to move forward.
> Five or six years ago, I had been taking a combination of Effexor 300mg and nortriptyline 75mg. It helped, but was inadequate. The doctor should have tested my blood level of nortriptyline. He did not. In retrospect, we now know that I was significantly underdosed with nortriptyline. I predict that I will do better with the 150mg that I am currently taking when we combine it with the Effexor.
> I know that I can always go back to an MAOI if my planned treatment changes do not produce adequate results. Although making these changes is a gamble of sorts, I think it is a good investment of time to look for a better quality of life.
> - Scott
Effexor + nortriptyline sounds like a potentially powerful combination, and yes, 75mg is probably a little low. When I took nortrip we took serum concentrations two times, at 75mg it was in the lower end, I can't remember the dosage for the second blood draw but it was a lot higher than 100mg(175mg?). The serum concentration was at that time slightly above the therapeutic window.
And there is plenty to augment the combo with: