Posted by ed_uk2010 on July 11, 2010, at 13:39:05
In reply to Re: Nortriptyline day 1, posted by inanimate peanut on July 10, 2010, at 19:11:32
>I agree that my med regimen is one total mess. I definitely need to stay on the Parnate. That is the only thing I am certain of on my med regimen. I think I need to stay on the Geodon since I'm pretty certain it's what's controlling the mixed states and it may have a barely perceptible impact on the depression. I would honestly be willing to try to go without the Geodon except I have a strange thing that once I go off a med, it no longer works for me anymore, so I don't get to experiment like that. I would like to decrease the Geodon as it's making my hair fall out.
OK, stick with the Geodon for now. If the nortriptyline helps your depression, perhaps you could consider a small reduction in your Geodon dose.
>Mirapex, although competing with Geodon, does help my motivation and anhedonia some, so I am slow to give it up.
I get the impression that most people find that the motivational benefits of Mirapex tend to 'poop out' after a while. I'm not sure that it's a good med to take long term (except for Parkinson's disease). I think you should review whether you still need Mirapex once the nortriptyline kicks in.
>The rest of my meds are ridiculous-- seroquel is for sleep but I don't even think it works anymore because I went off it for awhile and things generally don't work when I go off of them and then back on them. Perphenazine is for sleep.
I think you should consider tapering them both if your doctor agrees. You should probably wait until your nortriptyline dose is stable because if you make too many changes at once you won't know 'what's doing what'.
>Topamax is for binge eating, which xenical wouldn't necessarily help with. We just added amantadine, so maybe we'll be able to get rid of the topamax.
Amantadine can cause psychiatric adverse effects in its own right. I think you should manage the binge eating by reducing the use of drugs which contribute to it eg. Seroquel. Combining amantadine with antipsychotics is controversial. Adding more drugs to deal with drug side effects can lead to more problems than it solves.
>I don't think lamictal works anymore but am too scared to get off of it just in case it is doing something.
Stick with it for now. At least it's normally well tolerated, especially at doses less than 200mg per day.
>I have to hide it from her for risk that she'll stop prescribing parnate if she knows I'm on it.
I honestly think that you have to tell her. Once she sees that you are 'still alive' on the combination, she might be willing to prescribe nortriptyline herself.
>I hope the blood tests aren't too important, because I have no way to get those.
Most psychiatrists do not do nortriptyline levels.
Perhaps in a few weeks you're psych meds could be........
Parnate
Nortriptyline
Geodon
Lamictal
Ambien
poster:ed_uk2010
thread:954002
URL: http://www.dr-bob.org/babble/20100709/msgs/954117.html