Posted by mtdewcmu on April 15, 2011, at 9:05:29
In reply to Re: Med Plan and Questions » mtdewcmu, posted by SLS on April 15, 2011, at 8:22:19
>
> Perhaps you are a tricyclic responder. These drugs seem to be particularly effective where early morning awakenings and ruminations are present.
>I appreciate the suggestion. I tried Elavil at one time and I liked the effects, but my heart rate increased steadily until it was uncomfortably fast by a few days in. This was not a high dose, either. I went through the same thing with Flexeril. So I think I am sensitive to the cardiac effects of tricyclics.
Incidentally, I ran my meds on an interaction checker that I have access to and I found the following major interactions:
"Increased mirtazapine serum concentrations (34 fold) have been reported following the addition of fluvoxamine, a CYP3A4 inhibitor, to stable mirtazapine regimens."
"Fluvoxamine induced an increase in the AUC and peak concentrations of melatonin by 23-fold and 12-fold, respectively after the coadministration of a 5 mg melatonin dose in several healthy volunteers. The mechanism is unknown. The interaction may increase the sedative effects of melatonin"
So I think I will decrease my mirtazapine and be cautious with melatonin. Melatonin is said to potentiate some of the effects of amphetamines, and IIRC it carries a slight risk of seizure.
poster:mtdewcmu
thread:982787
URL: http://www.dr-bob.org/babble/20110406/msgs/982901.html