Posted by psychobot5000 on June 2, 2012, at 0:33:27
In reply to Re: Sudden worsening of Nortriptyline side effects, posted by g_g_g_unit on May 31, 2012, at 1:58:04
> p.s. I don't know if you've already been on Epilim, but I personally hated it -- I felt dulled, stuporous etc.
>
> I don't know if you're in a position to self-medicate, but if I suffered from melancholic depression, I'd totally capitalize on the chance to try Stablon (via mailorder). Since I have atypical depression, it just exacerbated my symptoms, but I hear it should work for melancholic.Stablon is awesome! And often side-effect free! I took it for years, and prefer it to SSRIs or tricyclics.
I don't know your case well, but I thought I'd throw a thought out there: around the time things took a turn for the worse, did you make any other change in medication, or supplementation, perhaps? I'm just wondering if there could have been a metabolic (i.e. liver) interaction that's changed the blood-levels of the nortrip in your system, presumably raising them and causing the increased side-effects. Has your doc taken blood-levels of the medication? Might be worth checking that you're in the therapeutic range.
On an unrelated note, according to wikipedia, nortrip has a reputation for working initially, then stopping, possibly due to some 'toxic' metabolite. However the article does not mention a pattern of side-effects suddenly going out of control like this, so I don't know how useful that is.
Re: schizophrenia, unless you have a parent, brother or sister who has it, I think the benefits of taking something like clomipramine are worth the risks (which likely are not high, in any case). It is the most effective tricyclic. That said, if you don't like SSRIs, that drug may not be the way to go, as its profile is somewhat similar (like a cross between imipramine and an SSRI, with features of both). That said...if doctors there don't like combining antidepressants, clomipramine may be just the thing, since it's almost a combination drug on its own.
MAOis are statistically better than tricyclics for atypical depression, but I'm not aware of any reverse law that indicates they're worse for melancholic depression. Statistically, MAOis are simply the most powerful drugs we have (clomipramine, effexor and remeron are also probably slightly better than SSRIs, according to meta-analyses).
poster:psychobot5000
thread:1018899
URL: http://www.dr-bob.org/babble/20120522/msgs/1019089.html