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Re: TCAs

Posted by SLS on July 25, 2012, at 4:55:14

In reply to Re: TCAs, posted by jono_in_adelaide on July 24, 2012, at 21:55:43

> Amitriptyline is generaly considered more potent, but it also has more side effects.
>
> I think that controlled studies of 150mg/day in severely depressed inpatients showed it to be superior.
>
> A cocktail that is easier to take but very effective is Nortriptyline 75-100mg at night, and Zoloft 50-100mg in the morning, giving you the best of both worlds

For me, Effexor 300 mg/day worked better in combination with nortriptyline than did Zoloft at 200 mg/day. Of course, Effexor would be harder to discontinue were that to become necessary.

To really explore the combination you suggest, I would first establish nortriptyline treatment by using blood tests as a guideline to determine dosage. Too much nortriptyline can be as ineffective as too little. It's window of efficacy lies between blood levels of 50 - 150 ng/ml. My blood level at a dosage of 150 mg is about 125 ng/ml if I remember correctly. I would add the Zoloft only if the nortriptyline fails to produce results after 3 - 4 weeks at the therapeutic dosage. If Zoloft is tolerated well, I can't think of any reason why administering it at a dosage of 200 mg/day would be disadvantageous should the lower dosages not produce results.


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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