Posted by SLS on March 19, 2018, at 16:16:39
In reply to insomnia on Nortrip! Help me block the NE SLS, posted by porkpiehat on March 19, 2018, at 11:33:27
> Nortiptyline is proving a good add on to Marplan in terms of mood and anxiety, but the NE in my brain makes it impossible to sleep! I don't feel stimulated, but I am so hyperfocused my brain can't wander off into sleep.
>
> I'm hoping that something can help block the NE in the central nervous symptom...I was thinking prazosin or propranolol but I think they work peripherally.
>
> SLS if you're out there your pharmacological wisdom might help!
>
> please and thank you!Total insomnia?
Insomnia can be a good predictor of a positive response. I'm not sure that I would try to block NE. It might be precisely the NE effect that is responsible for your feeling better.
You can try adjusting the nortriptyline dosage downwards as was suggested by Ed_UK. However, if you lose the improvement, you will probably need to maintain a higher dosage. In this event, you can add sleep aids - hopefully on a temporary basis. The insomnia might resolve on its own. If all else fails, you can switch from nortriptyline to amitriptyline. Amitriptyline tends to be soporific, so I doubt sleep would be a problem. Unfortunately, anticholinergic side effects are pronounced. You cannot take imipramine or clomipramine in combination with Marplan because of the risk of serotonin syndrome.
A few ideas:
1. Ambien for problems with sleep initiation.
2. Ativan or Restoril for problems with sleep maintenance.
3. Seroquel at low dosages.Stay away from trazodone. It is unpredictable and is capable of producing serotonin syndrome when combined with a MAOI.
No caffeine! You might want to give things a few more days before making a move.
I'm guessing that you are close to finding a treatment that works well for you.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1097503
URL: http://www.dr-bob.org/babble/20180212/msgs/1097516.html