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Re: Help. Need advice for switching off Nortriptyline.

Posted by bleauberry on January 14, 2019, at 8:45:20

In reply to Help. Need advice for switching off Nortriptyline., posted by Schlepo on January 9, 2019, at 9:57:43

Since your body has had a quarter of a century of the Nortriptyline molecule running things, I think it could be a challenge to change to any med. But if you are at that point then you are at that point and you have to.

My first thought was to switch to something similar. Another TCA for example. Simply because your body is addicted to the anti-histamine angle, and the other angles, separate from the mood chemical stuff. TCAs are dirty, non-specific, and your body is now well accustomed to the dirty. It only knows how to operate with the dirty. Take the dirty away, and what happens? We don't know. It could be rough as hell or it could be easier than expected.

I can't really offer any suggestions on med choices because I don't fully understand your complaint. "Sensitivity to dopamine" - I don't know what you mean by that. Benzos and abilify - don't know what those did to you either.

If you are thinking there is too much dopamine and you need to squash it down, then go with an SSRI. I prefer Prozac or Zoloft in that family, but they can boost dopamine.

If you are thinking you need more dopamine then you want either Ritalin or Adderall. Actually, if you think you have too much dopamine, Ritalin could help squash that down, by retraining the sensitivity of the receptors. Like it does in ADHD.

But I am also thinking, with respect to 26 years, that maybe it makes sense to leave Nortriptyline alone, maybe reduce the dosage a bit, but try adding in other new things with it. You are going to rock the boat no matter what you do. But if you keep Nortriptyline on board and work with other meds/herbs to combine with it, then maybe it isn't as rocky.

> Okay, now after 26 years nortriptyline is starting to affect me adversely and it looks as though I might need to switch antidepressents. I think my problem is a sensitivity to dopamine (I've read that nortriptyline is a dopamine agonist on a certain part of the brain, and I'm having the same problems as I had with benzos and Abilify.)
>
> So the first criteria would be that the new med doesn't alter dopamine. Second criteria would be something I could make an easy switch to. I tried amitriptyline a few years ago and couldn't handle it, so that's out. Are there any drugs very close to nortriptyline that don't affect dopamine? What would be the next logical choice?
>
> As far as the second criteria, I've been looking at http://wiki.psychiatrienet.nl/index.php/SwitchAntidepressants, and see these as possibilities:
>
> fluoxetine, bupropion, citalopram, clomipramine, dosulepine, doxepine, imipramine, maprotiline, sertraline. venlafaxine.
>
> I'm not sure how many meet the first criteria yet.


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