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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by lest on September 22, 2004, at 17:33:24
about it? my dr is recommending it. anyone had good or bad experiences..
Posted by King Vultan on September 22, 2004, at 19:25:52
In reply to Anyone tried noritriptyline (pamelor) or know?, posted by lest on September 22, 2004, at 17:33:24
> about it? my dr is recommending it. anyone had good or bad experiences..
It probably makes the most sense of the tricyclic meds to try first. It has relatively low anticholinergic side effects, but side effects like dry mouth and constipation are still possible. In my case, I found it excessively sedating, but this is fairly unusual. Unlike an SSRI, it has multiple mechanisms of action, and it also primarily works on norepinephrine. I think it would be hard to go wrong at least giving it a try.Todd
Posted by lia mason on September 22, 2004, at 23:06:46
In reply to Re: Anyone tried noritriptyline (pamelor) or know?, posted by King Vultan on September 22, 2004, at 19:25:52
I've been on all the tricyclics and found pamelor too sedating. Imipramine and desipramine were--in my experience--much more easily tolerated. But I do believe it's highly individual. I'm now taking elavil and tolerating it and elavil has a much worse reputation than pamelor in terms of side effects. With all the tricyclics, side effects improve over time. It's probably best to start slow and climb if you can do that. Elavil knocked me out the first day I took it and I grew to tolerate it.
Lia
Posted by zeugma on September 23, 2004, at 4:51:54
In reply to Anyone tried noritriptyline (pamelor) or know?, posted by lest on September 22, 2004, at 17:33:24
Nortriptyline is the only AD that I have been able to tolerate over the long run. I experienced many side effects at the beginning, but unlike other meds I've tried, they lessened over time. If you have problems getting to sleep it will also probably help; as others have said, it can be fairly sedating. FWIW, my experience was that it knocked me out when I got to a certain dose (about 50 mg), but the unpleasant sedation gradually lifted and the sedation is now confined to when it's desired: at night when I need to sleep. It also has a potent analgesic effect, and I believe it also to be a potent antipanic agent.
-z
Posted by lest on September 24, 2004, at 1:17:30
In reply to Re: Anyone tried noritriptyline (pamelor) or know?, posted by zeugma on September 23, 2004, at 4:51:54
my dr is making me, he said something about a thearupitic window? anyone know what hes talking about?
Posted by Sad Panda on September 24, 2004, at 1:52:38
In reply to thanks.. did you guys have to take blood tests too, posted by lest on September 24, 2004, at 1:17:30
> my dr is making me, he said something about a thearupitic window? anyone know what hes talking about?
>
>Hi lest,
Nortriptyline is a great drug if you can tolerate the side effects, it combines a sedative, stimulant & anxiolytic is one drug. It is the most studied AD as far as blood testing is concerned & the thearupitic window is when your plasma level is between 50 & 150 ng/ml.
Are you taking any other drugs?
Cheers,
Paul.
Posted by King Vultan on September 24, 2004, at 6:59:41
In reply to thanks.. did you guys have to take blood tests too, posted by lest on September 24, 2004, at 1:17:30
> my dr is making me, he said something about a thearupitic window? anyone know what hes talking about?
I dont' recall that I did, but this is something I would have done had I stayed on it a little longer. I did have my blood tested on another tricyclic to see if I was in the therapeutic window.
Todd
Posted by lest on September 24, 2004, at 12:32:12
In reply to Re: thanks.. did you guys have to take blood tests too, posted by Sad Panda on September 24, 2004, at 1:52:38
62.5 paxil , 50 lamictal
Posted by LEST on September 24, 2004, at 14:52:46
In reply to Re: sad panda, posted by lest on September 24, 2004, at 12:32:12
Abdominal cramps, agitation, anxiety, black tongue, blurred vision, breast development in males, breast enlargement, confusion, constipation, delusions, diarrhea, dilation of pupils, disorientation, dizziness, drowsiness, dry mouth, excessive or spontaneous flow of milk, excessive urination at night, fatigue, fever, fluid retention, flushing, frequent urination, hair loss, hallucinations, headache, heart attack, high or low blood pressure, high or low blood sugar, hives, impotence, inability to sleep, inability to urinate, increased or decreased sex drive, inflammation of the mouth, intestinal blockage, itching, loss of appetite, loss of coordination, nausea, nightmares, numbness, panic, perspiration, pins and needles in the arms and legs, rapid, fluttery, or irregular heartbeat, rash, reddish or purplish spots on skin, restlessness, ringing in the ears, seizures, sensitivity to light, stomach upset, strange taste, stroke, swelling of the testicles, swollen glands, tingling, tremors, vision problems, vomiting, weakness, weight gain or loss, yellow eyes and skin
looks like fun!
Posted by Sad Panda on September 25, 2004, at 1:34:30
In reply to the side effects of pamelor, posted by LEST on September 24, 2004, at 14:52:46
> Abdominal cramps, agitation, anxiety, black tongue, blurred vision, breast development in males, breast enlargement, confusion, constipation, delusions, diarrhea, dilation of pupils, disorientation, dizziness, drowsiness, dry mouth, excessive or spontaneous flow of milk, excessive urination at night, fatigue, fever, fluid retention, flushing, frequent urination, hair loss, hallucinations, headache, heart attack, high or low blood pressure, high or low blood sugar, hives, impotence, inability to sleep, inability to urinate, increased or decreased sex drive, inflammation of the mouth, intestinal blockage, itching, loss of appetite, loss of coordination, nausea, nightmares, numbness, panic, perspiration, pins and needles in the arms and legs, rapid, fluttery, or irregular heartbeat, rash, reddish or purplish spots on skin, restlessness, ringing in the ears, seizures, sensitivity to light, stomach upset, strange taste, stroke, swelling of the testicles, swollen glands, tingling, tremors, vision problems, vomiting, weakness, weight gain or loss, yellow eyes and skin
>
> looks like fun!
>
Hi Lest,That is the complete list of possible side effects, the common ones are dry mouth, constipation, urinary retention & orthostatic hypotension. The not so common but serious one is irregular heart beat & it probably stops 5% of people from taking TCA's. My doctors took a baseline ECG before I started taking it.
Sounds like poison doesn't it? For me I had practically no side effects & I found it much easier to take than Prozac or Effexor.
Paxil inhibits the liver enzymes that metabolize Nortriptyline (& alot of other drugs) & you will need a very small doseage & blood testing would be 100% mandatory. I was taking mine with Effexor, 125mg of Nortriptyline swallowed gave me a plasma level of 75ng/ml, but for you with Paxil you may find that 25mg gives you a similar or greater plasma level. I would start you at 5mg/day just to be extra cautious.
Cheers,
Paul,
This is the end of the thread.
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