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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by tensor on January 13, 2005, at 5:56:53
Hi,
I would like to hear experiences with nortrip and amitrip, especially side effects.
Thank you!
/Mattias
Posted by ed_uk on January 13, 2005, at 6:50:59
In reply to Nortriptyline/Amitriptyline side effects, posted by tensor on January 13, 2005, at 5:56:53
Hello Mattias!!!!
Nortriptyline is a metabolite of amitriptyline. In general, nortriptyline has considerably milder side effects than amitriptyline.
Here is a link to a table which compares some of the side effects of the TCAs. Scroll down the page and you'll see it!
http://web.uct.ac.za/depts/mmi/jmoodie/n06html.html#table
Your friend,
Ed.
Posted by Kenny Koala on January 13, 2005, at 7:51:56
In reply to Nortriptyline/Amitriptyline side effects, posted by tensor on January 13, 2005, at 5:56:53
Nortriptyline for me has no side effects, I have taken right up to 200mg. Amitriptyline side effects for me started at 100mg, primarily mild confusion after my nightly dose & dry mouth while sleeping. Amitriptyline is one of the my efficient AD's of all time, probably because it helps anxiety a lot & it gives a great nights sleep. If you are taking an SSRI that is partly working for you try adding Nortriptyline first as it can be a mild sedative. If you want just one drug, try Clomipramine.
KK.
Posted by sfy on January 13, 2005, at 15:45:24
In reply to Nortriptyline/Amitriptyline side effects, posted by tensor on January 13, 2005, at 5:56:53
I take 50 mg. of nortriptyline at bedtime. The only side effects I have encountered are a dry mouth with an occasionally slightly metallic taste which has improved over time (and is nothing sucking on a hard candy can't overcome) and a noticeable, though not distressing, constipation issue. Taking a stool softener has relieved this issue for the most part.
Posted by jujube on January 16, 2005, at 13:23:00
In reply to Re: Nortriptyline/Amitriptyline side effects » tensor, posted by sfy on January 13, 2005, at 15:45:24
I have a few questions for you, if you don't mind. Could you please tell me if it is absolutely necessary to have blood tests done when on nortriptyline to check blood plasma levels? Have you found 50 mg sufficient to provide a good antidepressant effect, or is the 50 mg just a maintenance dose? And, what effect has nortriptyline had on anxiety (both social and general), if these were issues for you?
Thnaks.
> I take 50 mg. of nortriptyline at bedtime. The only side effects I have encountered are a dry mouth with an occasionally slightly metallic taste which has improved over time (and is nothing sucking on a hard candy can't overcome) and a noticeable, though not distressing, constipation issue. Taking a stool softener has relieved this issue for the most part.
Posted by zeugma on January 16, 2005, at 14:59:22
In reply to Re: Nortriptyline/Amitriptyline side effects » sfy, posted by jujube on January 16, 2005, at 13:23:00
Hi Tamara, I'll jump in, if you don't mind. A plasma level is not absolutely necessary. When I was in the hospital years ago, they did it each week as they titrated me up to 75 mg, but nowadays I think insurance plans are stingier :). The plasma-level phenomenon is fascinating, but it is mostly important if you are experiencing excessive side effects or insufficient response.
I have debilitating social and general anxiety. Nortriptyline is somewhat anxiolytic, but its chief action here was to eliminate panic attacks- which it did, with surprising speed and at a low, low dose.
I currently take 50 mg, because TCA's can amplify the cardiac s/e of stimulants. I was on 100 mg until recently.
-z
Posted by KaraS on January 16, 2005, at 18:30:45
In reply to Re: Nortriptyline/Amitriptyline side effects » sfy, posted by jujube on January 16, 2005, at 13:23:00
> I have a few questions for you, if you don't mind. Could you please tell me if it is absolutely necessary to have blood tests done when on nortriptyline to check blood plasma levels? Have you found 50 mg sufficient to provide a good antidepressant effect, or is the 50 mg just a maintenance dose? And, what effect has nortriptyline had on anxiety (both social and general), if these were issues for you?
>
> Thnaks.
>
> > I take 50 mg. of nortriptyline at bedtime. The only side effects I have encountered are a dry mouth with an occasionally slightly metallic taste which has improved over time (and is nothing sucking on a hard candy can't overcome) and a noticeable, though not distressing, constipation issue. Taking a stool softener has relieved this issue for the most part.
>
>Hi Tamara,
Just wanted to add my two cents here. I reacted very differently to amitriptyline and nortriptyline. Ami. made me really groggy. I found it incredibly sedating. Nort. gave me a racing heart rate. I found it very energizing so just keep that in mind as a possibility. I know I am the exception with regard to my response to nort. but there are others out there who respond the same way. Even if it does that for you, it can still be effective against panic disorder.I have also taken doxepin and maprotiline and found them extremely helpful for anxiety and panic attacks. They got rid of them completely so I think you're on the right track with the nort. (In fact I just left my doctor a message requesting a prescription for maprotiline. I'll just use it low dose to help me sleep now and get the horrible anxiety under control again.)
k
Posted by jujube on January 16, 2005, at 18:56:41
In reply to Re: Nortriptyline/Amitriptyline side effects » jujube, posted by zeugma on January 16, 2005, at 14:59:22
I don't mind at all. It is much appreciated. You do realize, however, that you just set yourself up to be asked a few more questions! I apologize in advance if you have already directly or indirectly answered the questions I am about to ask (I have been somewhat absent-minded the past couple of weeks and I am really a bit too tired right now to focus on doing more research). So, here goes. Do you find 50 mg gives an adequate antidepressant effect? Did nortriptyline help you in terms of motivation? In addition to helping with panic, do you find it has been effective for the "what if" thoughts that can stop a person if their tracks?
Thanks again for the information. I am just preparing myself in case the pdoc nixes the Provigil option.
Take care,
Tamara
Posted by jujube on January 16, 2005, at 19:12:32
In reply to Re: Nortriptyline/Amitriptyline side effects » jujube, posted by KaraS on January 16, 2005, at 18:30:45
Thanks so much Kara. You are very kind. Here I go again with a ton of questions. I just want to have an alternate plan that I am comfortable with should the pdoc not be keen on Provigil (he can be a bit of a stick in the mud at times). So, my questions. Can you tell me what dose of nortriptyline you were taking? If it had not been for the racing, would you have found nort effective for adhedonic depression? Did you experience any weight gain (even though I was unhappy about gaining 7 pounds on Anafranil, I don't really need to worry too much about gaining some weight. I just don't want to end up becoming a happy heffer!). Did you experience any cognitive impairment while you were taking it? Well, those are the questions I can think of for now. If Ihave more, I know where to find you!
And, good luck to you with the maprotiline. It must be somewhat of a relief to know that you will have some anxiety relief soon.
Take care,
Tamara
>
> Hi Tamara,
> Just wanted to add my two cents here. I reacted very differently to amitriptyline and nortriptyline. Ami. made me really groggy. I found it incredibly sedating. Nort. gave me a racing heart rate. I found it very energizing so just keep that in mind as a possibility. I know I am the exception with regard to my response to nort. but there are others out there who respond the same way. Even if it does that for you, it can still be effective against panic disorder.
>
> I have also taken doxepin and maprotiline and found them extremely helpful for anxiety and panic attacks. They got rid of them completely so I think you're on the right track with the nort. (In fact I just left my doctor a message requesting a prescription for maprotiline. I'll just use it low dose to help me sleep now and get the horrible anxiety under control again.)
>
> k
Posted by zeugma on January 16, 2005, at 19:34:08
In reply to Re: Nortriptyline/Amitriptyline side effects » zeugma, posted by jujube on January 16, 2005, at 18:56:41
> I don't mind at all. It is much appreciated. You do realize, however, that you just set yourself up to be asked a few more questions! I apologize in advance if you have already directly or indirectly answered the questions I am about to ask (I have been somewhat absent-minded the past couple of weeks and I am really a bit too tired right now to focus on doing more research). So, here goes. Do you find 50 mg gives an adequate antidepressant effect? Did nortriptyline help you in terms of motivation? In addition to helping with panic, do you find it has been effective for the "what if" thoughts that can stop a person if their tracks?
>
> Thanks again for the information. I am just preparing myself in case the pdoc nixes the Provigil option.
>
> Take care,
>
> Tamara
>
Nortriptyline definitely helps with motivation.as for 'what if' thoughts, I think it is somewhat helpful-hard to say. Clonazepam is a lot better than nortriptyline for this, because i noticed I wasn't having them when I took an extra Klonopin before going to a party.
As for 50 mg providing an adequate AD effect, that's also hard to say because I'm not really using it for depression at the moment- I'm using it to prevent cataplexy. I certainly don't want to become depressed again, and I don't want to press my luck, if you know what I mean, but let's say that my problems have been elsewhere lately.
-z
Posted by jujube on January 16, 2005, at 21:11:50
In reply to Re: Nortriptyline/Amitriptyline side effects » jujube, posted by zeugma on January 16, 2005, at 19:34:08
Posted by KaraS on January 16, 2005, at 23:24:05
In reply to Re: Nortriptyline/Amitriptyline side effects » KaraS, posted by jujube on January 16, 2005, at 19:12:32
No problem. I'm the same way. I have to explore everything completely and feel "in control" of the situation. (Even though we never can be with these medications, it never stops me from trying.)
I was only on 50 mg. of nort. It was a long time ago. I wasn't on it long enough to get an antidepressant effect from it. Since it was extrememly energizing for me, I felt better though. It was a forced kind of motivation but it was a welcomed one. I wasn't aware of any cognitive problems from it either. (I had previously been on doxepin which gave me a lot of cognitive problems so by comparison it was so much better.) Since it was so energizing for me, it really cut my appetite a lot. I actually lost weight on it. I wish I could have tolerated it better. I still think of possibly adding a small amount of it onto Effexor for some energy.
I was going to say "you have no idea how much I'm looking forward to that anxiety relief" from the maprotiline and Effexor but then I realized that you probably do.
Take care,
Kara> Thanks so much Kara. You are very kind. Here
I go again with a ton of questions. I just want to have an alternate plan that I am comfortable with should the pdoc not be keen on Provigil (he can be a bit of a stick in the mud at times). So, my questions. Can you tell me what dose of nortriptyline you were taking? If it had not been for the racing, would you have found nort effective for adhedonic depression? Did you experience any weight gain (even though I was unhappy about gaining 7 pounds on Anafranil, I don't really need to worry too much about gaining some weight. I just don't want to end up becoming a happy heffer!). Did you experience any cognitive impairment while you were taking it? Well, those are the questions I can think of for now. If Ihave more, I know where to find you!
>
> And, good luck to you with the maprotiline. It must be somewhat of a relief to know that you will have some anxiety relief soon.
>
> Take care,
>
> Tamara
> >
> > Hi Tamara,
> > Just wanted to add my two cents here. I reacted very differently to amitriptyline and nortriptyline. Ami. made me really groggy. I found it incredibly sedating. Nort. gave me a racing heart rate. I found it very energizing so just keep that in mind as a possibility. I know I am the exception with regard to my response to nort. but there are others out there who respond the same way. Even if it does that for you, it can still be effective against panic disorder.
> >
> > I have also taken doxepin and maprotiline and found them extremely helpful for anxiety and panic attacks. They got rid of them completely so I think you're on the right track with the nort. (In fact I just left my doctor a message requesting a prescription for maprotiline. I'll just use it low dose to help me sleep now and get the horrible anxiety under control again.)
> >
> > k
>
>
Posted by jujube on January 17, 2005, at 8:32:46
In reply to Re: Nortriptyline/Amitriptyline side effects » jujube, posted by KaraS on January 16, 2005, at 23:24:05
Posted by sfy on January 17, 2005, at 12:44:49
In reply to Re: Nortriptyline/Amitriptyline side effects » sfy, posted by jujube on January 16, 2005, at 13:23:00
> I have a few questions for you, if you don't mind. Could you please tell me if it is absolutely necessary to have blood tests done when on nortriptyline to check blood plasma levels? Have you found 50 mg sufficient to provide a good antidepressant effect, or is the 50 mg just a maintenance dose? And, what effect has nortriptyline had on anxiety (both social and general), if these were issues for you?
>
> Thnaks.My pdoc hasn't said anything to me about checking blood plasma levels though most things I've read about nort seem to indicate this is a good idea. One issue being that there is a therapeutic window for the plasma level at which nort is most effective.
I've been on the 50 mg. for about 5 weeks. At best it seems to have a subtle mood brightening effect but I can't necessarily attribute it to the nort. My mood has been fairly good in the past few months, I'm just trying to see if the nort will help my chronic low-level dysthymia. I just bumped up the dosage to 75 mg. a couple of days ago so I'll see if that provides any dramatic effect.
I have a lifelong history of social anxiety but I can't say that the nort has had any measurable pro-social effect. (My anxiety tends to manifest itself less in physical terms than in emotional terms.)
One other thing I didn't mention in my earlier post is that the nort is definitely helping with my chronic, early-awakening form of insomnia (which is most likely depression-related). I'm able to sleep through the morning without having to take anything else and with no morning hangover. For some, this sedation may be a benefit while for others this might be an unwanted side effect.
Posted by jujube on January 17, 2005, at 18:04:55
In reply to Re: Nortriptyline/Amitriptyline side effects » jujube, posted by sfy on January 17, 2005, at 12:44:49
This is the end of the thread.
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