Psycho-Babble Medication Thread 135174

Shown: posts 1 to 13 of 13. This is the beginning of the thread.

 

Nortriptyline-Need some support!

Posted by hopko on January 10, 2003, at 9:20:28

HI all,

I have depression, anxiety, OCD and insomnia. I was taking 7.5mg of remeron and .5mg of klonopin at bedtime and had good help with my sleep but had to withdraw due to some side effects of the remeron (and yes, there was a withdrawal syndrome for me!) As soon as I went off remeron I basically quit sleeping. Talk about return of my depression! If I don't sleep I am depressed!

I upped the klonopin to 1.5mg and my p-doc started me on nortriptyline. I have tried all of the SSRI's and cannot tolerate any of them.

I am only at 40mgs as we are increasing the dose very slowly. I sleep about 5 hours (I am sure due to the klonopin), wake up at 3am and that is it. I cannot do this much longer. Will an increased dose of nortriptyline help my sleep eventually?

Ambien only helps me sleep about 4 hours and if I take it at 3am I am wasted for the entire next day.

I have tried valerian when I wake at 3 but it has not helped.

I am curious to know if anyone out there has had help with their sleep taking nortriptyline. (Someone please say yes!!!) And also, any ideas for a temporary solution so that I can sleep longer while the dose is building up?

Thanks.

 

Re: Nortriptyline-Need some support! hopko

Posted by Ritch on January 10, 2003, at 13:25:25

In reply to Nortriptyline-Need some support!, posted by hopko on January 10, 2003, at 9:20:28

> HI all,
>
> I have depression, anxiety, OCD and insomnia. I was taking 7.5mg of remeron and .5mg of klonopin at bedtime and had good help with my sleep but had to withdraw due to some side effects of the remeron (and yes, there was a withdrawal syndrome for me!) As soon as I went off remeron I basically quit sleeping. Talk about return of my depression! If I don't sleep I am depressed!
>
> I upped the klonopin to 1.5mg and my p-doc started me on nortriptyline. I have tried all of the SSRI's and cannot tolerate any of them.
>
> I am only at 40mgs as we are increasing the dose very slowly. I sleep about 5 hours (I am sure due to the klonopin), wake up at 3am and that is it. I cannot do this much longer. Will an increased dose of nortriptyline help my sleep eventually?
>
> Ambien only helps me sleep about 4 hours and if I take it at 3am I am wasted for the entire next day.
>
> I have tried valerian when I wake at 3 but it has not helped.
>
> I am curious to know if anyone out there has had help with their sleep taking nortriptyline. (Someone please say yes!!!) And also, any ideas for a temporary solution so that I can sleep longer while the dose is building up?
>
> Thanks.

Consider switching to amitriptyline instead. It is much much better for sleep, and you will get more serotonergic activity which may be more helpful for your OCD symptoms. The amitrip.'s primary metabolite is nortriptyline anyhow. You could also consider taking the nortriptyline in the daytime only (since it isn't near as sedative) at the dose you are currently at and just add 10mg of amitriptyline (possibly more) at nighttime to get you to sleep. I have read a few posts here where people were doing that so they could get the benefit of the sleep from the amitrip., but have fewer side effects and sedation overall by using a mix. hope this helps.

 

Re: Nortriptyline-Need some support! hopko

Posted by johnj on January 10, 2003, at 23:54:11

In reply to Nortriptyline-Need some support!, posted by hopko on January 10, 2003, at 9:20:28

HI
I have been on nortryptline for about 10 years. How are the side effects. I think if you can tolerte the side effects it is a very good med. However, for me, I cannot seem to be able to workout without feeling really bad. My sleep becomes disrupted and I get depressed again. I have met through this board, a few people with this similiar problem and also on amitryptline, nor's mother drug. There are lots of people that have no problem working out so it is very individual.
I was on remeron for 3 months. The sleep was lovely, but I was always to spaced out. I was on 30, then to 37.5 and then to 45. 45 was way too much for me. In fact when I titrated down just for the sleep help(I was still on nort the whole tme) I started to feel terrible. the lower the remeron the more sedating, for me anyway. 7.5 mg or even half that had me feeling much worse than 30 mg. I didn't have the spaciness at the low doses, but just felt like hell. The withdrawl was actually enjoyable.
Nort will help with sleep, but amitrypltine is more sedating, but has more side effects too. You could try a small amount of amit for the sleep help? I am on a benzo for additional sleep help as nort by itself wasn't enough. But, who knows, if you get the depression under control the sleeping may resolvo itself. For all the bad rap TCA's get, they seem to work rather well and don't cause much sexual dysfunction. ssri's, from what little I tried made me want to almost hibernate. Man, I wish I could get remron's sleep effectiveness without all the other junk. Hope this helps a little. Compare the side effect profile of each TCA and then talk with your pdoc. Even though I sometimes hate benzo's they keep me going! take care and get your vitamins, especially extra B's. I take a multiple in the morning and some extra B's at lunch and a little after dinner. I feel better, but can't tell if it is the vitamins or not.
Take care
Johnj

 

Re: Nortriptyline-Need some support! hopko

Posted by fachad on January 11, 2003, at 1:17:51

In reply to Nortriptyline-Need some support!, posted by hopko on January 10, 2003, at 9:20:28

For sleep, amitriptyline (as others have suggested) is much better than nortriptyline. It is much harsher in terms of side effects, tho, which is why docs prefer nortrip.

Doxepin and Trimipramine are equal to or greater than amitriptyline for sleep, while being much gentler in side effects.

I would suggest that you ask your doc about doxepin.

As for a temporary solution, the best OTC sleep aids for me have been doxylamine, sold as Unisom and other brands and Dramamine, sold as a motion sickness tab. But those are very inferior to ami/dox/tri.

 

Re: Nortriptyline-Need some support!

Posted by oracle on January 11, 2003, at 1:41:30

In reply to Nortriptyline-Need some support!, posted by hopko on January 10, 2003, at 9:20:28

You may have to go to 75-100 mgs to get good sleep. I fine Doxipin is really good for this.
Nortriptyline should work well, too.
Increase slowly as TCA's can be very sedating at first.

 

Re: Nortriptyline-Need some support!

Posted by hopko on January 11, 2003, at 10:00:27

In reply to Nortriptyline-Need some support!, posted by hopko on January 10, 2003, at 9:20:28

Has anyone heard of Nortriptyline CAUSING insomnia? I went up to 50mg last night (along with my 1.5 of klonopin) and slept 4 hours waking at 2:30 and that was it. I even took ambien at 4 am and still could fall asleep. Feeling great this morning! On 30mgs at least I was sleeping 5 hours.

Maybe I need a higher dose of klonopin? I was at 2mg but dropped down to 1.5 when I started the nortriptyline.

Thanks.

 

Re: Nortriptyline-Need some support!

Posted by hopko on January 11, 2003, at 10:49:00

In reply to Re: Nortriptyline-Need some support!, posted by oracle on January 11, 2003, at 1:41:30

Do you mean to substitute Doxipin for the Nortriptyline or use it as an adjunct to help sleep?

 

Re: Nortriptyline-Need some support! hopko

Posted by johnj on January 11, 2003, at 14:42:01

In reply to Re: Nortriptyline-Need some support!, posted by hopko on January 11, 2003, at 10:00:27

Hi,
Some of the best advice I have gotten was that if you are trying new meds and are increasing one and decreasing another(like klonopin for you) it will be very hard to tell which med is working or not working.
Try one at a time, then you will know which one is having what effect. Sometimes it is tough to do because we want results, and for me that means I want sleep!!
If I titrate up to 60 or 70 of nort it makes me MORE depressed. We are all different and 50 mg works the best for me. I tried 40 and my sleep was really disturbed for a long period of time. Plus, give the med a chance to work. Good luck
johnj

 

Re: Nortriptyline and Memory johnj

Posted by Jumpy on January 11, 2003, at 14:59:34

In reply to Re: Nortriptyline-Need some support! hopko, posted by johnj on January 11, 2003, at 14:42:01

JohnJ,

Hey there. I have been considering nortriptyline and lithium. I was wondering if you have noticed any memory problems or sexual dysfunction? Any advise would be greatly appreciated.

Sincerely,

Jumpy

 

Re: Nortriptyline-Need some support!

Posted by zeugma on January 11, 2003, at 17:23:46

In reply to Nortriptyline-Need some support!, posted by hopko on January 10, 2003, at 9:20:28

I have had lifelong problems with insomnia, and taking nortriptyline has stabilized my sleep schedule for the first time in many years. I can only tolerate 40 mg per day also, due to hypotension (the only side effect I have had besides some increased irritability). It has been very helpful and I try to take it in the mid-afternoon so I can get to sleep by 1 am (that's very early for me). I also take 20 mg buspirone and I have found the combination most helpful for severe inattentive ADD as well as depression.

 

Re: Nortriptyline-Need some support! hopko

Posted by BrittPark on January 11, 2003, at 19:12:41

In reply to Nortriptyline-Need some support!, posted by hopko on January 10, 2003, at 9:20:28

The only suggestion that I can think of that others haven't already made is a trial of trazadone at night before bed, but only if you're a woman. It can have extremely painful and embarassing side effect for men, priapism.

It may take time but you will find the right treatment.

Good Luck,

Britt

 

Re: Nortriptyline-Need some support!

Posted by hopko on January 11, 2003, at 20:40:24

In reply to Re: Nortriptyline-Need some support! hopko, posted by BrittPark on January 11, 2003, at 19:12:41

Thanks to everyone. My doc did not want to switch me to doxipin but did switch me to elavil at the same dose I am currently taking of nortriptyline (50mg). She thought it was possible that I could be having a paradoxical reaction to the nortriptyline and that it was keeping me awake. It certainly wasn't sedating me! Hopefully the elavil will be sedating enough that when I wake up in the middle of the night, I can get back to sleep. She also gave me some ativan (temporary solution) to help me get back to sleep until we figure out the correct dose of the elavil. Thanks again for all of your suggestions and kind responses.

 

Re: Nortriptyline-Need some support!

Posted by oracle on January 11, 2003, at 21:20:17

In reply to Re: Nortriptyline-Need some support!, posted by hopko on January 11, 2003, at 10:49:00

> Do you mean to substitute Doxipin for the Nortriptyline or use it as an adjunct to help sleep?


Try Doxipin is nortrip does not work well for you.


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.