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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by WhatToDoNext on August 5, 2008, at 12:56:22
Started last Thursday at 25mg/day....Did this x 2 days, then went to 25mg twice /day.....No side effects, so Yesterday I went to 25mg three x day. In the late afternoon my anxiety completely lifted, which it hasn't done in months. My mood has been lifting as well. I'm starting to laugh and play more with my kids as I was disinterested before as I felt so bad.
Woke up today with a little anxiety out of bed which quickly abated and feeling great today so far. I'm still on Klonopin 50mg / day, but it never did anything for me even at 150mg. I'm on nothing else but Xanax XR and Klonopin, and 10mg of Propanolol daily for rapid heartrate which is controlled.
I've tried all the SSRI's, some mood stabilizers, and low dose antipsychotics, all with NO results. This is my first Tricyclic and I guess my problem was norepinephrine over Serotonin. I kind of knew this as I took 5-HTP for about 3 weeks while on the Zoloft and started getting Serotonin Syndrome and had to stop. That told me right there that my Serotonin levels were up, but I never felt well from the increased levels.
I think 5-HTP is the test folks....If you take it and don't feel better than your problem most likely isn't Serotonin, and may be Norepinephrine. I decided on Nortriptyline over Cymbalta or Effexor, as Nortriptyline works much harder on Norepi than Either Effexor or Cymbalta. Look up the pharmacology and you'll see Effexor works 8 to 1 on Serotonin/Norepi.... Cymbalta is even worse at 30 to 1, and Nortriptyline is 2 to 3. Are you getting my point ? Hope I'm not confusing anyone here.
BTW, I've had zero side effects thus far. Fingers and toes crossed. I deserve this break as my Anxiety has been severe over the last 18 mos. and it has been daily. My depression was bad too, but no where as much as the Anxiety, which just persisted all day. Amazingly, I could sleep like a baby but the minute I woke up, I was in a Frenzy and freaking out, short of breath, shaking, brain fogged, rapid heart racing, and irritable as could be. So yesterday and Today I feel like my old self and can leave the house and conquer the world...lol I'm not manic or anything, but just excited to feel better....It's been hell as most of you can relate to.......
Will keep you posted on my progress.......Steve
Posted by Phillipa on August 5, 2008, at 13:06:58
In reply to NORTRIPTYLINE IS WORKING !!!!!, posted by WhatToDoNext on August 5, 2008, at 12:56:22
Steve that is wonderful. So happy for you. May it continue for you and please update us frequently as you seemed so miserable it's great to see something happen good for someone. Phillipa
Posted by Phillipa on August 5, 2008, at 13:12:04
In reply to NORTRIPTYLINE IS WORKING !!!!!, posted by WhatToDoNext on August 5, 2008, at 12:56:22
I see it's pamelor I took a low dose of it and boy it let me sleep. Do you take 50mg of klonopin or 5? I had thought 20mg was the max for seizures. Just asking. Phillipa
Posted by WhatToDoNext on August 5, 2008, at 15:21:05
In reply to Re: NORTRIPTYLINE IS WORKING !!!!! » WhatToDoNext, posted by Phillipa on August 5, 2008, at 13:12:04
Zoloft is 50mg day and klonopin is 1 mg twice a day.
Posted by ricker on August 5, 2008, at 19:38:50
In reply to Zoloft 50 mg Not Klonopin, posted by WhatToDoNext on August 5, 2008, at 15:21:05
Hey Steve, I just noticed your med regiment is simular to mine. I posted just above your thread "Just back from doc - Question"
If you don't mind me asking, what is your target as far as nortriptylene/zoloft mg dose?
You can check my thread our first if you'd like, prior to responding.
Best of luck with your new med trial.
Regards, Rick
Posted by Marty on August 5, 2008, at 21:03:56
In reply to NORTRIPTYLINE IS WORKING !!!!!, posted by WhatToDoNext on August 5, 2008, at 12:56:22
Great! happy for you Steve. Keep us posted, especially about the side effects as I'm confident your antidepressant/anxiolitic effect will stay. Were you sensitive to sexual side effect with other antidepressant ?/\/\arty
Posted by UGottaHaveHope on August 7, 2008, at 2:57:31
In reply to NORTRIPTYLINE IS WORKING !!!!!, posted by WhatToDoNext on August 5, 2008, at 12:56:22
That is exciting to hear. I, like many others, are very interested to hear how you do. Please keep posting every day, or as often as you can, describing as much as possible.
I might have to give this a trial ...
Posted by dcruik518 on August 7, 2008, at 23:44:43
In reply to Re: NORTRIPTYLINE - please keep us updated » WhatToDoNext, posted by UGottaHaveHope on August 7, 2008, at 2:57:31
According to the guy at psychotropicalresearch.com the zoloft + nortryptyline combo is supposed to work especially well and be be especially safe. Right now I'm taking Pristiq and doing okay, but I'd like to try this combo next. I was thinking of 100 mg of each. Anybody know the ideal dosages?
Posted by SLS on August 8, 2008, at 5:53:07
In reply to Re: NORTRIPTYLINE - please keep us updated, posted by dcruik518 on August 7, 2008, at 23:44:43
> According to the guy at psychotropicalresearch.com the zoloft + nortryptyline combo is supposed to work especially well and be be especially safe. Right now I'm taking Pristiq and doing okay, but I'd like to try this combo next. I was thinking of 100 mg of each. Anybody know the ideal dosages?
Zoloft 100-200mgnortriptyline 75-100mg
If you want, you could add nortriptyline to Pristiq. If that produces only a partial response, I would then switch to Zoloft and add Wellbutrin if necessary.I found that Effexor + nortriptyline produced a signfificant, long-term improvement for me. Using Pristiq in place of Effexor makes sense to me.
- Scott
Posted by dcruik518 on August 8, 2008, at 11:52:25
In reply to Re: NORTRIPTYLINE - please keep us updated » dcruik518, posted by SLS on August 8, 2008, at 5:53:07
> > According to the guy at psychotropicalresearch.com the zoloft + nortryptyline combo is supposed to work especially well and be be especially safe. Right now I'm taking Pristiq and doing okay, but I'd like to try this combo next. I was thinking of 100 mg of each. Anybody know the ideal dosages?
>
>
> Zoloft 100-200mg
>
> nortriptyline 75-100mg
>
>
> If you want, you could add nortriptyline to Pristiq. If that produces only a partial response, I would then switch to Zoloft and add Wellbutrin if necessary.
>
> I found that Effexor + nortriptyline produced a signfificant, long-term improvement for me. Using Pristiq in place of Effexor makes sense to me.
>
>
> - Scott
>
>
>
Thanks, Scott. I'll try that first. You may have read this already, as you seem familiar with the concepts, but I'll give you this link anyway. It's about using Nortryptyline with SSRI's as being superior to the current SNRI's as a way to sufficiently boost NE and not just Serotonin.
http://www.psychotropical.com/dual_action_ads.shtmlDwight
Posted by SLS on August 8, 2008, at 12:17:39
In reply to Re: NORTRIPTYLINE - please keep us updated ( Scott, posted by dcruik518 on August 8, 2008, at 11:52:25
Posted by theo on August 9, 2008, at 14:53:57
In reply to Re: NORTRIPTYLINE - please keep us updated » dcruik518, posted by SLS on August 8, 2008, at 5:53:07
Is Pristiq a new and improved Effexor XR?
> I found that Effexor + nortriptyline produced a signfificant, long-term improvement for me. Using Pristiq in place of Effexor makes sense to me.
>
>
> - Scott
>
>
>
Posted by SLS on August 10, 2008, at 5:08:29
In reply to Re: NORTRIPTYLINE - please keep us updated » SLS, posted by theo on August 9, 2008, at 14:53:57
> Is Pristiq a new and improved Effexor XR?
>
> > I found that Effexor + nortriptyline produced a signfificant, long-term improvement for me. Using Pristiq in place of Effexor makes sense to me.Pristiq (O-desmethylvenlafaxine) is an active metabolite of Effexor (venlafaxine). From what I understand, it is supposed to produce a robust antidepressant effect, but has milder side effects. I'm not sure if Pristiq has shown itself superior with regard to efficacy when compared to Effexor.
- Scott
Posted by dcruik518 on August 10, 2008, at 11:17:23
In reply to Re: NORTRIPTYLINE - please keep us updated » theo, posted by SLS on August 10, 2008, at 5:08:29
> > Is Pristiq a new and improved Effexor XR?
> >
> > > I found that Effexor + nortriptyline produced a signfificant, long-term improvement for me. Using Pristiq in place of Effexor makes sense to me.
>
> Pristiq (O-desmethylvenlafaxine) is an active metabolite of Effexor (venlafaxine). From what I understand, it is supposed to produce a robust antidepressant effect, but has milder side effects. I'm not sure if Pristiq has shown itself superior with regard to efficacy when compared to Effexor.
>
>
> - ScottFor me personally Pristiq is working much better than Effexor did. I really couldn't tolerate Effexor as it made me too anxious. When you get past the first few days on Pristiq it almost feels as if the drug isn't doing anything, no side effects, no typical ssri feeling. And then finally after about a month you start noticing your mood has improved. In my experience it's subtle but effective. Also, I was wrong about it being more expensive than Effexor XR. It turns out that in an attempt to market the drug they've reduced the prince considerably so that it is currently less expensive than Effexor. By how much, I don't know.
~Dwight
Posted by theo on August 10, 2008, at 11:24:33
In reply to Re: NORTRIPTYLINE - please keep us updated, posted by dcruik518 on August 10, 2008, at 11:17:23
Do you take 50mg? Can the pill be split if one wants to play it safe and start with 25mg?
> > > Is Pristiq a new and improved Effexor XR?
> > >
> > > > I found that Effexor + nortriptyline produced a signfificant, long-term improvement for me. Using Pristiq in place of Effexor makes sense to me.
> >
> > Pristiq (O-desmethylvenlafaxine) is an active metabolite of Effexor (venlafaxine). From what I understand, it is supposed to produce a robust antidepressant effect, but has milder side effects. I'm not sure if Pristiq has shown itself superior with regard to efficacy when compared to Effexor.
> >
> >
> > - Scott
>
> For me personally Pristiq is working much better than Effexor did. I really couldn't tolerate Effexor as it made me too anxious. When you get past the first few days on Pristiq it almost feels as if the drug isn't doing anything, no side effects, no typical ssri feeling. And then finally after about a month you start noticing your mood has improved. In my experience it's subtle but effective. Also, I was wrong about it being more expensive than Effexor XR. It turns out that in an attempt to market the drug they've reduced the prince considerably so that it is currently less expensive than Effexor. By how much, I don't know.
>
> ~Dwight
>
>
Posted by dcruik518 on August 10, 2008, at 13:44:41
In reply to Re: NORTRIPTYLINE - please keep us updated » dcruik518, posted by theo on August 10, 2008, at 11:24:33
> Do you take 50mg? Can the pill be split if one wants to play it safe and start with 25mg?
>
> > > > Is Pristiq a new and improved Effexor XR?
> > > >
> > > > > I found that Effexor + nortriptyline produced a signfificant, long-term improvement for me. Using Pristiq in place of Effexor makes sense to me.
> > >
> > > Pristiq (O-desmethylvenlafaxine) is an active metabolite of Effexor (venlafaxine). From what I understand, it is supposed to produce a robust antidepressant effect, but has milder side effects. I'm not sure if Pristiq has shown itself superior with regard to efficacy when compared to Effexor.
> > >
> > >
> > > - Scott
> >
> > For me personally Pristiq is working much better than Effexor did. I really couldn't tolerate Effexor as it made me too anxious. When you get past the first few days on Pristiq it almost feels as if the drug isn't doing anything, no side effects, no typical ssri feeling. And then finally after about a month you start noticing your mood has improved. In my experience it's subtle but effective. Also, I was wrong about it being more expensive than Effexor XR. It turns out that in an attempt to market the drug they've reduced the prince considerably so that it is currently less expensive than Effexor. By how much, I don't know.
> >
> > ~Dwight
> >
> >
>
>
YEs, I take 50 mg, the recommend dose. And no, you can't split the pills because they medicine is encased in a special time-release outer layer. If you want to start at less than 50 mg, i think the way to do it is just take the pill every other day..
Posted by theo on August 10, 2008, at 16:40:27
In reply to Re: NORTRIPTYLINE - please keep us updated, posted by dcruik518 on August 10, 2008, at 13:44:41
Do you take it in the evening or morning?
> YEs, I take 50 mg, the recommend dose. And no, you can't split the pills because they medicine is encased in a special time-release outer layer. If you want to start at less than 50 mg, i think the way to do it is just take the pill every other day..
>
Posted by dcruik518 on August 10, 2008, at 18:25:21
In reply to Re: NORTRIPTYLINE - please keep us updated » dcruik518, posted by theo on August 10, 2008, at 16:40:27
> Do you take it in the evening or morning?
>I take it in the morning, but it's not particularly stimulating. Could take it at night.
> > YEs, I take 50 mg, the recommend dose. And no, you can't split the pills because they medicine is encased in a special time-release outer layer. If you want to start at less than 50 mg, i think the way to do it is just take the pill every other day..
> >
>
>
Posted by theo on August 10, 2008, at 20:24:04
In reply to Re: NORTRIPTYLINE - please keep us updated, posted by dcruik518 on August 10, 2008, at 18:25:21
When you take it in the morning, do you feel it wear off late afternoon or early evening or is it smooth enough to where you don't really notice. Do you think it has a long enough half life to be taken at night?
> I take it in the morning, but it's not particularly stimulating. Could take it at night.
Posted by dcruik518 on August 11, 2008, at 14:08:12
In reply to Re: NORTRIPTYLINE - please keep us updated » dcruik518, posted by theo on August 10, 2008, at 20:24:04
> When you take it in the morning, do you feel it wear off late afternoon or early evening or is it smooth enough to where you don't really notice. Do you think it has a long enough half life to be taken at night?
>
> > I take it in the morning, but it's not particularly stimulating. Could take it at night.
>
It's extended release and you don't notice it wearing off at all. that's enough questions for now, please.
Posted by theo on August 12, 2008, at 19:54:05
In reply to Re: NORTRIPTYLINE - please keep us updated, posted by dcruik518 on August 11, 2008, at 14:08:12
Sorry, thought asking questions was what this site was about.
> It's extended release and you don't notice it wearing off at all. that's enough questions for now, please.
Posted by Marty on August 12, 2008, at 20:57:10
In reply to Re: NORTRIPTYLINE - please keep us updated » dcruik518, posted by theo on August 12, 2008, at 19:54:05
> Sorry, thought asking questions was what this site was about.
---
Hi, It's part of what you can do here, yes. Don't take this personnally as people here aren't always feeling energic and in the mood to reply/post always.. and so sometimes they just don't reply .. at least this person warned you about how he felt!Later,
/\/\arty
Posted by Marty on August 12, 2008, at 20:57:21
In reply to Re: NORTRIPTYLINE - please keep us updated » dcruik518, posted by theo on August 12, 2008, at 19:54:05
> Sorry, thought asking questions was what this site was about.
---
Hi, It's part of what you can do here, yes. Don't take this personnally as people here aren't always feeling energic and in the mood to reply/post always.. and so sometimes they just don't reply .. at least this person warned you about how he felt!Later,
/\/\arty
Posted by dcruik518 on August 13, 2008, at 15:47:32
In reply to Re: NORTRIPTYLINE - please keep us updated » dcruik518, posted by theo on August 12, 2008, at 19:54:05
> Sorry, thought asking questions was what this site was about.
>
> > It's extended release and you don't notice it wearing off at all. that's enough questions for now, please.
>
>
Sorry if that came across as rude, Theo. I just felt sort of overwhelmed by the series of questions. You're right it ought to be a place for questions. Did you have any more? ~Dwight
Posted by theo on August 14, 2008, at 19:49:32
In reply to Re: NORTRIPTYLINE - please keep us updated THEO, posted by dcruik518 on August 13, 2008, at 15:47:32
It didn't, I totally understand. I'm just one of those detail people that overanalyze and tend to ask a lot of questions.
> Sorry if that came across as rude, Theo. I just felt sort of overwhelmed by the series of questions. You're right it ought to be a place for questions. Did you have any more? ~Dwight
>
This is the end of the thread.
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