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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 inanimate peanut on June 26, 2010, at 1:53:36
Those of you who are/were on nortriptyline and parnate together, what is your parnate dose? What was your starting nortrip dose? What is your current/was your stable nortrip dose? Thanks!
Posted by SLS on June 26, 2010, at 6:15:42
In reply to nortriptyline and parnate, posted by inanimate peanut on June 26, 2010, at 1:53:36
> Those of you who are/were on nortriptyline and parnate together, what is your parnate dose? What was your starting nortrip dose? What is your current/was your stable nortrip dose? Thanks!
I am a rapid metabolizer of TCA, so I ended up at 150mg of nortriptyline. You can use blood tests to help find the right dosage. 50-75mg is probably a good place to start as a target dose. You can begin treatment at 10mg or 25mg. If you have never taken nortriptyline before, it might sedate you in the beginning. My final dosages were Parnate 80mg and nortriptyline 150mg.
- Scott
Posted by Phillipa on June 26, 2010, at 12:41:03
In reply to Re: nortriptyline and parnate » inanimate peanut, posted by SLS on June 26, 2010, at 6:15:42
Is that why l0mg knocked me out? Phillipa
Posted by SLS on June 26, 2010, at 12:44:47
In reply to Re: nortriptyline and parnate » SLS, posted by Phillipa on June 26, 2010, at 12:41:03
> Is that why l0mg knocked me out? Phillipa
Yes. You can't judge nortriptyline by the amount of sedation you experience when you first start it.
- Scott
Posted by inanimate peanut on June 26, 2010, at 16:00:57
In reply to Re: nortriptyline and parnate » SLS, posted by Phillipa on June 26, 2010, at 12:41:03
When you combine it with parnate, what is dangerous, BP lows or highs?
Posted by SLS on June 27, 2010, at 5:33:39
In reply to Re: nortriptyline and parnate, posted by inanimate peanut on June 26, 2010, at 16:00:57
> When you combine it with parnate, what is dangerous, BP lows or highs?
I think most doctors worry about the combination triggering an acute hypertensive event. Certainly, hypotension can become a more chronic problem. However, Parnate is somewhat unpredictable with respect to blood pressure. Monotherapy can sometimes elicit a hypertensive reaction, usually early in treatment. I have not had a problem mixing either desipramine or nortriptyline with Parnate. Nortriptyline would be my first choice because it is less cardiotoxic.
- Scott
Posted by inanimate peanut on June 27, 2010, at 23:10:26
In reply to Re: nortriptyline and parnate » inanimate peanut, posted by SLS on June 27, 2010, at 5:33:39
Did you start them at the same time or did you add one to the other? Sorry so many questions :-)
Posted by SLS on June 28, 2010, at 6:28:07
In reply to Re: nortriptyline and parnate » SLS, posted by inanimate peanut on June 27, 2010, at 23:10:26
> Did you start them at the same time or did you add one to the other? Sorry so many questions :-)
I have established treatment in three ways without sequalae:
1. Start both drugs simultaneously.
2. Add MAOI to ongoing TCA treatment.
3. Add TCA to ongoing MAOI treatment.1 and 2 are considered acceptable. 3 is not, although I don't know why. I never had a problem with it. I will be adding Nardil to ongoing nortriptyline treatment next week.
- Scott
Posted by inanimate peanut on June 28, 2010, at 21:59:01
In reply to Re: nortriptyline and parnate, posted by SLS on June 28, 2010, at 6:28:07
Thanks for the info. I hope adding the Nardil goes well for you.
Posted by SLS on June 29, 2010, at 13:13:02
In reply to Re: nortriptyline and parnate, posted by inanimate peanut on June 28, 2010, at 21:59:01
> Thanks for the info. I hope adding the Nardil goes well for you.
Thanks.
:-)
- Scott
This is the end of the thread.
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