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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 July 10, 2010, at 19:14:52
I know the max is about 150 but what is the lower end of the therapeutic dose range for nortriptyline? Is it similar to the SSRIs in that it takes 4-6 weeks to take effect or does it take effect more quickly? What is the story on these blood tests (what are they for, how often, etc.)?
Posted by morgan miller on July 10, 2010, at 21:15:02
In reply to nortriptyline questions, posted by inanimate peanut on July 10, 2010, at 19:14:52
I think it acts faster that SSRIs and I believe it's very possible you may get the therapeutic benefit you need at a fairly low dose.
Good Luck! I may be trying Nortriptyline soon!
Posted by Phillipa on July 10, 2010, at 23:41:30
In reply to Re: nortriptyline questions, posted by morgan miller on July 10, 2010, at 21:15:02
10mg the first night put me in la la land slept til 2pm next day so it was rapid. Phillipa
Posted by inanimate peanut on July 11, 2010, at 18:19:24
In reply to nortriptyline questions, posted by inanimate peanut on July 10, 2010, at 19:14:52
what is the minimum effective dose of nortriptyline for bipolar depression (generally)? I've seen 75mg some places-- is that right? I want to keep my dose as low as possible since I'm on a high dose (90mg) of Parnate. How long does nortriptyline take to work? Is it 4-6 weeks like SSRIs or should I except to feel better sooner? I was planning to go up to the minimum effective dose and wanted to know how long I should stay there before I increase if I don't get any effects.
Posted by inanimate peanut on July 11, 2010, at 18:21:59
In reply to Re: nortriptyline questions, posted by morgan miller on July 10, 2010, at 21:15:02
that would be really good news on both accounts. if you do go with nortriptyline, i hope it works out well for you!
Posted by morgan miller on July 11, 2010, at 19:27:00
In reply to Re: nortriptyline questions » morgan miller, posted by inanimate peanut on July 11, 2010, at 18:21:59
I hope it works well for you to. I'm curious to see how things go. Good luck!
Posted by SLS on July 11, 2010, at 20:53:50
In reply to anyone else? SLS? ed_uk2010?, posted by inanimate peanut on July 11, 2010, at 18:19:24
> what is the minimum effective dose of nortriptyline for bipolar depression (generally)?
That is going to depend upon whether or not you are a rapid metabolizer. Blood tests will reveal this. The therapeutic range is between 50-150 ng/ml. Nortriptyline is the best studied of the tricyclic antidepressants with respect to clinical use of blood tests.
> I've seen 75mg some places-- is that right?
This seems to be true of most people. I take 150mg. Without using blood tests, you can try 75mg for 3 weeks or so. If you tolerate it, you can then move up by 25mg every 2 weeks.
It has been my experience that the dosage of TCA needed to produce a therapeutic effect is not reduced when used in combination with a MAOI. I don't know that this is universally true, though.
- Scott
Posted by inanimate peanut on July 11, 2010, at 21:02:27
In reply to Re: anyone else? SLS? ed_uk2010? » inanimate peanut, posted by SLS on July 11, 2010, at 20:53:50
Thanks!
Posted by inanimate peanut on July 11, 2010, at 21:10:28
In reply to Re: anyone else? SLS? ed_uk2010? » inanimate peanut, posted by SLS on July 11, 2010, at 20:53:50
So did you have no response at all until you got to 150mg or did you have a partial response at lower doses that was just improved as the dose was increased?
Posted by SLS on July 11, 2010, at 21:30:02
In reply to Re: anyone else? SLS? ed_uk2010? » SLS, posted by inanimate peanut on July 11, 2010, at 21:10:28
> So did you have no response at all until you got to 150mg or did you have a partial response at lower doses that was just improved as the dose was increased?
I experienced a partial response at 75mg, but it varied around dosing. I lost the antidepressant effect between doses. It was not obvious at first. I know that you want to take the minimum dose necessary to produce the greatest effect. That is the goal, of course. Blood tests should help facilitate this. They would help prevent you from wasting time unnecessarily at subtherapeutic dosages.
- Scott
This is the end of the thread.
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