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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by rculater on August 2, 2011, at 5:47:36
Im coming into 3rd week of nortriptyline 20mg, I cant sleep properly, vivid horrid dreams, im terribly irritable and short tempered, hungry, my legs feel like lead if I try and excersise and I feel general like crap.
Tried Amitrptyline - had too many cognitive effects and left me zombified and then chest pains scared the hell out of me.
This is my second go with nort,. failed early due to same problems 2 years back.
Any ideas ive run out??
If im going to go through the TCAs what would anyone recommend next ?
Posted by B2chica on August 2, 2011, at 8:16:30
In reply to At my wits end- ami zonked me, nort wires me. Next, posted by rculater on August 2, 2011, at 5:47:36
i had three on my list to try two were the same as your two, my third was tramipramine...
but i'm afraid my knowledge about it is limited. i'm not even sure why i picked that one now. it was a while ago.
Posted by Christ_empowered on August 2, 2011, at 9:52:35
In reply to At my wits end- ami zonked me, nort wires me. Next, posted by rculater on August 2, 2011, at 5:47:36
I've never taken Surmontil, but its supposedly kinda sorta like clozapine (only different). High doses have been used in trials for schizophrenia with good results. At lower doses it has sedating and anti-anxiety effects. I don't know about cardiovascular sides; I would think they'd be less pronounced, but I don't know.
What symptoms are you trying to deal with? Do you think another TCA trial is a good idea, or do you want to move on to a different class of ADs? Do you think maybe you could try something that isn't an antidepressant?
Posted by rculater on August 2, 2011, at 10:26:27
In reply to Re: At my wits end- ami zonked me, nort wires me. Next, posted by Christ_empowered on August 2, 2011, at 9:52:35
Most gps here wont prescribe maoi or anticonvulsants they are for pdocs only and getting one of those on the free health service inst easy.
Atypical/dysthemia is the condition i am trying to treat.
Posted by Phillipa on August 2, 2011, at 11:03:05
In reply to Re: At my wits end- ami zonked me, nort wires me. Next » Christ_empowered, posted by rculater on August 2, 2011, at 10:26:27
It just sounds like maybe TCA's arent for you. I was given one 41 years ago and anxiety so bad cried and walked the streets all night that was it for me. Was then on valium for up til now. Phillipa
Posted by jono_in_adelaide on August 2, 2011, at 20:01:21
In reply to At my wits end- ami zonked me, nort wires me. Next, posted by rculater on August 2, 2011, at 5:47:36
Why not try somthing other than a TCA - if such a low dose of nortriptyline troubles you, why not try Remeron or Effexor or one of the other choices out there?
Posted by bleauberry on August 3, 2011, at 4:59:41
In reply to At my wits end- ami zonked me, nort wires me. Next, posted by rculater on August 2, 2011, at 5:47:36
Well for what it's worth, my opinion is that TCAs should be combined with ssris. Neither should be monotherapy.
Nortriptyline was supposed to cause weight gain. For me it did the opposite. I also found it uncomfortably stimulating. Easily agitated, etc.
The dose that did actually feel like it was beginning to do some good, without hardly any side effects, was 5mg. I had to make my own custom capsules. But....this was in combination with 6.25mg zoloft. The synergy of the two was totally different than either drug alone.
The TCAs feel different when combined with SSRIs.
So I would say listen to your instincts.. If your side effects are telling you 20mg is too much, then lower it. But before getting too frustrated or burned out on the whole TCA thing, they need to be combined with small dose ssri, preferably zoloft, because otherwise you won't know what the drug really could have done.
IMO
Ok, so worst case scenario months down the road and none of the TCAs worked good for you. Next stop....Milnacipran.
And no matter what med you are trying, I think either monotherapy or combination therapy with Rhodiola is a good idea. A pdoc in NYC does that too. It is a tricky plant however....dosing tricky because it takes on significantly different flavors and results depending on the dose size...it takes some patience and trial to find your own sweet spot.
Posted by rculater on August 3, 2011, at 11:11:14
In reply to Re: At my wits end- ami zonked me, nort wires me. Next, posted by jono_in_adelaide on August 2, 2011, at 20:01:21
remeron had me eating spoonfuls of sugar.
Effexor was OK for a while but i made a mistake of stopping (gradually) rather than upping my dose,well that experience of trying to get off was hell really hell.
Never again will i touch effexor or pristiq.
Posted by rculater on August 3, 2011, at 11:14:03
In reply to Re: At my wits end- ami zonked me, nort wires me. Next, posted by bleauberry on August 3, 2011, at 4:59:41
interesting - might go down to 10mg see what happens. Its weird, although im sleeping like crap, i seem to have energy in the day and no overwhelming urge to sleep like previously.
Will try every option mono before i try cocktails. thanks for input....
ps Milnacipran looks interesting, have you had any experience with this ??
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