Psycho-Babble Medication Thread 1024261

Shown: posts 1 to 10 of 10. This is the beginning of the thread.

 

Anyone ever try combining Lexapro witha Tricyclic?

Posted by schleprock on August 26, 2012, at 18:17:23

In my case, Nortriptyline (150mg). Nortriptyline is apparently a little weak with regards to serotonin, so Lexapro might make a good compliment. What would be a safe dosage? And how is it's standing in regards to severe depression and anxiety?

 

Re: Anyone ever try combining Lexapro witha Tricyclic?

Posted by jono_in_adelaide on August 26, 2012, at 19:08:28

In reply to Anyone ever try combining Lexapro witha Tricyclic?, posted by schleprock on August 26, 2012, at 18:17:23

Nortriptyline + sertraline is a pretty common combo, so I cant see any reason why nortriptyline + Lexapro shouldnt work.

Your nortriptyline dose is at the upper end of normal, have you ever had a blood test to make sure that you're in the theraputic zone?

 

Re: Anyone ever try combining Lexapro witha Tricyclic?

Posted by schleprock on August 26, 2012, at 21:39:51

In reply to Re: Anyone ever try combining Lexapro witha Tricyclic?, posted by jono_in_adelaide on August 26, 2012, at 19:08:28

I've recently had a blood test, and my nortriptyline was only slightly above the reference range.

The reason that the combination of Nortriptyline and Lexapro intrigues me is mainly due to the conclusion of this article:

"Nortriptyline has superior pharmacological properties to all other TCAs as a psychotropic; it is potent as an NRI and has a wide margin between desired effects, side effects and toxicity. It is safe to combine it with either MAOIs (including moclobemide) or selected SSRIs (sertraline and possibly citalopram)."

"...to achieve the maximum efficacy from SNRI strategies, it may be necessary, and perhaps preferable, to combine two different drugs to achieve individual tailoring of the NRI/SRI ratio. For this purpose, nortriptyline has favourable characteristics, including minimal CYP450 interaction propensity and, because of this, it may be combined with sertraline without the need for therapeutic drug monitoring, except in special circumstances. All the other SSRIs are unsuitable for combination with TCAs (and many other drugs, particularly neuroleptics), with the possible exception of citalopram/escitalopram."

http://onlinelibrary.wiley.com/doi/10.1038/sj.bjp.0707253/full

Because I've heard that Lexapro (escitalopram) is more effective for depression and has a faster onset time, I find the option more attractive than Zoloft (sertraline.)

 

Re: Anyone ever try combining Lexapro witha Tricyclic?

Posted by jono_in_adelaide on August 26, 2012, at 21:54:05

In reply to Re: Anyone ever try combining Lexapro witha Tricyclic?, posted by schleprock on August 26, 2012, at 21:39:51

I'd try it - you have everything to gain and very little to lose by trying the combination.

 

Re: Anyone ever try combining Lexapro witha Tricyclic? » schleprock

Posted by brynb on August 26, 2012, at 22:03:56

In reply to Anyone ever try combining Lexapro witha Tricyclic?, posted by schleprock on August 26, 2012, at 18:17:23

> In my case, Nortriptyline (150mg). Nortriptyline is apparently a little weak with regards to serotonin, so Lexapro might make a good compliment. What would be a safe dosage? And how is it's standing in regards to severe depression and anxiety?

Hi Schleprock,

I've been on 20mg of Lexapro for awhile (and it's good for anxiety). My pdoc had me try Nortriptyline recently, but unfortunately, I couldn't tolerate it. He thought it would be a good combo, and theoretically, that makes sense, but I don't do well with too much Norepinephrine.

That said, being that you're already on Nortriptyline, I think Lexapro will be a great addition. I'm sure you'll need to start with a low dose and go from there. On its own, Lexapro was only temporarily good for my depression, but, when used in the right combo, it's great for mood and anxiety.

good luck!
b

 

Re: Anyone ever try combining Lexapro witha Tricyclic? » brynb

Posted by Phillipa on August 26, 2012, at 23:17:51

In reply to Re: Anyone ever try combining Lexapro witha Tricyclic? » schleprock, posted by brynb on August 26, 2012, at 22:03:56

What did you add to the lexapro for anxiety? Thanks Phillipa

 

Re: Anyone ever try combining Lexapro witha Tricyclic? » Phillipa

Posted by brynb on August 27, 2012, at 8:33:12

In reply to Re: Anyone ever try combining Lexapro witha Tricyclic? » brynb, posted by Phillipa on August 26, 2012, at 23:17:51

> What did you add to the lexapro for anxiety? Thanks Phillipa

Hi Phillipa,

Actually, Lexapro has been pretty good for my anxiety on its own. I take it in combo with Lithium and Tramadol. I also stopped taking benzos on a regular basis, and that actually helped my anxiety tremendously. When I'm really anxious or panicky, I take a Xanax or Valium (but only once in awhile and as a prn).

 

Re: Anyone ever try combining Lexapro witha Tricyclic? » schleprock

Posted by phidippus on August 31, 2012, at 20:00:09

In reply to Anyone ever try combining Lexapro witha Tricyclic?, posted by schleprock on August 26, 2012, at 18:17:23

Lexapro is a popular SSRI and is prescribed for severe to moderate cases of depression. I would go with a dose of 20 mg with the Nortriptalyne.

Eric

 

Re: Anyone ever try combining Lexapro witha Tricyclic?

Posted by JohnWatford on April 23, 2016, at 23:08:13

In reply to Re: Anyone ever try combining Lexapro witha Tricyclic? » schleprock, posted by phidippus on August 31, 2012, at 20:00:09

Hi - how much nortrip would you combine with 20 mg Lexapro?

 

Re: Anyone ever try combining Lexapro witha Tricyclic? » JohnWatford

Posted by SLS on April 24, 2016, at 2:50:15

In reply to Re: Anyone ever try combining Lexapro witha Tricyclic?, posted by JohnWatford on April 23, 2016, at 23:08:13

> Hi - how much nortrip would you combine with 20 mg Lexapro?

In my experience, the answer to that question is to take the same amount of nortriptyline as you would without the Lexapro. This is 75-150 mg/day, depending on your rate of metabolism. There is no interaction between the two drugs. However, it does not hurt to use blood tests for levels of nortriptyline as a guide to dosing. The optimum range of 50-150 ng/mL.


- Scott


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