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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by schleprock on September 19, 2012, at 11:31:38
(...plus klonopin and Lyrica and whatevr else I happen to be on at the time...)
Anyone think this would be a good idea as an augment (maybe 50 mg Trazodone w/ 100-150 mg of Nortriptyline), so as to make more serotonin available than nortriptyline alone?. Has it ever been done? Is it safe? What about side effects? How would this choice compare with other commonly used meds in this class (SARI).
Posted by SLS on September 19, 2012, at 15:38:31
In reply to Low dose Trazodone with Nortriptyline, posted by schleprock on September 19, 2012, at 11:31:38
> (...plus klonopin and Lyrica and whatevr else I happen to be on at the time...)
>
> Anyone think this would be a good idea as an augment (maybe 50 mg Trazodone w/ 100-150 mg of Nortriptyline), so as to make more serotonin available than nortriptyline alone?. Has it ever been done? Is it safe? What about side effects? How would this choice compare with other commonly used meds in this class (SARI).Why did you choose trazodone rather than Zoloft or Lexapro?
- Scott
Posted by jono_in_adelaide on September 19, 2012, at 16:30:09
In reply to Low dose Trazodone with Nortriptyline, posted by schleprock on September 19, 2012, at 11:31:38
I'm sure every possible combination has been done at some point, but I'm with SS, an SSRI (Citralopram, Sertaline, Lexapro) would have much more effect on seretonin than tradodone, and would be a much more logical combination.
What does your pdychiatrist think?
Posted by schleprock on September 19, 2012, at 21:28:36
In reply to Re: Low dose Trazodone with Nortriptyline, posted by jono_in_adelaide on September 19, 2012, at 16:30:09
I'm not really too sure on the exact differences between SSRIs and SARIs (the class Trazadone belongs to). It seems that trazodone works exclusively on serotonin receptors, so I'm thinking it might be easier to get a sense of what raising serotonin would do than other meds that do a bunch of things (and maybe cause more side effects?.) I'm also interested in knowing as to whether Trazodone would mess with Nortriptyline plasma levels. Also, Trazodone seems more fast-acting. I'm still in the early exploratory stages right now...
AI have come across an anecdotal report of some one using a higher dose of Trazodone with a lower dose of Nortriptyline, but this seemed to be more insomnia related.
So what are some disadvantages to Trazodone (as an adjunct)? Anyone have any side effects? Does tolerance build up quickly? Dr. Stahl seems to think Trazodone is effective as an adjunct therapy (for SSRIs, at least.) Why all the hate? I'm just looking for something to free-up a little serotonin that won't put me through hell in the process.
Posted by jono_in_adelaide on September 19, 2012, at 22:18:43
In reply to Re: Low dose Trazodone with Nortriptyline, posted by schleprock on September 19, 2012, at 21:28:36
I dont think trazadone raises seretonin, i think it blocks certain seretonin recptors
An SSRI plus nortriptyline would make a lot more sense in my book - have a read of the australian psychiatrist ken gillmans site psychotropical.com
Posted by phidippus on September 22, 2012, at 1:39:22
In reply to Low dose Trazodone with Nortriptyline, posted by schleprock on September 19, 2012, at 11:31:38
Trazodone acts predominantly as a 5-HT2A receptor antagonist to mediate its therapeutic benefits against anxiety and depression. Its inhibitory effects on serotonin reuptake and 5-HT2C receptors are relatively weak (~15-fold lower than for 5-HT2A) and contribute only lightly to its overall effects. Hence, trazodone does not have similar properties to selective serotonin reuptake inhibitors (SSRIs).
>so as to make more serotonin available than >nortriptyline alone?
At 50 mg, Trazadone's effects will be negligible. A dose of 200-400 mg might be more useful.
>Has it ever been done? Is it safe?
I'm sure it's been done before. I looked into drug reactions and couldn't find any between Trazadone and Nortryptaline.
>What about side effects?
Headache or heaviness in head
Nausea, vomiting, or bad taste in mouth
Dry mouth
Stomach pain
Diarrhea
Constipation
Changes in appetite or weight
Weakness or tiredness
Nervousness
Decreased ability to concentrate or remember things
Confusion
Brain fog or "zombie-like" sensations
Nightmares
Muscle pain
Sweating
Blurred vision
Tired, red, or itchy eyes
Ringing in earsChest pain
Fast, pounding, or irregular heartbeat
Shortness of breath
Fever, sore throat, chills, or other signs of infection
Hives
Skin rash
Itching
Difficulty breathing or swallowing
Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
Hoarseness
Decreased coordination
Uncontrollable shaking of a part of the body
Numbness, burning, or tingling in the arms, legs, hands, or feet
Dizziness or lightheadedness
Fainting
Painful erection that lasts longer than normal-That's Trazadone's side effect profile from Wikipedia
>How would this choice compare with other commonly used meds in this class (SARI)?
There are other drugs in this class, but they are not available in the US.
Eric
This is the end of the thread.
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