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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 Schlepo on October 21, 2018, at 9:39:30
Hi. What are some good nortriptyline augmentation options? I tried Lyrica back in 2012 and it was pretty productive. I'm wondering if there's anything new out there.
Posted by SLS on October 21, 2018, at 11:13:15
In reply to Nortriptyline augmentation options., posted by Schlepo on October 21, 2018, at 9:39:30
> Hi. What are some good nortriptyline augmentation options? I tried Lyrica back in 2012 and it was pretty productive. I'm wondering if there's anything new out there.
Have you tried Effexor (venlafaxine) yet? I once combined it with nortriptyline. It helped.
My doctor has had some success using Trintellix (vortioxetine) with his treatment-resistance patients.
- Scott
Posted by Schlepo on October 21, 2018, at 12:48:57
In reply to Re: Nortriptyline augmentation options., posted by SLS on October 21, 2018, at 11:13:15
So are any of those in the same class as Lyrica, or have a similar method of action?
Posted by Christ_empowered on October 21, 2018, at 17:38:51
In reply to Nortriptyline augmentation options., posted by Schlepo on October 21, 2018, at 9:39:30
gabapentin...i would think you'd need more mgs than lyrica and more frequent dosing. a benzodiazepine...personally, id say avoid klonopin...
maybe just a cleaner, less toxic, more modern anti-seizure drug? some people do well on trileptal. id try to avoid high doses, if you can...mind numbing, for me...
ok. hope this helps.
Posted by Schlepo on October 21, 2018, at 18:15:59
In reply to Re: Nortriptyline augmentation options., posted by Christ_empowered on October 21, 2018, at 17:38:51
I'm already on clonazepam, and that's what;s sort of causing issues with me. What other benzo would you recommend and why. There also seem to be some troubling interactions between Effexor and Nortriptyline. Is the danger overstated?
Posted by Schlepo on October 21, 2018, at 18:41:01
In reply to Re: Nortriptyline augmentation options., posted by Schlepo on October 21, 2018, at 18:15:59
I also just read something about Xanax working for depression. Is that true?
Posted by Christ_empowered on October 22, 2018, at 4:20:55
In reply to Re: Nortriptyline augmentation options., posted by Schlepo on October 21, 2018, at 18:41:01
xanax has been used for some forms of depression. back in the day, some doctors would use high doses. not the best idea. now, there's an xr. oh, and the advice is 4mgs/day or less.
Posted by Schlepo on October 22, 2018, at 15:00:24
In reply to Re: Nortriptyline augmentation options., posted by Christ_empowered on October 22, 2018, at 4:20:55
I've heard you can build up a tolerance to it, though. Is that true? And would the xr reduce the chances?
Posted by Schlepo on October 22, 2018, at 19:28:36
In reply to Re: Nortriptyline augmentation options., posted by Schlepo on October 22, 2018, at 15:00:24
Also, what are the pros and cons of Atavan when compared to Xanax?
Posted by Christ_empowered on October 23, 2018, at 13:03:51
In reply to Re: Nortriptyline augmentation options., posted by Schlepo on October 22, 2018, at 19:28:36
hi. i have no idea how popular xanax xr is, honestly. the idea was all day anxiolytic coverage with 1 pill, which is funny because when xanax 1st hit the market...they more or less invented the panic attack DSM criteria. true story.
a quick google search shows that there can be a problem waking up with anxiety, so maybe 2x doses, 1 at night? or a different bzd for sleep?
i preferred ativan to xanax. it works quickly. not as potent, mg per mg as xanax. more relaxing (muscle relaxer qualities...I imagine depends on dosage...), and...xanax, if i recall correctly, has some unusual effects in addition to the sedative stuff, so....not so great if your "anxiety" runs into "agitation," but I could see xanax being a better choice if the "anxiety" includes seriously low mood.
ativan tapers can be rough, too...but i don't think they rise to the level of xanax tapers. where i live, doctors seem to be more about the ativan now than xanax, but...i cannot generalize that to anywhere else, clearly.
hope this helps.
This is the end of the thread.
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