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Re: Nortriptyline addition (25mg) seems to help...... PeterMartin

Posted by SLS on October 29, 2023, at 23:02:47

In reply to Nortriptyline addition (25mg) seems to help......, posted by PeterMartin on October 26, 2023, at 3:38:31

I am taking the following:

Nardil: 90 mg/day
Nortriptyline: 100 mg/day
Lamotrigine: 300 mg/day
Lithium: 450 mg/day (Increased from 300 mg/day)

My comment is that you don't treat the dosages of MAOI + TCA when combined any different than each alone. In other words if you needed 150 mg/day of nortriptyline to produce a maximal effect in monotherapy, you will likely need 150 mg/day of nortriptyline when combined with a MAOI. Likewise, your dosage of MAOI does not have to be adjusted when nortriptyline is added to it.

This has been my personal expereince and the strategy used by aggressive doctors.

If this doesn't apply to you, then start nortriptyine at 25 mg/day and titrate gradually.

The TCAs to stay from are imipramine and clomipramine - SRI being the culprit. Doxepin and trimipramine might be safe to combine with a MAOI, too. Nortriptyline has the mildest side-effects, and makes me feel better than desipramine does. I find nortriptyline to be more anhedonic.



- Scott


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I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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