Posted by SLS on June 25, 2005, at 0:35:34
In reply to Re: Desimpramine vs Nortriptyline » SLS, posted by TamaraJ on June 24, 2005, at 21:05:26
> > I think the first thing you should do is to get a nortriptyline blood level and see if it makes sense to raise the dosage to 100mg. You might as well try pushing it now.
> -- I asked my pdoc about a blood test the last time I saw him, but he didn't seem to want to do one. I will raise it again when I see him next week. I did, however, try 100mg a little over a month ago for a week or so, and it seemed to have an adverse effect on my mood, not to mention that it left me feeling sluggish and slow.
Your feeling worse at a higher dosage (100mg) is not an unexpected phenomenon with nortriptyline. This drug has a therapeutic window that is pretty narrow. There is a minimum and a maximum dosage that will be effective. Anything higher than that maximum will cause a relapse. The drug just stops working if the dosage is too high. I don't know whether or not it is worth retrying the higher dosage.
I find it unusual that an older psychiatrist should be so averse to using the older medications. Maybe he believes all of the hype surrounding the newer ones at the expense of all of the rest. Although it might not be time to try one, I hope he will not be adamant about not trying an MAOI. When I shop for a doctor, I use MAOIs as a litmus test. If they don't prescribe them, I don't bother seeing them. Actually, if they are unwilling to prescribe MAOI + TCA, I can't afford to see them. This combination, along with Lamictal, seems to be the only thing that helps. I can report, however, that for the past few days, adding Tileptal has given me a significant improvement for which I am very grateful. I am beginning to believe that this drug will be my magic pill when added to the others.
- Scott
poster:SLS
thread:518211
URL: http://www.dr-bob.org/babble/20050622/msgs/518482.html