Posted by ed_uk2010 on May 27, 2010, at 14:49:12
In reply to Need some advice. Those of you knowledgeable, posted by Laney on May 27, 2010, at 10:18:02
If you actually feel worse after taking 100mg of sertraline (a full therapeutic dose) for six weeks, I would recommend that you taper off it. I do not think it would be appropriate to increase the dose of sertraline because you are still taking paroxetine, another SSRI. I do not see any reason to continue sertraline if it is providing no benefit.
Nortriptyline could certainly prove useful for your depression. You need to start with a low dose because it may be potentiated by paroxetine. Initially, you may feel drowsy on nortriptyline, but this should decrease after a couple of weeks.
Nortriptyline is clearly an effective antidepressant in its own right. If you were able to stop paroxetine, I would recommend trying nortriptyline on its own. Unfortunately, since you obviously find it very difficult to reduce the dose of paroxetine, you may as well continue taking 10mg for the time being.
In future, if you wish to stop taking paroxetine, a transition over to fluoxetine (Prozac) might be helpful because fluoxetine is much easier to stop than paroxetine and it also reduces paroxetine withdrawal symptoms. Fluoxetine and paroxetine both interact with nortriptyline so you wouldn't be able to make this transition if you were taking nortriptyline.
poster:ed_uk2010
thread:949099
URL: http://www.dr-bob.org/babble/20100524/msgs/949127.html