Posted by papillon2 on June 2, 2012, at 10:25:31
In reply to Re: Sudden worsening of Nortriptyline side effects, posted by psychobot5000 on June 2, 2012, at 0:33:27
> I don't know your case well, but I thought I'd throw a thought out there: around the time things took a turn for the worse, did you make any other change in medication, or supplementation, perhaps? I'm just wondering if there could have been a metabolic (i.e. liver) interaction that's changed the blood-levels of the nortrip in your system, presumably raising them and causing the increased side-effects. Has your doc taken blood-levels of the medication? Might be worth checking that you're in the therapeutic range.
Unfortunately there have been no recent med or supplement changes at which to point a finger. Getting another blood level done is a fantastic idea, however. Thank you! :-)
> Re: schizophrenia, unless you have a parent, brother or sister who has it, I think the benefits of taking something like clomipramine are worth the risks (which likely are not high, in any case). It is the most effective tricyclic. That said, if you don't like SSRIs, that drug may not be the way to go, as its profile is somewhat similar (like a cross between imipramine and an SSRI, with features of both). That said...if doctors there don't like combining antidepressants, clomipramine may be just the thing, since it's almost a combination drug on its own.
Re: SSRIs, it's more that those I've tried have never done very much for me. My first, Luvox, either made me catatonic or didn't prevent my depression worsening to that state. The second, Celexa, improved my condition enough for me to be discharged from hospital only to attempt suicide suicide two weeks later. I don't recall any side effects.I hypothesize that I need a good amount of noradrenalin/norepinephrine action. Seretonin alone isn't enough. My depression was treated fairly successfully by Effexor XR for 7 years but then the medication stopped working and/or my depression worsened/morphed. Probably both. I had a reasonable response to Remeron but the side effects (weight gain and related anxiety / threat of ED relapse) were intolerable.
> MAOis are statistically better than tricyclics for atypical depression, but I'm not aware of any reverse law that indicates they're worse for melancholic depression. Statistically, MAOis are simply the most powerful drugs we have (clomipramine, effexor and remeron are also probably slightly better than SSRIs, according to meta-analyses).
I did not mean to suggest that MAOIs are bad for melancholic depression, I have just read that they are better suited to atypical depression.Thank you for weighing in. I'll go get that blood test this week. Last reading was 500ng/mL - top of the therapeutic window.
Ring the bells that still can ring
forget your perfect offering
there is a crack in everything
that's how the light gets in
~ Leonard Cohen
poster:papillon2
thread:1018899
URL: http://www.dr-bob.org/babble/20120522/msgs/1019104.html