Posted by Schlepo on November 16, 2018, at 10:24:30
Okay, so I've had something pretty interesting happen during my first few days as an inpatient. There was an apparent nortriptyline shortage when I arrived in the evening. I had plenty of pills in my bag, but I was accused of smuggling opiates and denied access to them. They managed to find 50mg at midnight (my nightly dose is 150mg). I didn't sleep my first night there, but I hadn't slept the past 5 nights either.
Early the next day (8 AM) They were able to give me another 50mg. The Pdoc didn't want me taking more than 150mg in a day, so he prescribed only 100mg the evening (9 PM) of the second day, and I had the best sleep I'd had in years. And I dreamed in perfect clarity as opposed to dream quality on clonazepam (which I had been off a few days.) I'd even felt a little better the following day.
The following evening, I had an episode that was almost, but not quite a panic attack. It was as if I was calm and anxious at the same time, and Amazingly I was able to sleep through it, and slept just as well as the previous evening. My nortriptyline dose that night was the regular 150mg. Then my sleep quality slowly degraded, under a consistent dose of 150mg.
I'm wondering if I can gauge my nortriptyline blood level from these varying events. In general the entire dosage for that period was 100mg less than under normal circumstances. The first night/morning (12AM - 8AM taken together) was only 100mg, as was the dosage following. One could take this as an indication that I would do better on 100mg than 150mg.
On the other hand, the totality of those first three dosages occurred over a 24-hour period (50mg @ 12AM, 50mg @ 8AM, 100mg @ 9PM), 200mg altogether, the most I've taken in the complete space of a day, so maybe 200mg is better for me.
Of course this all depends on the amount of time it takes for nortriptyline to decay in your system, so it's difficult for me to gauge how much was in my system without knowing this. Of course the brief improvement could be due to a number of other factors, as well.
One last thing- could a nortriptyline level test reveal if you're not responding to nortriptyline at all, regardless the dosage?
poster:Schlepo
thread:1102072
URL: http://www.dr-bob.org/babble/20181024/msgs/1102072.html