Posted by SLS on November 20, 2018, at 21:14:42
In reply to Re: Playing Nortriptyline levels by ear..., posted by Schlepo on November 20, 2018, at 16:39:25
> > You might indeed have to play it by ear.
> >
> > It would be nice to get a nortriptyline blood level. It would help guide you. However, it does not always predict the right dosage. At 150 mg/day, my blood level was about 150 ng/mL. Apparently, this was too high, even though it was technically within the therapeutic window. I did significantly better once I lowered the dosage to 100 mg/day. It is more likely that someone would respond to 100 mg/day than to 200 mg/day. So, it makes sense to investigate how you feel at 100 mg/day first. No guarantees, of course. At this point in your treatment, you may only need to give a new dosage 7 days to see in what direction things are headed.
> >
> > Let us know how things go.
> >
> > Good luck.
> >
> >
> > - Scott
>
> So I got my test results from an outpatient Pdoc and I think sheshe said my nortriptyline level was 220 (she couldn't give me a copy for some reason). Can this account for an onset of previously controlled depression and anxiety and the reduction of clonazepam efficacy?220 is way too high. The top of the window should not exceed 150 ng/mL. The range is generally accepted to be 50-150. However, I have also seen it listed at 70-170. 150 ng/mL was too high for me. Depression will return if one goes too high. Odd. No other TCA displays this behavior. Not even amitriptyline does this, despite nortriptyline being its metabolite.
What will you do?
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1102072
URL: http://www.dr-bob.org/babble/20181024/msgs/1102129.html