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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by hansi555 on December 19, 2008, at 10:51:06
...I am taking it together with Lexapro (20 mg morning) and Remeron (15 mg in the evening).
Since going to a therapeutic dose w. Nortriptyline I have had no depression-like sympthoms such as crying spells, early wakening, poor appaetite etc.
But I never seem to get real happy as I did when I had my good periods on Lexapro/Remeron (soon followed by a bad period).
So now I am wondering whether to reduce the Lexapro a bit as my PD says this not-100% feeling is a typical SSRI feeling.
Maybe I cant have it all but tomorrow I am going on one week skiing holiday, so would be nice to get it a bit better...
Any thoughts?
Posted by desolationrower on December 19, 2008, at 13:08:42
In reply to Nortriptyline (85 mg) is working but..., posted by hansi555 on December 19, 2008, at 10:51:06
That sounds worth trying.
Have you been on a therapeutic dosage long? It might take a bit to recover positive affect. you could also try increasing the mirtazepine dose, since it antagonizes the receptors thought to be responsible for ssri-apathy.
i'd have trouble not enjoying a whole week skiing : )
-d/r
Posted by hansi555 on December 19, 2008, at 17:09:25
In reply to Re: Nortriptyline (85 mg) is working but..., posted by desolationrower on December 19, 2008, at 13:08:42
> That sounds worth trying.
>
> Have you been on a therapeutic dosage long? It might take a bit to recover positive affect. you could also try increasing the mirtazepine dose, since it antagonizes the receptors thought to be responsible for ssri-apathy.
>
> i'd have trouble not enjoying a whole week skiing : )
>
> -d/rAprrox. 3 weeks, how long should I wait?
Posted by desolationrower on December 21, 2008, at 14:21:33
In reply to Re: Nortriptyline (85 mg) is working but..., posted by hansi555 on December 19, 2008, at 17:09:25
full response often take 6 weeks or so. SSRIs tend to increase postivie affect slower, if they do it at all, but i'm not sure how fast nris increase it. I guess i'd make an appointment for a few weeks foward, and if you feel the same then, ask your pdoc to increase the mirt or decrease the ssri.
-d/r
Posted by hansi555 on December 25, 2008, at 13:00:01
In reply to Re: Nortriptyline (85 mg) is working but..., posted by desolationrower on December 19, 2008, at 13:08:42
> also try increasing the mirtazepine dose, since it antagonizes the receptors thought to be responsible for ssri-apathy.
>Hi again
how sure are you about this?
Posted by desolationrower on December 26, 2008, at 1:14:50
In reply to Re: Nortriptyline (85 mg) is working but..., posted by hansi555 on December 25, 2008, at 13:00:01
> > also try increasing the mirtazepine dose, since it antagonizes the receptors thought to be responsible for ssri-apathy.
> >
>
> Hi again
>
> how sure are you about this?
>like most of this, its just a possibility. a lot of it is just trying meds until you get the right ones and right dosages, and making educated guesses based on past reactions what you should try next.
you may also just not need quite so much nortriptiline to stay out of depression...some people on stimulants report feeling robotic, espcially in a allwork-noplay kind of way. does that seem to fit more than the apathy being a depression symptom that hasn't gone away?
-d/r
Posted by hansi555 on December 30, 2008, at 17:15:06
In reply to Re: Nortriptyline (85 mg) is working but..., posted by desolationrower on December 26, 2008, at 1:14:50
>
> you may also just not need quite so much nortriptiline to stay out of depression...some people on stimulants report feeling robotic, espcially in a allwork-noplay kind of way. does that seem to fit more than the apathy being a depression symptom that hasn't gone away?
>
> -d/rWell I never felt apathy when depressed, so I guess it is more the robotic feeling that is dominant right now.
I have lowered the Lexapro to 15 mg (from 20) as my PD claims this robotic, no joy, no sadness feeling is caused by the Lexapro and the serotonine effect it has, it seemd to have helped a bit, but I dont know for sure just yet.
This is the end of the thread.
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