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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by ihatedrugs on December 22, 2009, at 1:31:34
Hello all,
I am going to the psyc doctor tomorrow to discuss my lack of progress with Emsam. I don't know if I should give it more time but the insomnia is definitely not helping. I have been reading through some of the posts and it seems that Nortriptyline may be a possibility. The only thing was that I've had an ischemic attack a year ago and according to the literature this med should not be taken if you have any vascular disease eg. stroke. I don't have high blood pressure but I suffer from high cholesterol. I want a med that makes me feel relatively normal doesn't cause weight gain and allows me to get a good night sleep. I wonder if used in combination with Lexapro may work. I tried Lexapro several years ago and it performed at around 70% efficacy, perhaps if I add Nortriptyline, it could potentiate its effect.
What do you guys think? How many of you have used Nortriptyline succesfully. Also in addition, it seems that Nortriptyline helps with body aches and pain which I have been lately suffering but do not know the reason. I guess I am a little hesitant because all the searches I did on this med basically said it works but it carries fatal danger risks.ihatedrugs
Posted by bleauberry on December 22, 2009, at 16:28:36
In reply to Nortriptyline (should I try it), posted by ihatedrugs on December 22, 2009, at 1:31:34
Based on what you have said, and based on a general view of what many others have said here and elsewhere, I would not recommend doing Nortriptyline as monotherapy. I would however cheer loudly at the idea of starting Nortryptiline alongside Lexapro or Zoloft. I would strongly favor that approach. Don't start one and add another later. Start them both at the same time.
And while you are it, don't get aggressive with dosing right from the start. 10mg Nortriptyline and 5mg Lexapro would be a good starting point. For me I found about a 40% overall improvement within days with a mere 5mg Nortriptyline and 6.25mg Zoloft. My general view, which is contrary to most views, is that these drugs are often overdosed. You can always go to higher doses later. Don't jump the gun and blow right past your magic therapeutic window. Too much is just as bad, if not worse, than not enough.
Nortriptyline + SSRI starting at low doses, awesome idea. Outstanding idea.
Nortirptyline by itself, not impressed at all with that idea.
Posted by ihatedrugs on December 23, 2009, at 2:40:30
In reply to Re: Nortriptyline (should I try it), posted by bleauberry on December 22, 2009, at 16:28:36
I went to the dr. today and that is what we are planning on. I am going to start the maoi wash out on January 1st. I would begin earlier but my family and I are going to NYC for New Year's eve and I don't want to be going through any withdrawal while on vacation. I am switching to Lexapro and 10mg of nortriptyline and see where that takes me. I've tried so many meds and combinations that at this point I don't even get my hopes up. I just keep on pushing through hoping one day the nightmare is over.
Happy holidays,
ihatedrugs
Posted by Jay_Bravest_Face on December 23, 2009, at 9:51:27
In reply to Nortriptyline (should I try it), posted by ihatedrugs on December 22, 2009, at 1:31:34
> Hello all,
>
> I am going to the psyc doctor tomorrow to discuss my lack of progress with Emsam. I don't know if I should give it more time but the insomnia is definitely not helping. I have been reading through some of the posts and it seems that Nortriptyline may be a possibility. The only thing was that I've had an ischemic attack a year ago and according to the literature this med should not be taken if you have any vascular disease eg. stroke. I don't have high blood pressure but I suffer from high cholesterol. I want a med that makes me feel relatively normal doesn't cause weight gain and allows me to get a good night sleep. I wonder if used in combination with Lexapro may work. I tried Lexapro several years ago and it performed at around 70% efficacy, perhaps if I add Nortriptyline, it could potentiate its effect.
> What do you guys think? How many of you have used Nortriptyline succesfully. Also in addition, it seems that Nortriptyline helps with body aches and pain which I have been lately suffering but do not know the reason. I guess I am a little hesitant because all the searches I did on this med basically said it works but it carries fatal danger risks.
>
> ihatedrugsHello...
Well, I am just going by my little bit of evidence, but I do have many years experience being on Nortriptyline. The drug has worked well for me, but Nortriptyline has some often bizarre side-effects, even though the drug is often great with many different types of depression and anxiety. There is a warning in the Canadian monograph about why you should not use the drug if you have problems with anger, or very activating drugs. If you have any cardiovascular issues, I'd honestly stay away from Nortriptyline. I think you would be taking too much of a risk. The drug often does cause weight gain.
There are often paradoxical reactions to Nortriptyline..sometimes Nortriptyline can be a bit sedating, and sometimes very activating.
It can affect blood pressure either down or up.I don't know the finer details about Cymbalta and cardiovascular issues, but it may be a med worth asking your pdoc about. It is supposed to help a bit with pain. An addition of another drug, Lyrica, may also help a bit with pain, and possibly a bit with depression.(It may help with anxiety too.)
Best wishes..
Jay
Posted by ihatedrugs on December 24, 2009, at 0:47:01
In reply to Re: Nortriptyline (should I try it) » ihatedrugs, posted by Jay_Bravest_Face on December 23, 2009, at 9:51:27
Thanks for the input. I am a little bit scared about Nortriptyline and cardiovascular issues since I had a ischemic attack (blood clot in my intestines) about 3 years ago. The dr. wants me to take only 10 mg for pain and sleep. Hopefully I won't have any paradoxical side effects. I have tried Cymbalta in addition to Savella, Pristiq but they didn't do much. Savella actually made me very angry although it did help with the pain. The only thing I can do is try it and hope for the best. I really do not have that many options since I have pretty much tried everything in the arsenal except for the old meds. The dr. told me about the weight gain but there are others who actually loose weight on it. With my luck I'd probably gain weight. Since I have gained a total of 40lbs since being on psychotropic meds. Thanks again for your input.
Happy holidays
ihatedrugs
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