Posted by King Vultan on July 19, 2004, at 17:45:03
In reply to nortriptyline + celexa (+ trazodone?) for ocd ibs, posted by yeltom on July 19, 2004, at 14:09:24
Nortriptyline is not as powerful a sleep aid as trazodone and has a much longer half life, such that you are probably going to be feeling more of the effects the next day--my reference shows a half life of 18-44 hours for nortriptyline and only 4-9 hours for trazodone. I also found nortriptyline to induce constipation, this at higher dosages than what you are taking, however (50 to 75 mg/day). This is not an uncommon side effect of tricyclic antidepressants, even ones that are low in anticholinergic effects as nortriptyline is.
The trazodone isn't actually a med that you can become dependent upon like a benzodiazepine sleep aid (Halcion, for instance), but it may be that with all that's going on, you need something as powerful as trazodone to get you to sleep. I know very little about IBS, but from what I can gather, I think the reasoning to use nortriptyline in this situation was sound. Unfortunately, even with good planning, things often don't work out as one hopes in endeavors where there is a psychiatric component. All I can suggest is to reconvene with your doctor(s).
I am ignorant in this area, but is there any chance the Celexa could be part of the IBS? I ask because of a friend of mine takes Paxil and suffers from this, but he has a multitude of other problems that may be factors also.
Todd
poster:King Vultan
thread:367805
URL: http://www.dr-bob.org/babble/20040719/msgs/367904.html