Posted by Racer on June 8, 2008, at 14:52:41
In reply to Nortryptylin, posted by georgia52 on June 4, 2008, at 13:21:12
> He had to change docs because of insurance and the new doc was shocked he was taking this drug. He said it was very old and that there were better ones.
Well, he's half right, and the other half is more opinion than fact. Nortriptyline is part of a very old class of drug, the tricyclic antidepressants. They've been around since about the late 50s. Lexapro is a member of the SSRI class, which is considerably newer. For many people, the benefit of SSRIs over TCAs is actually the more tolerable side effect profile of the SSRIs. (Keep in mind -- many people here have had a different experience of these medications. I'm talking about overall, on average, for people who are not treatment resistant.)
It sounds as though your son was responding to nortriptyline, but I'm wondering why you asked about increasing the dose? Was he not finding it entirely effective? If so, increasing the dose might have increased side effects, and wouldn't necessarily have offered more effectiveness. On the other hand, nortriptyline has a known therapeutic window, which can be checked by testing blood levels. If your son was in that window, there wouldn't be a good reason to increase the dose.
And I would wonder a lot about increasing the Ritalin, if your son is doing well on a low dose PRN.
Honestly, I wonder if your new doctor isn't making changes either because he feels as though he needs to make changes to justify his fees, or perhaps because he isn't familiar enough to be comfortable with this medication protocol. It's worth asking him why he's making these changes, and what the reasoning behind them is.
Good luck.
poster:Racer
thread:832894
URL: http://www.dr-bob.org/babble/20080606/msgs/833644.html