Posted by tonyz on May 23, 2009, at 15:02:37
In reply to Re: Nortriptyline and Seroquel, etc, posted by desolationrower on May 22, 2009, at 17:43:08
> i can't tell if you are increasing or decreasing the nortr. now... have you had plasma measurement. i'm not sure what the ideal dose of it is for sleep, i guess it would depend on 5ht2 and alpha1 occupancy. gapentin might help too.
>
> have you asked about using mirtazipine instead of quitiapine
>
> temazepam seems to tbe the prefered benzo for sleep.
>
> Have you had sleep test and cbt for insomnia? i think anyone would have difficulting during the day on that little sleep. was depression or insomnia the first thing?
>
> -d/r
Always starts with high anxiety which leads to confusion and lack of sleep and rapidly turns into a very bad depression. 10 years ago when this would happen I would treat it with amitryptyline and a little valium and/or temazepam. The recovery was usually pretty quick maybe 3 months or so and I maintained some level of functionality during that time period.I never had much faith in the SSRIs because of the anxiety component of my depression.
Started back on the seroquel last night, I can't be sure but I think I got about 6.5 hours sleep - the quality of it is questionnable.
The problem with all of these drugs is that they interfere with sleep architecture. I wish I could find a different alternative. I have not been to a sleep lab. I'm not sure what they would do - could they adjust your medication based on what they observe? Not sure what cbt is?
Nortriptyline is being increased will probably go up to 150-175 mg. I've had blood levels in those ranges before so I know that is the therapeutic point for me.
For maintenance they seem to think I should be on either lithium or lamictal although no one thinks I'm bipolar.
Because of side effects Nortriptyline is not something I could stay on for the long haul.
poster:tonyz
thread:897135
URL: http://www.dr-bob.org/babble/20090515/msgs/897276.html