Posted by polarbear206 on July 22, 2009, at 19:31:29
In reply to Re: Calling SLS » polarbear206, posted by SLS on July 22, 2009, at 15:07:23
> > Question for you about Nortip. I take 300mg of effexor and would like to cut dose in half, and add nortrip. Reason is d/t sexual side effects of effexor. P-doc gave me 10mg caps to start off with and can take up to 3. I knew from the get-go that I would need a higher dose, more like 100mg with the 150 effexor. Been down the wellbutrin road and it caused increased anxiety and anger. Your thoughts.
>
>
> Hi.
>
> You are doing everything right in the way you are bringing nortiptyline on board. It is an interesting notion that one can reduce the need for Effexor by bringing in a NE reuptake inhibitor to make up the difference. One can argue that the high dosage of Effexor is necessary only to establish enough NE reuptake inhibition to produce the therapeutic response, and that the 5-HT reuptake inhibition is exceeding what is necessary. It makes sense.
>
> You should, of course, consider this an experiment. Based upon my own experience, though, my first reaction is to say that if you absolutely need to take no less than 300mg of Effexor to obtain a response, adding nortriptyline won't change that. Since I have been known to be wrong from time to time :-), you might as well run your experiment to see what happens.
>
> Effexor 300mg and nortriptyline 75mg treated me pretty well, all things considered. It was only a partial improvement, though. If my doctor had been smart enough at the time, he would have had me take a test for nortriptyline blood levels. I really needed to take twice as much. Perhaps I would have attained remission were I to have taken 150mg.
>
> If your doctor will allow you to continue to take 300mg of Effexor while you titrate the nortriptyline, I would first establish a therapeutic dosage of the nortriptyline. Then, you can begin to reduce the Effexor gradually. With a little luck, perhaps you won't need any Effexor at all. And if you do, I hope your hypothesis is correct and that you are able to cut the Effexor dosage down low enough to reduce side effects.
>
> I really hope this works for you. Please apprise us of your progress. I'll keep my fingers crossed for you.
>
>
> - ScottThanks Scott. I really appreciate your knowledge and input. You are a great asset to this community. :)
poster:polarbear206
thread:907915
URL: http://www.dr-bob.org/babble/20090721/msgs/908007.html