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Re: Discontinuation: How do you know?

Posted by SLS on September 14, 2009, at 17:16:01

In reply to Re: Discontinuation: How do you know? » zana, posted by SLS on September 14, 2009, at 16:45:24

> Maybe you should get rid of the Remeron first. That would leave Seroquel in place to continue to provide histamine H1 blockade and prevent rebound insomnia and anxiety. I would then attempt to discontinue the Risperdal. You then might want to bring nortriptyline in before getting rid of the Seroquel. This might replace the 5-HT2a antagonism of the Seroquel and the NE reuptake inhibition of the Seroquel metabolite to prevent relapse

Now that I think about it, I think it makes more sense to add the nortriptyline after you discontinue the Remeron and before you try to discontinue the Risperdal. Risperdal is a potent antagonist of 5-HT2a receptors, and it might be smart to have nortriptyline on board as a buffer.


- Scott

 

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