Posted by papillon2 on July 25, 2012, at 11:59:16
In reply to Re: Relation between nortriptyline levels and efficacy, posted by linkadge on July 18, 2012, at 20:46:00
I don't understand. If your blood level is adequate but you have relapsed / have breakthrough depression for no good reason, then surely the med has indeed failed or just isn't up to scratch. It's not like it goes POOF! out of your system. It's still there, but it's no longer doing its thing.
Is your doc saying that your blood level used to be higher, so it may just be a dosage issue? Because that I understand. If that's what he's saying, that you still have room to move, then push the dose higher to see if it switches into gear again.
If that doesn't work, or you have indeed maxed out your dose, try augmenting it with a mood stabilizer such as Lithium. If that in turn doesn't work, it's time to switch your anti-depressant.
Obviously your current treatment isn't working well enough for you. We can argue about causes as much as we like, but if something's not working it's time to stop flogging the dead horse and move on. Stop the suffering. Change things up. It sucks having to take another ride on the med-go-round, but untreated depression sucks more.
Hang in there. I know it's tough. I went through this process last year when Effexor stopped being effective after 7 years. I thought that was a good innings, but 20 -- wow! I now take Nortriptyline amongst other things. Here's hoping it's as successful for me as it seems to have been for you.
Ring the bells that still can ring
forget your perfect offering
there is a crack in everything
that's how the light gets in
~ Leonard Cohen
poster:papillon2
thread:1021709
URL: http://www.dr-bob.org/babble/20120718/msgs/1022104.html