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Re: Currently on low dose Nortriptyline but not sure.. undopaminergic

Posted by Skeletor on November 8, 2020, at 12:30:55

In reply to Re: Currently on low dose Nortriptyline but not sure.., posted by undopaminergic on November 8, 2020, at 11:37:50

> > >>>Currently on low dose nortriptyline (10mg) but not sure if that's the med for me<<<
> >
> > A few days ago I added 10mg of Nortriptyline to my present 7.5 mg of Escitalopram to help with IBS, Anxiety and Depression. I figured my target dose of the Nortriptyline would probably be 25 mg, but right now I can hardly handle 10 mg: It makes me feel lethargic, sedated and drowsy. I sleep 12 hours / day. I feel kinda spaced out in the head, somewhat slow and forgetful in the hand.
> >
> > On the plus side: It enhances my appetite and that is great! It gives me good sleep! It relaxes my muscles. It also seems to diminish my restless legs.
> >
> > Will those negative side effects diminish? I want to try 25 mg, but I am afraid of even more sedation and sleepiness. Do 10 mgs seem like a ridiculously low dose? I am worried about sedation! Will it become more sedating when I get past 10 mg...?
> >
>
> Intuitively, you would think the side effects are dose-related, and, indeed, that 10 mg/day is almost a ridiculously low dose. A quick Google search suggests the maximum recommended dose to be 150 mg, and the usual adult dose to be 25 mg 3-4 times daily.
>
> Wikipedia reports there are substantial differences between individuals in terms of nortriptyline metabolism. Your symptoms suggest you may be a poor metaboliser.
>
> It's not really possible to predict whether your side effects will diminish, or whether your dose is adequate for an antidepressant response. What can be said with certainty, on the other hand, is that your current dose is sufficient to have a powerful effect on you.
>
> I suggest you wait and see before you increase the dose, given the substantial adverse effects you're experiencing.
>
> -undopaminergic
>

I always suspected that I might be a slow metabolizer at various CYP450-enzymes. I got strong effects from lowish SSRI dosages (37,5mg Sertralin, 5mg Escitalopram) and could barely tolerate higher dosages of SSRIs, e.g. 100mg Sertraline was brutal in terms of side effects... unbearbale.

And now I read that the dosage range for nortriptyline when used to treat depression is generally 75 - 150 mg/day. JESUS F CHRIST.... xD ^^

It is my hope that at higher dosages Nortriptyline becomes more pro-noradrenergic and less sedating. H1-saturation and desensitization should occur at fairly low dosages.


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poster:Skeletor thread:1112475
URL: http://www.dr-bob.org/babble/20201025/msgs/1112480.html