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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by SLS on March 23, 2002, at 11:50:24
Hi.
I would like to know what dosages of nortriptyline people have taken. At what dosage did you feel best? Also, what were the drug blood-levels at these dosages?
Thanks.
- Scott
Posted by Psydoc on March 23, 2002, at 22:50:06
In reply to Nortriptyline (Pamelor) dosage ???, posted by SLS on March 23, 2002, at 11:50:24
The most common effective dose of nortriptyline is 75 mg per day. This dose most often is taken once a day at bedtime.
The blood levels associated with this dose usually fall within the therapeutic range of 50 to 150 ng/ml when measured exactly 12-hours (plus or minus 30 minutes) following the last dose.
Occasionally people do best on doses as low as 50 mg/day and I have occasionally run across patients who required over 200 mg/day to achieve a therapeutic blood level and a good clinical response.
Best regards . . .
Ivan Goldberg
psydoc@psycom.net
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Posted by Ron Hill on March 23, 2002, at 23:24:09
In reply to Re: Nortriptyline (Pamelor) dosage ???, posted by Psydoc on March 23, 2002, at 22:50:06
Dr. Ivan,
FYI. I have great respect for you. Your free time is valuable and scarce, and yet you choose to spend some time here helping people voluntarily. You have my respect!
-- Ron
---------------------------------
> The most common effective dose of nortriptyline is 75 mg per day. This dose most often is taken once a day at bedtime.
>
> The blood levels associated with this dose usually fall within the therapeutic range of 50 to 150 ng/ml when measured exactly 12-hours (plus or minus 30 minutes) following the last dose.
>
> Occasionally people do best on doses as low as 50 mg/day and I have occasionally run across patients who required over 200 mg/day to achieve a therapeutic blood level and a good clinical response.
>
> Best regards . . .
>
> Ivan Goldberg
> psydoc@psycom.net
> %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Posted by SLS on March 24, 2002, at 7:27:21
In reply to Re: Nortriptyline (Pamelor) dosage ???, posted by Psydoc on March 23, 2002, at 22:50:06
Posted by SLS on March 24, 2002, at 7:44:27
In reply to Re: Nortriptyline (Pamelor) dosage ???, posted by Psydoc on March 23, 2002, at 22:50:06
Hi Doctor.
One more question:
When the blood-level of nortriptyline exceeds 150ng/ml, does the expression of the depression that reappears have any special characteristics that would differentiate it from the under-dosed baseline?
Thanks again.
Sincerely,
Scott
> The most common effective dose of nortriptyline is 75 mg per day. This dose most often is taken once a day at bedtime.
>
> The blood levels associated with this dose usually fall within the therapeutic range of 50 to 150 ng/ml when measured exactly 12-hours (plus or minus 30 minutes) following the last dose.
>
> Occasionally people do best on doses as low as 50 mg/day and I have occasionally run across patients who required over 200 mg/day to achieve a therapeutic blood level and a good clinical response.
>
> Best regards . . .
>
> Ivan Goldberg
> psydoc@psycom.net
> %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
Posted by Psydoc on March 24, 2002, at 8:35:55
In reply to Nortriptyline dosage ??? - One more question. » Psydoc, posted by SLS on March 24, 2002, at 7:44:27
The conventional wisdom is that nortriptyline is most effective as an antidepressant when the blood level is between 50 and 150 ng/ml. The actual situation is more compex with some people responding optimally to lower levels and others requiring blood levels higher than the usually stated range.
When the blood level is higher than what is optimal for an individual, depression is likely to increase. I am not aware that the depression that happens in the presence of a high blood level is different from the depression for which the nortriptyline was originally prescribed.
Sometimes when the blood level is too high the clinical picture is complicated by CNS side-effects such as forgetfulness.
Best regards . . .
Ivan
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
> Hi Doctor.
>
> One more question:
>
> When the blood-level of nortriptyline exceeds 150ng/ml, does the expression of the depression that reappears have any special characteristics that would differentiate it from the under-dosed baseline?
>
> Thanks again.
>
>
> Sincerely,
> Scott
>
>
> > The most common effective dose of nortriptyline is 75 mg per day. This dose most often is taken once a day at bedtime.
> >
> > The blood levels associated with this dose usually fall within the therapeutic range of 50 to 150 ng/ml when measured exactly 12-hours (plus or minus 30 minutes) following the last dose.
> >
> > Occasionally people do best on doses as low as 50 mg/day and I have occasionally run across patients who required over 200 mg/day to achieve a therapeutic blood level and a good clinical response.
> >
> > Best regards . . .
> >
> > Ivan Goldberg
> > psydoc@psycom.net
> > %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
This is the end of the thread.
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