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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by ed_uk on March 17, 2005, at 16:27:03
Hi!!!!!
How are you doing? Is the nortriptyline still agreeing with you?
Best regards,
Ed.
Posted by TamaraJ on March 17, 2005, at 20:03:01
In reply to Dear TamaraJ...., posted by ed_uk on March 17, 2005, at 16:27:03
Hi to you too!!!
The nort is still agreeing with me. I had gone up to 50mg for a couple of nights, but felt a little over-sedated in the morning, so went back down to 25mg (stupid me). I will upping the dose to 50mg tomorrow night (I am sure the morning sedation will likely subside as my body adjusts to the increased dose). Even at 25mg I noticed an improvement in mood, including a lessening and almost elimination of the feeling of dread I had been experiencing, so I am hopeful about the benefits of the increased dose.
And, the pdoc gave me a small script for Klonopin to use for the next month. I think that will help with some of the residual anxiety (fingers crossed). Ed, do you think I should start Klonopin by using at night for the first week or so to allow my body to get used to it and to try to avoid the sedation that can come with starting Klonopin? I am a little nervous about Klonopin since I have only ever used Xanax, and it has never made me sluggish or fatigued or dampened my mood. Oh well, time will tell, and hopefully it will only be needed for the short-term.
Take good care Ed. Hope you have fully recovered from the virus you had.
Tamara
> Hi!!!!!
>
> How are you doing? Is the nortriptyline still agreeing with you?
>
> Best regards,
> Ed.
Posted by ed_uk on March 18, 2005, at 8:41:27
In reply to Re: Dear TamaraJ.... » ed_uk, posted by TamaraJ on March 17, 2005, at 20:03:01
Hi!
>The nort is still agreeing with me.
Excellent :-)
>I had gone up to 50mg for a couple of nights, but felt a little over-sedated in the morning, so went back down to 25mg (stupid me). I will upping the dose to 50mg tomorrow night (I am sure the morning sedation will likely subside as my body adjusts to the increased dose).
Have you got a prescription for the 10mg pills, so you can adjust your dose?
>Ed, do you think I should start Klonopin by using at night for the first week or so to allow my body to get used to it and to try to avoid the sedation that can come with starting Klonopin?
Yes, it can be helpful to take it at night for the first few days and then to give it in divided doses thereafter.
>Hope you have fully recovered from the virus you had.
Thank you, I have :-)
Best regards,
Ed.PS. Keep posting on YOUR new thread! I hope you like it.
Posted by TamaraJ on March 18, 2005, at 18:45:30
In reply to Re: Dear TamaraJ.... » TamaraJ, posted by ed_uk on March 18, 2005, at 8:41:27
> Hi!
>
> Excellent :-)
>
-- My sentiments exactly :-) I hope to get a good response to the 50mg, and be able to eventually (within a year or so) get myself back to my usual state so that I can perhaps be AD free. But, I will take it one day at a time.
>
> Have you got a prescription for the 10mg pills, so you can adjust your dose?
>
-- I raised it with the pdoc, but he seemed to want me to try 50mg first. I don't think I will have a problem tolerating 50mg, so I didn't want to irritate him by insisting on 10mg pills.
> >
> Yes, it can be helpful to take it at night for the first few days and then to give it in divided doses thereafter.
>
-- Thanks, that's what I will do. If all goes well, I don't imagine I will have to use it for that long (hopefully). Then I can just use Xanax for those times when anxiety becomes overwhelming (i.e., during PMS :-().
>
> Thank you, I have :-)
>
-- That is very good to hear. Be well Ed, and take good care of yourself.All the best to you,
Tamara
>
> PS. Keep posting on YOUR new thread! I hope you like it.-- Yes, it was very nice of you to start it. Thank you :-) I had actually planned to post today, but I very much appreciate your starting this thread. You are a Babbler par excellence - and very kind too!
Posted by ed_uk on March 19, 2005, at 12:03:49
In reply to Re: Dear TamaraJ.... » ed_uk, posted by TamaraJ on March 18, 2005, at 18:45:30
Hi Tamara!
I hope you are ok today :-)
I told Mattias (tensor) that you'd recently started nortriptyline, I thought he might be interested. I think he has sent you an email.
Btw, do you have a dry mouth on nortriptyline 50mg? Did you get a dry mouth from clomipramine 75mg? (or whatever the maximum dose you took was, I can't remember!)
>I don't think I will have a problem tolerating 50mg, so I didn't want to irritate him by insisting on 10mg pills.
I thought it might be useful to get the 10mg pills at your next appointment in case you want to adjust the dose. If 50mg isn't adequate after about 6 weeks you could go to 60mg etc. If 50mg isn't adequate I suppose you might want to try 75mg though!
>If all goes well, I don't imagine I will have to use it for that long (hopefully). Then I can just use Xanax for those times when anxiety becomes overwhelming (i.e., during PMS :-().
What dose of clonazepam will you be taking?
Ed xxx
Posted by TamaraJ on March 19, 2005, at 13:12:54
In reply to Re: Dear TamaraJ.... » TamaraJ, posted by ed_uk on March 19, 2005, at 12:03:49
> Salut Ed!
>
> I hope you are ok today :-)
>
-- I am, thanks for asking :-) I slept a little late (until after 9 a.m.), but I don't feel fatigued or lethargic at all.
>
> I told Mattias (tensor) that you'd recently started nortriptyline, I thought he might be interested. I think he has sent you an email.
>
-- Yes, we have exchanged a couple of e-mails this morning. Hopefully, I have given him some useful information (given that I am a new user of nort).
>
> Btw, do you have a dry mouth on nortriptyline 50mg? Did you get a dry mouth from clomipramine 75mg? (or whatever the maximum dose you took was, I can't remember!)
>
-- Well, I can't say for sure because I smoke (yuk I know). So, because I am a smoker, I usually have a dry mouth in the morning. Plus, I have always consumed a lot of water or diluted juice during the day, so I can usually avoid severe dry mouth. It was the same on the Clomipramine. The maximum dose I took was 75mg, but the already bad hypotension got even worse, which is why I stopped it. And, even at 75mg, I didn't notice much of an AD effect for me (but then I have read that smoking can reduce the effectiveness of TCAs), and felt like I was just using a SSRI with much more severe side effects.
>
> I thought it might be useful to get the 10mg pills at your next appointment in case you want to adjust the dose. If 50mg isn't adequate after about 6 weeks you could go to 60mg etc. If 50mg isn't adequate I suppose you might want to try 75mg though!
>
-- I will raise the 10mg pills with him at my next visit. I am so hoping that 50mg will do the trick. I am also taking a couple of natural supplements - Enada NADH and L-Tyrosine - both of which are good for energy and motivation.
>
> What dose of clonazepam will you be taking?
>
-- The pdoc prescribed .5mg twice a day. I took .5 last night and slept very well. Once I get used to it, I will probably try .5 at night and .5 in the a.m.Take care Ed.
Tamara
xxx
Posted by rainbowbrite on March 20, 2005, at 20:00:18
In reply to Re: Dear TamaraJ.... » ed_uk, posted by TamaraJ on March 19, 2005, at 13:12:54
Hi Tamara!
How are you doing? just wanted to say HI :-)
Take care
Rain
Posted by TamaraJ on March 20, 2005, at 20:07:38
In reply to Re: Dear TamaraJ.... » TamaraJ, posted by rainbowbrite on March 20, 2005, at 20:00:18
Hi to you too! I am doing pretty good, thanks. How about you? Hope things are going well. How is the paper going? Hope you've managed to make some progress. Deadlines - Ugh! Hang in there. You will get it done :-)
Take care, and good luck with the paper.
Tamara
> Hi Tamara!
>
> How are you doing? just wanted to say HI :-)
>
> Take care
>
> Rain
Posted by rainbowbrite on March 20, 2005, at 20:24:02
In reply to Re: Dear TamaraJ.... » rainbowbrite, posted by TamaraJ on March 20, 2005, at 20:07:38
HEY
Paper? do I have a paper? HAHA funny joke Tamara! If I had a paper due I would not be on my computer LOL :-P That would be procrastinating.
Im glad you are well, did you have a nice weekend?
Posted by TamaraJ on March 26, 2005, at 20:09:18
In reply to Re: Dear TamaraJ.... » TamaraJ, posted by ed_uk on March 19, 2005, at 12:03:49
> Hi Ed!
>
My trial of nortriptyline continues to go well. I increased my dose to 50mg about a week ago, and have tolerated the increased dose very well. I have not had any troubling side effects, which makes me very happy :-). I have noticed that I am craving carbs more than usual, and have probably gained a couple of pounds, but not much more than that (which isn't too bad since before I started nort I really wasn't eating, so having an appetite is a welcome change). And, I have a little bit of dry mouth, but nothing than keeping myself hydrated won't help (which I do anyway - lots of water for me). It appears that 50mg is going to be a therapeutic and effective dose for me, to which I will supplement with a few natural supplements - Enada NADH, L-Tyrosine, L-Glutamine and Acetyl L-Carnitine or DMAE (or both), as well as increased physical activity/exercise.Anyway, that's about it. I seem to be doing alright.
Posted by ed_uk on March 27, 2005, at 16:54:51
In reply to Re: Dear TamaraJ - Nortriptyline trial » ed_uk, posted by TamaraJ on March 26, 2005, at 20:09:18
Hi Tamara!
>My trial of nortriptyline continues to go well.
Excellent :-) Are you (almost) completely free of depression now? I'm really glad that you're not having any bad side effects, especially dizziness! It's a good thing that your pdoc agreed to prescribe nort!
Ed x
Posted by TamaraJ on March 27, 2005, at 17:38:30
In reply to Re: Dear TamaraJ - Nortriptyline trial » TamaraJ, posted by ed_uk on March 27, 2005, at 16:54:51
> Hi Ed!
>
> Excellent :-) Are you (almost) completely free of depression now?~~~ I would say I am pretty close - yahoo! Just wrestling with some residual anxiety and avoidant behaviours, which bring me down a bit, but not majorly. But, those should subside as I continue to be more active.
I'm really glad that you're not having any bad side effects, especially dizziness!
~~~ I am too :-) Even the mild dizziness that had become a part of my life for the past year or so is much reduced. So, that is also a relief.
It's a good thing that your pdoc agreed to prescribe nort!
~~~ I think so too. I feel pleased with myself for being so assertive :-), although I am sure he would probably describe me as difficult :-( Oh well, such is life!
Take care Ed.
Tamara xx
>
>
Posted by ed_uk on March 27, 2005, at 17:55:30
In reply to Re: Dear TamaraJ - Nortriptyline trial » ed_uk, posted by TamaraJ on March 27, 2005, at 17:38:30
Hi!
>I would say I am pretty close - yahoo!
:-D It looks like you won't even need to increase the dose! In a few weeks time the maximum effect of 50mg should be evident.
>I am sure he would probably describe me as difficult.........
I can't imagine you being difficult! I'm sure many of his patients are much more difficult!
Kind regards,
Ed.PS. Keep posting your progress, it's great to hear when someone does well. Are you taking anything for your anxiety at the moment? I think you mentioned clonazepam.
Posted by TamaraJ on March 28, 2005, at 19:21:37
In reply to Re: Dear TamaraJ - Nortriptyline trial » TamaraJ, posted by ed_uk on March 27, 2005, at 17:55:30
> Hi!
>
> :-D It looks like you won't even need to increase the dose! In a few weeks time the maximum effect of 50mg should be evident.
>
~~~ I've been at 50mg for a little over a week I think. So are you saying that the longer I take it, and as the medication builds up in my body, the good effects could increase (is that what is meant by peak plasma levels)? Sorry for the stupid question. For the most part, I am pretty new to this medication stuff.
>
> I can't imagine you being difficult! I'm sure many of his patients are much more difficult!~~ You're so nice :-) I just feel like I have been difficult because he has had to change my medication a few times (due to non-response, but always after close to 8 week trials). And, one time, I burst into tears in his office. Oh well, if all goes well, he won't have to put up with me for much longer :-)
>
> All the best to you,Tamara
>
> PS. Keep posting your progress, it's great to hear when someone does well. Are you taking anything for your anxiety at the moment? I think you mentioned clonazepam.
>
~~~ The pdoc agreed to let me try Klonopin. I have been using .5mg at night for about a week. I am not sure I like the effects. I didn't take it on Saturday night, and Sunday I felt even more energetic. I took it last night, and have felt a little sluggish today. But, it has been overcast today, so that could be why I feel a bit sluggish. But, I have to say, I much prefer the effects of Xanax, which never made me feel sluggish, but rather made me feel calm, focussed and even a bit more confident. Geez, talk about making a short story long! :-)
Posted by ed_uk on March 28, 2005, at 19:44:06
In reply to Re: Dear TamaraJ - Nortriptyline trial » ed_uk, posted by TamaraJ on March 28, 2005, at 19:21:37
Hiya!
>So are you saying that the longer I take it, and as the medication builds up in my body, the good effects could increase (is that what is meant by peak plasma levels)?
You'll already have reached the peak plasma level but the effects of nort should continue to increase as changes continue to occur in the brain in response to the med. (sorry about bad grammar!)
>I just feel like I have been difficult because he has had to change my medication a few times ........
That's not your fault :-)
>I much prefer the effects of Xanax...
LOL Dump the Klonopin, get some more Xanax!
Ed xxx
Posted by TamaraJ on March 28, 2005, at 20:18:09
In reply to Re: Dear TamaraJ - Nortriptyline trial » TamaraJ, posted by ed_uk on March 28, 2005, at 19:44:06
> Hi there!
>
> You'll already have reached the peak plasma level but the effects of nort should continue to increase as changes continue to occur in the brain in response to the med. (sorry about bad grammar!)
>
~~~ Ah, now I understand. Thanks :-)> LOL Dump the Klonopin, get some more Xanax!
>
~~~ I think that's what I'll do. I have Xanax on hand, as prescribed by my family doctor (before I started seeing the pdoc). Unfortunately, I will have to convince the pdoc to renew the prescription, when necessary, because my family doc has closed her practise due to illness :-( He isn't very keen on Xanax (or any benzo really). Well, I'll cross that bridge when I get to it.Tamara xxx
Posted by ed_uk on March 29, 2005, at 6:46:39
In reply to Re: Dear TamaraJ - Nortriptyline trial » ed_uk, posted by TamaraJ on March 28, 2005, at 20:18:09
Hi!!!
>Xanax...
I'm sure you could convince your pdoc to give you some Xanax as a prn :-)
Ed xx
This is the end of the thread.
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