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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by TamaraJ on September 19, 2005, at 15:14:08
My biggest problem is anxiety, which is causing depression. My new pdoc has started me on Paxil CR (12.5 to start) since I had good results with regular Paxil in the past. I have found that since I stopped the small amount of Nortriptyline (25mg) I had been taking prior to starting the Paxil CR about 10 days ago, my sleep hasn't been as good. I wake up a few times in the night, and, when it is time to get up in the morning, I feel like I haven't slept at all. When I was on Paxil before, I never had a problem with sleep or getting up in the morning.
My question: Is it safe to take 25mg of nortriptyline for a few nights while I am taking Paxil CR? Or would that be too much serotonin? I had read that nortriptyline has only a mild effect on serotonin and a moderate effect on norephedrine. I take the Paxil CR in the
morning.Any advice would be appreciated. Thanks so much.
Posted by linkadge on September 19, 2005, at 15:16:07
In reply to Nortriptyline plus SSRI - Is this ok?, posted by TamaraJ on September 19, 2005, at 15:14:08
I don't see this as causeing a problem.
Linkadge
Posted by zeugma on September 19, 2005, at 15:48:09
In reply to Nortriptyline plus SSRI - Is this ok?, posted by TamaraJ on September 19, 2005, at 15:14:08
the problem with the nortriptyline/paxil combination has nothing to do with serotonin, but with paxil blocking the hepatic enzymes needed to metabolize nortriptyline, leading to potential toxicity of nortriptyline levels. 25 mg nortriptyline is a very low dose so is unlikely to pose a problem, but I would definitely let your pdoc know what you are doing.
nortriptyline is an excellent med for sleep.
-z
Posted by Phillipa on September 19, 2005, at 18:09:24
In reply to Re: Nortriptyline plus SSRI - Is this ok?, posted by zeugma on September 19, 2005, at 15:48:09
It sure is. I took l0mg with l5mg of valium per pdoc order and couldn't get out of bed in the morning. I've been afraid to try the nortiptaline again because of it. But how come all the benzos don't do this? And how does nortriptaline help depression? Ed said for me to continue the valium and take 5mg of nortriptaline. But so far I've been scared. Oh and does it cause wt gain at these doses? Fondly, Phillipa
Posted by TamaraJ on September 20, 2005, at 16:16:59
In reply to Re: Nortriptyline plus SSRI - Is this ok?, posted by zeugma on September 19, 2005, at 15:48:09
I'll raise it with my pdoc when I see him this week. I had forgotten about SSRIs increasing the blood plasma levels of Nortriptyline, so it's probably best that I not take any nort with the Paxil CR until I talk to the pdoc.
This is the end of the thread.
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