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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Maxime on February 18, 2006, at 9:23:24
Hi
Anyone taking or who has taken nortriptyline
also know as Aventyl/Pamelor, how sedating is it?Would it go well with Prozac? I am thinking of adding Desipramine, but wondering if Pamelor would be a better choice. I will of course consult with my doctor.
Maxime
Posted by Racer on February 18, 2006, at 11:38:15
In reply to How sedating is nortriptyline, posted by Maxime on February 18, 2006, at 9:23:24
Nortriptyline was the first AD I ever took, back in the bad old days. It was a revelation.
In fact, once it kicked in, the doctor who dragged me to a psychiatrist to get treated for depression in the first place, dragged me to the psychiatrist to be checked for bipolar, because she couldn't believe that the cheerful, bubbly person she was seeing had just been hidden by the depression. She thought it more likely I was manic. (Answer was nope -- that was probably the person I was supposed to be.)
Anyway, I do remember a bit of sedation -- remember, this was 1985? 1986? Long time ago. Anyway, I do remember there was some, and some insomnia -- which might have been me, not the drug -- and some constipation. And I know that none of them were as bad as the same things on Paxil. On Paxil, I needed a daily nap. On nortriptyline, I felt draggy part of the afternoon. That sort of thing.
And personally? Although this was before Prozac was available, so I don't really know, I would expect that the nortriptyline/Prozac combo would be a good choice. It seems as though Prozac would help counter some of the side effects of the nortriptyline.
Good luck with it.
Posted by Maxime on February 18, 2006, at 14:11:23
In reply to Re: How sedating is nortriptyline, posted by Racer on February 18, 2006, at 11:38:15
Thanks Racer. Actually my doctor has a patient on the Prozac/Nortriptyline combo. I was worried about sedation because I think Nortriptyline turns into Amitriptyline which is so sedating that I couldn't get past 10 mg.
All I know is that I am going nowhere with the Prozac alone.
Maxime
> Nortriptyline was the first AD I ever took, back in the bad old days. It was a revelation.
>
> In fact, once it kicked in, the doctor who dragged me to a psychiatrist to get treated for depression in the first place, dragged me to the psychiatrist to be checked for bipolar, because she couldn't believe that the cheerful, bubbly person she was seeing had just been hidden by the depression. She thought it more likely I was manic. (Answer was nope -- that was probably the person I was supposed to be.)
>
> Anyway, I do remember a bit of sedation -- remember, this was 1985? 1986? Long time ago. Anyway, I do remember there was some, and some insomnia -- which might have been me, not the drug -- and some constipation. And I know that none of them were as bad as the same things on Paxil. On Paxil, I needed a daily nap. On nortriptyline, I felt draggy part of the afternoon. That sort of thing.
>
> And personally? Although this was before Prozac was available, so I don't really know, I would expect that the nortriptyline/Prozac combo would be a good choice. It seems as though Prozac would help counter some of the side effects of the nortriptyline.
>
> Good luck with it.
Posted by ed_uk on February 18, 2006, at 14:32:46
In reply to Re: How sedating is nortriptyline » Racer, posted by Maxime on February 18, 2006, at 14:11:23
Hi Maxie
>I was worried about sedation because I think Nortriptyline turns into Amitriptyline
It's the other way around. Ami turns into nort. Nort is less sedating that ami itself.
Ed xx
Posted by blueberry on February 18, 2006, at 15:18:33
In reply to How sedating is nortriptyline, posted by Maxime on February 18, 2006, at 9:23:24
Nortriptyline isn't overly sedating, but until you get used to it you will feel kind of drugged a little bit during the day. Foggy eyes, maybe some dry mouth. Prozac will increase the nortriptyline blood level, so you would only need small doses of nortriptyline to get a strong effect. I think the combo would be good. I tried both for about a week and the nortriptyline did help me sleep better, I could tolerate the drugginess somewhat, but the dry mouth I got was just too much. Funny, I remember I had hand tremors before nortriptyline, and they completely went away while on it. It was overal calming but kind of motivating at the same time. But, don't expect side effects to be as tame as prozac. Desipramine might be good too, but it could be too activating. I tried just a little bit once and it was calming for the first couple hours and then oh my did it get me uncomfortably overstimulated.
Posted by Maxime on February 18, 2006, at 17:40:33
In reply to Re: How sedating is nortriptyline » Maxime, posted by ed_uk on February 18, 2006, at 14:32:46
Ed - *blush* oops!
Maxie xx
> Hi Maxie
>
> >I was worried about sedation because I think Nortriptyline turns into Amitriptyline
>
> It's the other way around. Ami turns into nort. Nort is less sedating that ami itself.
>
> Ed xx
Posted by Maxime on February 18, 2006, at 17:43:56
In reply to How sedating is nortriptyline, posted by Maxime on February 18, 2006, at 9:23:24
Now I am trying to remember if I had an allergic reaction to Nortriptyline. It was either that or imipramine. Darn!
Maxime
Posted by Phillipa on February 18, 2006, at 23:49:33
In reply to How sedating is nortriptyline, posted by Maxime on February 18, 2006, at 9:23:24
Maxie pamelar is sedating couldn't get out of bed all the next day. Felt like I was part of the bed. Fondly,Phillipa
Posted by Cairo on February 19, 2006, at 23:08:48
In reply to Re: How sedating is nortriptyline, posted by blueberry on February 18, 2006, at 15:18:33
I take 20mg Nortriptyline at bedtime for chronic pain. I can tolerate it much better than 5mg of amitriptyline, which totally knocked me out all day, but I still crash in the afternoons. I'm not sure if it's the nortriptyline or hypofunctioning adrenals and poor sleep, as I suspect.
I have a couple of questions regarding nortriptyline, though. How much SSRI effect does it have and what might it do to your sleep cycle?
Cairo
Posted by zeugma on February 20, 2006, at 5:57:18
In reply to Re: Better than amitriptyline, posted by Cairo on February 19, 2006, at 23:08:48
Nortriptyline promotes delta sleep, much like trazodone, and for the same reason (5HT-2 blockade). Nortriptyline is more powerful as a serotonin antagonist than as a serotonin reuptake inhibitor. It is much more powerful than trazodone as a suppressant of REM sleep because it is also an NRI.
It is much more sedating than fatiguing (i.e. it causes the desire to sleep but i don't feel hung over from it). Since my baseline is so fatigued and drowsy anyway (even 300 mg Provigil does not make me feel energetic, though it does help me focus, and combined with lots of caffeine I can stay awake) I don't think it causes any kind of 'crash' for me, unlike Strattera. If I do fall asleep in the afternoon, though, I know the nortriptyline has lost its effect, because I go immediately into REM, which is very unpleasant for me, as I suffer from intense hypnagogic hallucinations.
-z
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