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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Laney on May 9, 2010, at 11:50:16
Gillman? You can skype him for free and he's fond of the combo of Nortrip + Zoloft? What do you think of my taking his advice?
He thinks I should just go ahead and add Nortip. to my Zoloft which I've been on for almost 4 wks. with some "patchy" results.
Thanks!
Laney
Posted by linkadge on May 9, 2010, at 12:44:11
In reply to Bleauberry, ed, Link, ?? What do you think of Dr., posted by Laney on May 9, 2010, at 11:50:16
Worth a try. There is always the idea too of switching SSRIs. Many patients respond to one SSRI but not another.
I'm fond of the nortriptyline + citalopram combo, but I'm sure nortriptyline + sertaline is just as effective.
Linkadge
Posted by ed_uk2010 on May 9, 2010, at 13:27:35
In reply to Bleauberry, ed, Link, ?? What do you think of Dr., posted by Laney on May 9, 2010, at 11:50:16
Hi Laney,
I sent you a babblemail.
Nortriptyline is often a useful drug to combine with Zoloft. It can also be combined with Celexa or Lexapro.
Paxil may block the metabolism of nortriptyline and increase the risk of side effects/toxicity. These two drug are not usually combined.
Posted by Phillipa on May 9, 2010, at 13:59:41
In reply to Re: Bleauberry, ed, Link, ?? What do you think of Dr., posted by ed_uk2010 on May 9, 2010, at 13:27:35
Hi Laney no good results as yet? Phillipa
Posted by bleauberry on May 9, 2010, at 19:20:29
In reply to Bleauberry, ed, Link, ?? What do you think of Dr., posted by Laney on May 9, 2010, at 11:50:16
I like the idea. Anecdotally the combo has a good track record. Certainly a lot less traumatic of an experience than switching meds to something else.
Posted by Roslynn on May 10, 2010, at 13:43:08
In reply to Re: Bleauberry, ed, Link, ?? What do you think of Dr., posted by ed_uk2010 on May 9, 2010, at 13:27:35
Hi, what about Prozac/nortriptyline combo? Would that potentially work also?
Thanks,
Roslynn
>
> Paxil may block the metabolism of nortriptyline and increase the risk of side effects/toxicity. These two drug are not usually combined.
Posted by ed_uk2010 on May 10, 2010, at 15:07:40
In reply to Re: Bleauberry, ed, Link, ?? What do you think of Dr. » ed_uk2010, posted by Roslynn on May 10, 2010, at 13:43:08
> Hi, what about Prozac/nortriptyline combo? Would that potentially work also?
Prozac is not an ideal drug to combine with tricyclics, since it may inhibit their metabolism. If someone on Prozac or Paxil needs to take nortriptyline, the initial dose of nortriptyline should be extremely low.
Posted by Roslynn on May 10, 2010, at 16:39:45
In reply to Re: Bleauberry, ed, Link, ?? What do you think of Dr. » Roslynn, posted by ed_uk2010 on May 10, 2010, at 15:07:40
Thank you, this is interesting..I have been on prozac/desipramine and now just started prozac/protriptyline. No one ever suggested to me that a different SSRI might be a better drug to pair with a TCA.
Wonder why??>
> Prozac is not an ideal drug to combine with tricyclics, since it may inhibit their metabolism. If someone on Prozac or Paxil needs to take nortriptyline, the initial dose of nortriptyline should be extremely low.
>
>
Posted by Brainbeard on May 19, 2010, at 14:22:36
In reply to Re: Bleauberry, ed, Link, ?? What do you think of Dr. » ed_uk2010, posted by Roslynn on May 10, 2010, at 16:39:45
Good results have been reported with a Prozac and amitriptyline (mother drug of nortriptyline) combo.
However, doses of any TCA should be low and/or built up slowly, since Prozac inhibits 2D6 liver enzymes dramatically and all secondary amino TCA's (nortriptyline, desipramine etc.) are dependent on 2D6.
I have been combining low doses of Prozac with low doses of imipramine with good results. It was obvious to me that my blood levels of desipramine were much higher than without the Prozac.
This is the end of the thread.
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