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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 dopedupUK on August 4, 2010, at 9:02:51
I recently started on Nortriptyline for neuropathic pain (trigeminal nerve damage after dental surgery) + depression/anxiety. Started on 10mg, went up to 20/25/then 50mg. Last weekend sweating, tinnitus, anxiety, depression, insomnia and sexual dysfunction all bad, went back down to 25mg and saw my doc yesterday. Slow 5mg increases until I reach my tolerance level, going up to 30mg in a few days.
Might have to go on Lamotrigine, Gabapentin, Pregabalin or Lithium as well if Nortriptyline not enough for depression (bipolar ii). Does Nortriptyline cause sexual problems at 50mg and higher? I wondered if anyone has had a similar experience. Thanks.
Posted by gman22 on August 5, 2010, at 10:18:33
In reply to Nortiptyline side effects, posted by dopedupUK on August 4, 2010, at 9:02:51
Nortriptyline does not cause sexual problems in most people. It is much better than SSRI's in that respect.
Posted by Maxime on August 5, 2010, at 22:03:41
In reply to Nortiptyline side effects, posted by dopedupUK on August 4, 2010, at 9:02:51
When I started Nortrip. I started at 75 mg with no problems. I should probably have my levels checked to see if I have enough in my system.
I don't have any side effects from the medication except think it may be causing some weight gain.
Posted by bearfan on August 8, 2010, at 4:03:06
In reply to Re: Nortiptyline side effects » dopedupUK, posted by Maxime on August 5, 2010, at 22:03:41
I don't understand how many people seem to tolerate Notriptyline (Pamelor) without issue. I took the standard dose at night (75mg) and just was out cold, hard to get out of bed and felt like I had the flu for the next couple of days. I may want to retry the med, what do you guys think?
Posted by Maxime on August 8, 2010, at 8:59:09
In reply to Re: Nortiptyline side effects, posted by bearfan on August 8, 2010, at 4:03:06
> I don't understand how many people seem to tolerate Notriptyline (Pamelor) without issue. I took the standard dose at night (75mg) and just was out cold, hard to get out of bed and felt like I had the flu for the next couple of days. I may want to retry the med, what do you guys think?
I think that you should retry it because you never found out if it worked for you. Try starting out with 25 mg. I am lucky, I don't usually have any side effects from medication except for weight gain.
Posted by dopedupuk on August 8, 2010, at 9:39:26
In reply to Re: Nortiptyline side effects, posted by bearfan on August 8, 2010, at 4:03:06
Thanks for your replies. I think I react to most anti-depressants quite badly, especially the SSRIs, have been on 8 different drugs in 12 years.
The best ones so far have been Mirtazipine/Remerol (but put on 42 pounds on that) and Trazodone (best for sleep). Had to come off Trazodone when the neuropathic pain was diagnosed as it was useless for that.
Started on 10 mg of Nortriptyline, went up to 20, 25, now on 50 mg. The pain has much improved but depression/anxiety/insomnia are very bad, my heart is beating faster and impotence/wiped out libido are a problem.
Think I can only tolerate up to 25-30mg for pain and will need to go on a secondary drug for everything else. Drug companies promise depressed people the earth but deliver little other than a cocktail of side effects and let downs.
Posted by dopedupuk on August 26, 2010, at 12:43:29
In reply to Re: Nortiptyline side effects, posted by dopedupuk on August 8, 2010, at 9:39:26
Update:
Now had the Nortriptyline reduced from 50 mg to 20 mg each morning due to palpatations and feeling more depressed than ever. Seems to work for neuropathic pain at 20-25 mg but it's useless for depression/anxiety/insomnia.
Back on the Trazodone now at 100 mg per night, great for getting a good sleep but not a high enough dose to keep the depression/anxiety under control. Can't be increased due to known interaction between Nortriptyline-Trazodone and risk of serotonin toxicity.
So back to the drawing board (again)...
Posted by ed_uk2010 on August 26, 2010, at 15:53:08
In reply to Re: Nortiptyline side effects, posted by dopedupuk on August 26, 2010, at 12:43:29
Pain due to trigeminal nerve damage is often treated with carbamazepine (Tegretol). Have you tried it?
Nortriptyline has very little serotonergic effect, by the way.
Posted by Conundrum on August 27, 2010, at 23:29:40
In reply to Re: Nortiptyline side effects, posted by dopedupuk on August 26, 2010, at 12:43:29
There are some blood pressure meds that can be given to stop palpitations. Beta Blockers maybe. I would consider asking my doctor about something like that if i were on a TCA.
This is the end of the thread.
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