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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Laney on March 3, 2012, at 12:08:31
I started back up with Nortiptyline and this time around I'm super amped at a low dose, feel like I'm on speed or something. Can get super irritable and pissed off. Another difference this time around is that I'm taking additional Klonopin to try to bring some calm to the situation. I am close to my menstrual cycle and I feel like I have a severe case of PMS (mood wise)!
Is this mania? I don't know. I don't like feeling so amped and irritated, etc. It's not all the time but enough to where I'm beginning to wonder??
Thanks for any input?
Laney
Posted by Raisinb on March 3, 2012, at 15:26:50
In reply to Nortriptyline - Do these SE mean I'm Bipolar?, posted by Laney on March 3, 2012, at 12:08:31
I feel like that a lot and describe it to myself as "mixed," though I don't know that it qualifies. I have been dx'd as BP 2. But I don't know that one med reaction means you are bipolar. A manic or hypomania reaction to an antidepressant is what's known as a "soft sign" of bipolar: it gives the physician a heads up to maybe look for other signs, but it is nowhere near sufficient in itself for a dx.
Posted by Christ_empowered on March 3, 2012, at 15:27:17
In reply to Nortriptyline - Do these SE mean I'm Bipolar?, posted by Laney on March 3, 2012, at 12:08:31
I'd just drop it. I don't think this means you're bipolar. I think it means this isn't the medication for you.
Posted by Phillipa on March 3, 2012, at 16:29:10
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by Christ_empowered on March 3, 2012, at 15:27:17
Laney I'd look at life situation and judge by extra stress at this time. And surely let the doc know. If no blood test for levels why not temporarily lower the dose? Phillipa
Posted by papillon2 on March 3, 2012, at 16:33:45
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by Christ_empowered on March 3, 2012, at 15:27:17
Some psych meds worsen PMS symptoms.
Posted by emmanuel98 on March 3, 2012, at 18:50:34
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by Christ_empowered on March 3, 2012, at 15:27:17
My p-doc always says that mood disorders are on a spectrum. He said I have bipolar 3a or something and laughed. I agree with this. I get in terrible mixed-like episodes, though I've never had mania or hypomania. Also, my depression swings around constantly. Currently taking lamictal to try to control the swings and parnate to control the severe depressions I have had.
Posted by linkadge on March 3, 2012, at 21:10:17
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by emmanuel98 on March 3, 2012, at 18:50:34
It doesn't mean anything.
It just means that nortriptyline is increasing irritability.
We all want answers. Unfortunatley psychiatry provides few.
Linkadge
Posted by Laney on March 4, 2012, at 10:23:51
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by linkadge on March 3, 2012, at 21:10:17
Thanks guys. I've been on this AD before for 9 months and don't remember feeling like this. I think I'm just gonna lower the dose even though I didn't need to last time.
We'll see. It worked well last time for my depression.
Thanks again for the input.
Laney
Posted by bleauberry on March 4, 2012, at 12:38:50
In reply to Nortriptyline - Do these SE mean I'm Bipolar?, posted by Laney on March 3, 2012, at 12:08:31
Just my two cents but it is fairly common when a patient returns to a previous med and that med turned problematic the second or third time around. I think brain and gene adaptations take place the first time around, and then sort of finalized or engrained when the weaning/withdrawal process is complete. So the next cycle we try that med again, it's not the same landscape as it was before.
I'm pretty sensitive to meds. I found 5mg beneficial but 10mg just made me really amped and irritated.
Posted by Raisinb on March 4, 2012, at 22:08:20
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by linkadge on March 3, 2012, at 21:10:17
Posted by rculater on March 5, 2012, at 5:09:53
In reply to You said it. (nm), posted by Raisinb on March 4, 2012, at 22:08:20
yes i felt the same on nort at a low dose of 10mg. On edge, irritable etc. What dose are you at ? Did you not combine it with another SSRi last time ?
Perhaps that why it worked better.
Posted by SLS on March 5, 2012, at 6:51:07
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by bleauberry on March 4, 2012, at 12:38:50
> Just my two cents but it is fairly common when a patient returns to a previous med and that med turned problematic the second or third time around. I think brain and gene adaptations take place the first time around, and then sort of finalized or engrained when the weaning/withdrawal process is complete. So the next cycle we try that med again, it's not the same landscape as it was before.
This is a great conceptualization.
- Scott
Posted by creepy on March 6, 2012, at 6:49:17
In reply to Nortriptyline - Do these SE mean I'm Bipolar?, posted by Laney on March 3, 2012, at 12:08:31
some SSRIs do that to me. I get energized, very irritable and lots of racing thoughts.
I didnt know what it was for the longest time and stayed like that.
you could try to manage on a very small dose just before those mixed effects kick in.. but when I tried that the benefits went away too.
Posted by Laney on March 6, 2012, at 10:35:30
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by creepy on March 6, 2012, at 6:49:17
Hey guys,
I am sticking to 25mg. to see if things calm down. Last time I did combine it with paxil as well. I could increase the paxil and see if anything good happens.
I am not really getting any mood benefit yet. A little disappointing because last time it worked so quickly.
Bleauberry - you might have something there?
Crazy drugs huh?
Be well!
Laney
Posted by bleauberry on March 9, 2012, at 14:57:22
In reply to Nortriptyline - Do these SE mean I'm Bipolar?, posted by Laney on March 3, 2012, at 12:08:31
For anyone looking to try nortriptyline, this is just my opinion, I think it is a mistake to approach it as nortriptyline monotherapy. In the same manner I think it is a mistake for someone to look at any of the SSRIs as monotherapy. What we need is a broad spectrum approach that allows us to do custom balancing of both NE and 5HT. So if someone wants to try nortriptyline, their next question should be..."which ssri do I want to go with it?" Zoloft is the better choice, primarily due to metabolism, liver, drug interaction issues. This type of combination also can allow for lower dosing of both meds, with upside potentials in....faster response, more complete response, less side effects, longer lasting efficacy.
I am a firm believer in the homemade SNRI approach, a good deal of it because of the writings of Dr Gillman. Good reading if you haven't seen it. pscyhotropical.com
Posted by creepy on March 14, 2012, at 8:24:12
In reply to Re: Nortriptyline - Do these SE mean I'm Bipolar?, posted by creepy on March 6, 2012, at 6:49:17
I had the worst reaction when I was cross titrating celexa and zoloft. Theres no interaction that I can find, but something about the two really made me super-irritable and mean as a snake.
This is the end of the thread.
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