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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by ChicagoKat on September 27, 2012, at 20:09:19
Hi Scott,
Sorry to bother you with this b/c I believe you made a few suggestions to me a while ago, but I was such a mess then I didn't make a note of them. Plus, Jono said you are much better at finding articles online :)
If it's not too much trouble for you I need articles I can give my pdoc on the use of MAOIs + TCAs (and I know you guys suggest Nortryptiline, so I will suggest that to him too). My pdoc is well aware that they are sometimes used together, but he is unsure whether they should be started together or separately. I also need info on Nortryptiline dosage - if you can't find an article on that you can just tell me, he goes with whatever I say since I am a PharmD, plus I've told him how intelligent you are and how you really know your stuff when it comes to psychotropics. Oh, FYI, I will be on a fairly low dose of Nardil - 45mg/day - b/c of the ataxia I experience at higher doses.
Thanks for any info you can provide. Are you feeling any better? I really hope so.
All my best,
Kat
p.s. If you don't have time to do this or are feeling too miserable to do it, don't worry, I have Jono's info, so it's no biggie. Take care :)
Posted by jono_in_adelaide on September 27, 2012, at 20:58:15
In reply to SLS- Need articles on MAOIs + Nortryptiline, posted by ChicagoKat on September 27, 2012, at 20:09:19
I'll leave the googling to Scott, because he's a master of the art, but i beleive that when used together, it is normal to start both at the same time, in a low dose.... say 15mg of nardil and 25mg of nortriptyline, and increase over a week or so to 45mg of nardil and 75mg of nortriptyline.
After a few weeks, its a good idea to get your nortriptyline blood levels checked, because while 75mg is the dose MOST women need, some women will need either less or more to be in "the zone"
You can take the nortriptyline three times a day, or in a single dose at bedtime.
Best of luck!
Posted by phillipa on September 27, 2012, at 21:06:42
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline, posted by jono_in_adelaide on September 27, 2012, at 20:58:15
I wonder if Scott is doing Karioke tonight? Phillipa
Posted by SLS on September 27, 2012, at 21:16:54
In reply to SLS- Need articles on MAOIs + Nortryptiline, posted by ChicagoKat on September 27, 2012, at 20:09:19
Hi Kat.
Since you have the opportunity to begin taking both drugs at the same time, I would take advantage of it. That is the preferred protocol for establishing a MAOI + TCA combination.
45 mg/day of Nardil is relatively low, but often sufficient.
I'll see what I can put together tomorrow.
Have a nice evening.
Oh, alright. You shamed me into it.
I found that full therapeutic dosages of both drugs are necessary for me to obtain a response.
- Scott
Posted by SLS on September 27, 2012, at 21:21:16
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline, posted by jono_in_adelaide on September 27, 2012, at 20:58:15
> I'll leave the googling to Scott, because he's a master of the art, but i beleive that when used together, it is normal to start both at the same time, in a low dose.... say 15mg of nardil and 25mg of nortriptyline, and increase over a week or so to 45mg of nardil and 75mg of nortriptyline.
>
> After a few weeks, its a good idea to get your nortriptyline blood levels checked, because while 75mg is the dose MOST women need, some women will need either less or more to be in "the zone"
>
> You can take the nortriptyline three times a day, or in a single dose at bedtime.
>
> Best of luck!
Very good advice.Perhaps start at 10 mg/day of nortriptyline?
I would initiate the nortriptyline by taking it at bedtime. It can be soporific at first.
- Scott
Posted by SLS on September 27, 2012, at 21:28:36
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline, posted by phillipa on September 27, 2012, at 21:06:42
> I wonder if Scott is doing Karioke tonight? Phillipa
Tomorrow night.
:-)
The Beatles, Bon Jovi, and Bruce Springsteen.
I have a knack of choosing great songs that nobody wants to hear.
- Scott
Posted by jono_in_adelaide on September 27, 2012, at 22:00:03
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline » phillipa, posted by SLS on September 27, 2012, at 21:28:36
Tramps like us, baby we were born to run!
Posted by SLS on September 27, 2012, at 22:16:31
In reply to Re: SLS- Need articles on MAOIs Nortryptiline-SLS, posted by jono_in_adelaide on September 27, 2012, at 22:00:03
> Tramps like us, baby we were born to run!
Yes, sir!
I have been very disappointed in his last 3 albums, but at age 63, Bruce still puts on a show that is ageless. He amazes me.
- Scott
Posted by ChicagoKat on September 28, 2012, at 13:16:25
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline, posted by jono_in_adelaide on September 27, 2012, at 20:58:15
> I'll leave the googling to Scott, because he's a master of the art, but i beleive that when used together, it is normal to start both at the same time, in a low dose.... say 15mg of nardil and 25mg of nortriptyline, and increase over a week or so to 45mg of nardil and 75mg of nortriptyline.
>
> After a few weeks, its a good idea to get your nortriptyline blood levels checked, because while 75mg is the dose MOST women need, some women will need either less or more to be in "the zone"
>
> You can take the nortriptyline three times a day, or in a single dose at bedtime.
>
> Best of luck!Thanks JONO, that's sound advice and I will pass it on to my pdoc :)
Posted by ChicagoKat on September 28, 2012, at 13:19:08
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline, posted by phillipa on September 27, 2012, at 21:06:42
> I wonder if Scott is doing Karioke tonight? Phillipa
Scott doing Kareoke?? I had him pegged as someone who constantly does scientific research, he is so knowlegeable. It is so fun to learn more and more about the people on this board. It's kinda like family. I'm glad I found you all, you're all great :)
Posted by ChicagoKat on September 28, 2012, at 13:34:31
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline » ChicagoKat, posted by SLS on September 27, 2012, at 21:16:54
> Hi Kat.
>
> Since you have the opportunity to begin taking both drugs at the same time, I would take advantage of it. That is the preferred protocol for establishing a MAOI + TCA combination.
>
> 45 mg/day of Nardil is relatively low, but often sufficient.
>
> I'll see what I can put together tomorrow.
>
> Have a nice evening.
>
> Oh, alright. You shamed me into it.
>
> http://tinyurl.com/9cwughh
>
> I found that full therapeutic dosages of both drugs are necessary for me to obtain a response.
>
>
> - ScottI didn't mean to shame you into it! You must have been tired after your Kareoke (sp?) What songs did you sing?? :)
Thanks for the article. I'm a little concerned b/c it mentioned using amitryptiline rather than nortryptiline, and it's my understanding that nortryptiline has fewer side effects than amitryiptiline, despite the fact that amitryp. is immediately metabolized to nortryp. Damn, but those names are a pain in the *ss to write so I shortened them! Whoever came up with them should have to take high doses of them and deal with all the horrid side effects. Did I ever tell you that when I started Elavil for sleep I got horrible dry mouth, not a surprise, but I didn't think about it and drank so much water that I gave myself dilutional hyponatremia! If my sodium had been one point lower I would have had to be hospitalized, which I HATE! Fortunately, with water restriction my Na jumped right back up to about 140 with no problem, and now I sometimes drink Gatorade when I get really thirsty :) But thanks for the link to the article, it gave me food for thought and I really appreciate it!
Posted by ChicagoKat on September 28, 2012, at 13:42:56
In reply to Re: SLS- Need articles on MAOIs Nortryptiline-SLS » jono_in_adelaide, posted by SLS on September 27, 2012, at 22:16:31
> > Tramps like us, baby we were born to run!
>
> Yes, sir!
>
> I have been very disappointed in his last 3 albums, but at age 63, Bruce still puts on a show that is ageless. He amazes me.
>
>
> - ScottI must admit, that for a few exceptions, I am an Evanescence type girl, wow she is great in concert, and for the most part I like music of her ilk. Maybe it's b/c she suffers from bipolar. and her songs really get to me. I used to be a HUGE Beatles fan, have ever album they ever put out (yes, I am old enough to have had to listen to LPs)....including a rare album they put out for their fan club when they were still together with songs and lots of talking. I used to treasure my collection. Now I think it is in my mother's basement lol
Posted by SLS on September 28, 2012, at 14:22:45
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline » SLS, posted by ChicagoKat on September 28, 2012, at 13:34:31
> > Hi Kat.
> >
> > Since you have the opportunity to begin taking both drugs at the same time, I would take advantage of it. That is the preferred protocol for establishing a MAOI + TCA combination.
> >
> > 45 mg/day of Nardil is relatively low, but often sufficient.
> >
> > I'll see what I can put together tomorrow.
> >
> > Have a nice evening.
> >
> > Oh, alright. You shamed me into it.
> >
> > http://tinyurl.com/9cwughh
> >
> > I found that full therapeutic dosages of both drugs are necessary for me to obtain a response.
> >
> >
> > - Scott
>
> I didn't mean to shame you into it!I'm sure you know that I was just kidding. Actually, I often must do what I am capable of in the present because I might be incapable of doing it in the future. These illnesses are very unpredictable. I figured that since I felt well enough to snoop a little for you, that I should take advantage of it.
> You must have been tired after your Kareoke (sp?) What songs did you sing?? :)
I usually go on Friday nights. As you might imagine, I am not always in the mood to get up in front of others and sing. My friends usually manage to shame me into it, though. To be honest, I have no idea why I subject myself to this stuff. I am not a "ham" and still get nervous when I go up on stage. I guess it is some old adolescent fantasy of being a rock star that gets me up there. It gets me out of the house and around people.
I hate amitriptyline. I find it to be disgustingly sedating, even after continued treatment. Generally speaking, amitriptyline will get a few more people well than nortriptyline, but I don't find the difference in numbers to be compelling enough to choose amitriptyline first. Besides, urinary retention might be more of a problem with amitriptyline because of its more potent anticholinergic side effects.
I am currently taking Parnate and nortriptyline. Previously, I had been taking Nardil and nortriptyline.
- Scott
Posted by phillipa on September 28, 2012, at 19:19:28
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline » ChicagoKat, posted by SLS on September 28, 2012, at 14:22:45
Scott oh what fun we could have with a thread about Scott the rock star!!!! Have fun tonight!!! Phillipa
Posted by ChicagoKat on September 28, 2012, at 21:01:46
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline » ChicagoKat, posted by SLS on September 28, 2012, at 14:22:45
> > > Hi Kat.
> > >
> > > Since you have the opportunity to begin taking both drugs at the same time, I would take advantage of it. That is the preferred protocol for establishing a MAOI + TCA combination.
> > >
> > > 45 mg/day of Nardil is relatively low, but often sufficient.
> > >
> > > I'll see what I can put together tomorrow.
> > >
> > > Have a nice evening.
> > >
> > > Oh, alright. You shamed me into it.
> > >
> > > http://tinyurl.com/9cwughh
> > >
> > > I found that full therapeutic dosages of both drugs are necessary for me to obtain a response.
> > >
> > >
> > > - Scott
> >
> > I didn't mean to shame you into it!
>
> I'm sure you know that I was just kidding. Actually, I often must do what I am capable of in the present because I might be incapable of doing it in the future. These illnesses are very unpredictable. I figured that since I felt well enough to snoop a little for you, that I should take advantage of it.
>
> > You must have been tired after your Kareoke (sp?) What songs did you sing?? :)
>
> I usually go on Friday nights. As you might imagine, I am not always in the mood to get up in front of others and sing. My friends usually manage to shame me into it, though. To be honest, I have no idea why I subject myself to this stuff. I am not a "ham" and still get nervous when I go up on stage. I guess it is some old adolescent fantasy of being a rock star that gets me up there. It gets me out of the house and around people.
>
> I hate amitriptyline. I find it to be disgustingly sedating, even after continued treatment. Generally speaking, amitriptyline will get a few more people well than nortriptyline, but I don't find the difference in numbers to be compelling enough to choose amitriptyline first. Besides, urinary retention might be more of a problem with amitriptyline because of its more potent anticholinergic side effects.
>
> I am currently taking Parnate and nortriptyline. Previously, I had been taking Nardil and nortriptyline.
>
>
> - ScottOf course I knew you were kidding about being shamed into looking up an article for me! I do feel kinda bad though about asking you to do it for me since we are almost complete strangers and I know you often don't feel well. After my monster of a post earlier today though we are at least less than strangers now, at least me to you; you almost know my life story. ha ha I honestly don't know what possessed me to keep writing and writing, and I still don't know if you've responded as I've not checked yet. I won't blame you if you never do b/c it's a lot of info to respond to.
I think it's great that you do Kareoke! As you said, it gets you out of the house and around people which can only be good for you. I have started suffering from pretty bad agoraphobia since I stopped work, and I can't imagine doing anything more than going through a drive-thru (mcdonald's chocolate chip cookies...yum!) until I get better.
Thanks so much for all the info and for the article. I appreciate it more than you know.
Kat
Posted by jono_in_adelaide on September 28, 2012, at 22:21:41
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline » SLS, posted by ChicagoKat on September 28, 2012, at 21:01:46
When are you going to staart the Nardil/Nortriptyline combo Kat?
Posted by schleprock on September 28, 2012, at 23:31:06
In reply to SLS- Need articles on MAOIs + Nortryptiline, posted by ChicagoKat on September 27, 2012, at 20:09:19
> Hi Scott,
>
> Sorry to bother you with this b/c I believe you made a few suggestions to me a while ago, but I was such a mess then I didn't make a note of them. Plus, Jono said you are much better at finding articles online :)
>
> If it's not too much trouble for you I need articles I can give my pdoc on the use of MAOIs + TCAs (and I know you guys suggest Nortryptiline, so I will suggest that to him too). My pdoc is well aware that they are sometimes used together, but he is unsure whether they should be started together or separately. I also need info on Nortryptiline dosage - if you can't find an article on that you can just tell me, he goes with whatever I say since I am a PharmD, plus I've told him how intelligent you are and how you really know your stuff when it comes to psychotropics. Oh, FYI, I will be on a fairly low dose of Nardil - 45mg/day - b/c of the ataxia I experience at higher doses.
>
> Thanks for any info you can provide. Are you feeling any better? I really hope so.
> All my best,
> Kat
> p.s. If you don't have time to do this or are feeling too miserable to do it, don't worry, I have Jono's info, so it's no biggie. Take care :)I believe there are some articles on psychotropical.com (a site from an Austrailian doctor - get it?) Also, if you can locate a copy of "The Prescriber's Guide" by Stephen M. Stahl, in the final section of the Nortriptyline (and other tca) enteries, he mentions: "For the expert only: although generally prohibited, a heroic but potentially dangerous treatment for severely treatment-resistant patients is for the expert to give a [tca] other than clomipramine simultaneously with an MAOI for patients who fail to respond to numerous other antidepressents." Then he mentions starting both at low doses after appropriate drug washout, then alternately increase drug dosage every day to a week. You might be able to find something by googling "Stahl" "nortriptyline" and "MAOI", etc.
Posted by SLS on September 28, 2012, at 23:59:20
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline » SLS, posted by phillipa on September 28, 2012, at 19:19:28
> Scott oh what fun we could have with a thread about Scott the rock star!!!! Have fun tonight!!! Phillipa
Bob Seger, Bon Jovi, Bruce Springsteen.
Nailed them.
I was with a few people last night, one of whom was a pleasant 16 year old girl. She had never heard of Bruce Springsteen. I remain incredulous. I had planned on dedicating "Dancing In The Dark" to her, but she left before they called me up to sing. I find it interesting that the younger crowd would rather hear Frank Sinatra than The Beatles.
- Scott
Posted by ChicagoKat on September 29, 2012, at 6:39:58
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline, posted by jono_in_adelaide on September 28, 2012, at 22:21:41
> When are you going to staart the Nardil/Nortriptyline combo Kat?
>On Tuesday, Jono...and if you saw one of my earlier posts, I'm starting to rething the Nortryptiline part of it b/c I really think I am of that reactive/atypical type of depressant - I'm not sure - but I'm afraid of Nortryptiline giving me too much noradrenalin. Anxiety is often one of my biggest problems and the relief Nardil gave me from that was truly amazing. I had read your post about how it works to do that. And I also think too much Noradrenalin is what made me too anxious on Ritalin. I'm not sure; what do you think?
Kat
Posted by ChicagoKat on September 29, 2012, at 6:42:24
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline » ChicagoKat, posted by schleprock on September 28, 2012, at 23:31:06
> > Hi Scott,
> >
> > Sorry to bother you with this b/c I believe you made a few suggestions to me a while ago, but I was such a mess then I didn't make a note of them. Plus, Jono said you are much better at finding articles online :)
> >
> > If it's not too much trouble for you I need articles I can give my pdoc on the use of MAOIs + TCAs (and I know you guys suggest Nortryptiline, so I will suggest that to him too). My pdoc is well aware that they are sometimes used together, but he is unsure whether they should be started together or separately. I also need info on Nortryptiline dosage - if you can't find an article on that you can just tell me, he goes with whatever I say since I am a PharmD, plus I've told him how intelligent you are and how you really know your stuff when it comes to psychotropics. Oh, FYI, I will be on a fairly low dose of Nardil - 45mg/day - b/c of the ataxia I experience at higher doses.
> >
> > Thanks for any info you can provide. Are you feeling any better? I really hope so.
> > All my best,
> > Kat
> > p.s. If you don't have time to do this or are feeling too miserable to do it, don't worry, I have Jono's info, so it's no biggie. Take care :)
>
> I believe there are some articles on psychotropical.com (a site from an Austrailian doctor - get it?) Also, if you can locate a copy of "The Prescriber's Guide" by Stephen M. Stahl, in the final section of the Nortriptyline (and other tca) enteries, he mentions: "For the expert only: although generally prohibited, a heroic but potentially dangerous treatment for severely treatment-resistant patients is for the expert to give a [tca] other than clomipramine simultaneously with an MAOI for patients who fail to respond to numerous other antidepressents." Then he mentions starting both at low doses after appropriate drug washout, then alternately increase drug dosage every day to a week. You might be able to find something by googling "Stahl" "nortriptyline" and "MAOI", etcThanks Schleprock, I really appreciate the info!
Kat.
Posted by ChicagoKat on September 29, 2012, at 6:44:56
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline, posted by SLS on September 28, 2012, at 23:59:20
> > Scott oh what fun we could have with a thread about Scott the rock star!!!! Have fun tonight!!! Phillipa
>
> Bob Seger, Bon Jovi, Bruce Springsteen.
>
> Nailed them.
>
> I was with a few people last night, one of whom was a pleasant 16 year old girl. She had never heard of Bruce Springsteen. I remain incredulous. I had planned on dedicating "Dancing In The Dark" to her, but she left before they called me up to sing. I find it interesting that the younger crowd would rather hear Frank Sinatra than The Beatles.
>
>
> - ScottSigh, you make me feel old. And if you start talking about Evanescence being old school I'll run right out and buy my first walker. :)
Hope you had a great time!
Kat
Posted by phillipa on September 29, 2012, at 19:29:39
In reply to Re: SLS- Need articles on MAOIs + Nortryptiline, posted by SLS on September 28, 2012, at 23:59:20
Humm hitting on underage girls? But seriously never heard of Beatles I thought they were back in vogue again? Phillipa
This is the end of the thread.
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