Psycho-Babble Medication Thread 1106670

Shown: posts 1 to 7 of 7. This is the beginning of the thread.

 

Noryriptyline advice please

Posted by Sac on November 1, 2019, at 17:17:36

I started Nortriptyline a few weeks ago at 10 mgs. Added to Prozac 40 msg and lithium 450mg. I was kind if I
Ok on the 10 and when my doctor upped it to 20 mgs. I feel even more depressed. Worse than before. Its supposed to boost norepinephrine but I feel like more of a zombie than ever

 

Re: Noryriptyline advice please

Posted by linkadge on November 2, 2019, at 7:05:11

In reply to Noryriptyline advice please, posted by Sac on November 1, 2019, at 17:17:36

How long ago was the increase?

Nortriptyline has some antihistamine effects that can cause sedation. It can take some time to adjust to this.

Alternatively, go back to 10mg and see if things improve.

Linkadge

 

Re: Noryriptyline advice please » linkadge

Posted by Sac on November 2, 2019, at 13:52:38

In reply to Re: Noryriptyline advice please, posted by linkadge on November 2, 2019, at 7:05:11

Thanks for the reply. Increased to 20 this past Monday. I felt a sudden worsening of my mood along with suicidal thoughts. As you mentioned, I may try going back down to 10 since Im also on 40 mgs. Prozac and am concerned about serotonin syndrome.

 

Re: Noryriptyline advice please

Posted by linkadge on November 3, 2019, at 13:51:16

In reply to Re: Noryriptyline advice please » linkadge, posted by Sac on November 2, 2019, at 13:52:38

I wouldn't be too worried about serotonin syndrome. It rarely occurs with monoamine reuptake inhibitors (even in combination). Combining with MAOIs is the major issue.

Nortriptyline has a different feel to it than SSRIs. I found that, if I took it at night, I generally felt worse in the mornings and then my mood improved at night.

Linkadge

 

Re: Noryriptyline advice please

Posted by Sac on November 3, 2019, at 21:19:33

In reply to Re: Noryriptyline advice please, posted by linkadge on November 3, 2019, at 13:51:16

Yes, I am taking it all night and feel worse around late morning. I also feel like it gets better in the evening. Do you think this medication should be dosed 2x a day? Im pretty sensitive to norepinephrine type meds but it seems like thats what I need. My depression is the apathetic ,lethargic, tired, I dont care about anything type which I think would indicate a need for a norepinephrine boost.

 

Re: Noryriptyline advice please

Posted by linkadge on November 10, 2019, at 14:51:32

In reply to Re: Noryriptyline advice please, posted by Sac on November 3, 2019, at 21:19:33

You shouldn't need 2x daily dosing. The morning effects could subside with time. I had the same pattern of mood on other TCAs (amitriptyline, clomipramine) which did improve with time.

I think the anticholinergic / antihistamine activity may cause some of it. If you're a coffee drinker, I found that morning coffee helped, to some extent.

Linkadge

 

Re: Noryriptyline advice please » linkadge

Posted by Clearskies on November 16, 2019, at 4:21:13

In reply to Re: Noryriptyline advice please, posted by linkadge on November 10, 2019, at 14:51:32

> You shouldn't need 2x daily dosing. The morning effects could subside with time. I had the same pattern of mood on other TCAs (amitriptyline, clomipramine) which did improve with time.
>
> I think the anticholinergic / antihistamine activity may cause some of it. If you're a coffee drinker, I found that morning coffee helped, to some extent.
>
> Linkadge
>
>
Hunh. I take 25mg at night to keep me under - but it works too well. I would love to have 12 hours of sleep at a time. Note: Pdoc visit coming up.


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