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Nortriptyline dosing.

Posted by SLS on August 17, 2021, at 8:21:06


> I added Nardil about a year ago. The onset of improvement was rapid at first. But I found myself needing to play with the dosage constantly. Then, I became suspicions that my dosage of nortriptyline was TOO HIGH. I had been taking 100 mg/day for a bunch of years, assuming that my being within the right range of therapeutic blood levels indicated that I was being dosed properly. Nortriptyline is the ONLY tricyclic for which there is a narrow therapeutic window that one must be within. If you go above a certain dosage, you relapse. After stopping nortriptyline completely for one day and leaving the Nardil dosage the same at 90 mg/day I was pleasantly surprised, to say the least. Bullseye - almost. My doctor advised me to restart nortriptyline at 50 mg/day. That was the right move, but I ended up relapsing. 75 mg/day is the magic number for me. I am now improving rapidly at a steady rate and at a steady dosage of Nardil.

* I just wanted to add that the range of nortriptyline therapeutic blood levels is between 50-150 ng/mL. However this is merely a guide, not an absolute index. When I was tested while taking 150 mg/day of nortriptyline, my blood level was 153 ng/mL. We figured that reducing the dosage from 150 mg/day to 100 mg/day would be sufficient to put me within the dosage window. I never had my blood level tested at 100 mg/day, but I will ask my doctor to take one once I stabilize at 75 mg/day.

Response to nortriptyline is bimodal. From what I have observed over the years, low dosage responders take between 50-75 mg/day. High dosage responders take between 125-150 mg/day.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.




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