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Re: Nortriptyline dosing. SLS

Posted by undopaminergic on August 21, 2021, at 2:04:06

In reply to Re: Nortriptyline dosing. undopaminergic, posted by SLS on August 20, 2021, at 16:21:54

> > Thanks for the scoop on nortriptyline. It clearly underlines that more is not always merrier.
> >
> > This is making me wonder if there is an analogous therapeutic dose window with trimipramine (Surmontil). I'm on 150 mg now. The conventional maximum dose seems to be 300 mg, but I can't say the 150 mg is better than 100 mg, or even slightly worse.
> >
> > -undopaminergic
> >
> That's an old drug for which there is no generic. The last time I looked in on it, it was not a reuptake inhibitor of any monoamine.

Yes, that is correct.

> I was on it, but my doctor never mentioned a therapeutic window. Perhaps you should treat the dosage range of trimipramine as if it were imipramine. The accepted top-end of imipramine is 300 mg/day. I think most people are kept at about 150 mg/day. Trimipramine is the one tricyclic that does not act deleteriously on sleep architecture. It might even enhance it. I have some vague recollection of that, but I'm not sure.

Yes, you are correct. I read it several times when I was researching trimipramine.

> Trimipramine was the first drug my present doctor tried on me 20 years ago. I don't recall having any side effects.

I think maybe, as an anticholinergic, it impairs long term memory, but I don't notice that subjectively.

> Linkadge once said that imipramine and trimipramine (maybe clomipramine to?) were genotoxic. You would have to ask him about the details.

Yes, I read that too, in one of his posts. He said trimipramine worked well for him, but the genotoxicity was a show stopper. For me, it's more like "big deal".





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