Posted by Ritch on December 29, 2004, at 17:03:42
In reply to Re: What to combine with a mood stabilizer? » Ritch, posted by tensor on December 29, 2004, at 13:24:37
> I was actually thinking of get rid of both remeron and zoloft. And then start with nortrip+mood stab. But do have i have to check blood levels for nortrip?
Some people don't get them checked if they show no signs of toxicity and they are responding to the nortriptyline (as Ed mentioned). I just thought it might be a good idea should you combine the Zoloft with it--- because the Zoloft (and other SSRI's) will inhibit liver enzymes that break down the nortriptyline, which may cause very high levels of the nortriptyline at a "standard" dosage and possible toxicity. Some people are "poor metabolizers" of TCA's like nortiptyline as well (without taking an SSRi). Combining SSRI and TCA can raise blood levels of the TCA ten-fold in some cases. Just being cautious. When I took Zoloft+Nortiptyline I was only taking 20-30mg of NT, didn't get blood level done, the only side effects I got from nortrip. besides some dry mouth was a little shakiness with "pins and needles" skin sensations(like from watching a scary movie) and an elevated heart rate. Oh, you might get a decent mood boost when you stop the Remeron.. I definitely did! Good luck!
poster:Ritch
thread:434951
URL: http://www.dr-bob.org/babble/20041228/msgs/435404.html