Posted by bulldog2 on October 4, 2008, at 19:18:54
In reply to How to start up Nortriptyline and combos...?, posted by hansi555 on October 1, 2008, at 3:30:09
> Hi all
> As some of you would know I started out with 4 months of Remeron but after increasing dose to 60 mg without getting constant relief, Lexapro was added since the last 4 months, I am currently doing 35 mg of Remeron at night and 25 mg Lexapro in the morning.
>
> But I have 4 or 5 melancholic features; morning start up problems, early wake ups, lack of apetite, no energy or interest etc. and then it gets better during day time end good in the evenings. When a good period comes it will last one or two weeks, then 2-5 days of depression, then things turn around and get acceptable again.
>
> 1 hour after taking Remeron I feel very good and have a lot of appetite but then I get sleepy and wake up the next day w the melancholic features and it starts all over again.
> Is it the noraldreline effect I am feeling in the evening?
> Lexapro works most of the time but is preventing real joy, especially after increasing dose, and I get these real annoying down periods also.
>
> After reading a lot in here, I have now (almost) decided to go for something more powerfull and Nortriptyline seems to be a good choice to me.
>
> But how should I make the transistion from my current combo? And which of the 2 current drugs, if any, should I keep and in what dosages?
>
> Thanks for all your inputs..Nortriptyline is a good adjunct to an ssri. The problem with snri's is you have a fixed ratio to se to ne. By adding nortriptyline to an ssri you get keep adding it until you get the correct ratio that suits you.
poster:bulldog2
thread:855044
URL: http://www.dr-bob.org/babble/20080926/msgs/855778.html