Psycho-Babble Medication Thread 56899

Shown: posts 1 to 14 of 14. This is the beginning of the thread.

 

Mood stabilizer only for depression?

Posted by shelby on March 19, 2001, at 11:42:34

My psy. doctor mentioned trying neurontin along with anti-depressents. I have been trying nortriptyline along with amitriptyline hoping to lower the amitriptyline while raising nortrip. I have been going by 10 mg. increments and changing the dose every 2 weeks.

Everything was going along fine and I was down to 70 mg. elavil and 30 mg. nortrip. until I increased the nortrip. to 35 mg. since Thurs. I have been battling a killer headache that hardly responds to Tylenol, had a couple of nosebleeds and Friday night, was woken up with my heart beating too fast for a couple of seconds (never had this happen before).

I phoned my psy. doctor but he was not available on the weekend and is still not available today (Mon.). Today I took just 30 mg. nortrip. and will take 70 mg. elavil tonight and hope this is okay. He is in tomorrow. So, there's the history.

Would taking neurontin help in decreasing the elavil? He said it helps with irritability and anxiety Any interactions that I should be aware of? Can neurontin be taken alone instead of anti-depressants or is this trial and error?

Thanks.

 

Re: Mood stabilizer only for depression?

Posted by Margit on March 19, 2001, at 13:56:00

In reply to Mood stabilizer only for depression?, posted by shelby on March 19, 2001, at 11:42:34

I am also taking Nortrip. My pdoc titrated me up over a 4 month period to 70 mg. The reason it took so long was because of racing heart. So I stopped for a while and as my body adjusted we went 10mg up again. But 70mg seems to be the limit for me, yet my depression is not under control. I am also taking Xanax and 800mg Neurontin. I am also at the moment debating if I should up the Neurontin. My pdoc has been suggesting this numerous times, but I was to scared. I have gotten good responses from other people who are taking Neurontin, so tomorrow when I see my doc I will discuss it with him. May I ask why you are taking an old AD vs. an SSRI? In my case I can't tolerate them. I was wondering also if Neurontin has antidepressant effects and maybe even could help with OCD. But it is a new drug, and I guess will know a lot more in a few years. I am desperatly looking for options , too, since the Nortrip is drying out my mouth terribly, besides the heart racing. My pdoc tried to augment with a low dose of an SSRI, but it was a disaster. Didn't mean to go on like that. Hope you find a good combination that works for you and if you do could you let me know.

 

Reply to Margit

Posted by shelby on March 19, 2001, at 15:46:59

In reply to Re: Mood stabilizer only for depression?, posted by Margit on March 19, 2001, at 13:56:00

Margit

I have tried the SSRI's and couldn't take them as the side effects were too much (insomnia, nervousness, aggression) I also gave these drugs a good trial period. I've also tried tryptophan (sp?) and St. John's Wort. Same problems. I have tried imipramine, doxepin, trimipramine but the one which works for the depression is elavil. I would like to get off this drug (been on it for 9 years) as I am tired of the carb cravings and weight gain so am trying this combo of elavil and nortriptyline. I am hoping to have some info before talking to my doctor tomorrow about neurontin so thanks for your reply. Maybe 30 mg. nortriptyline in the morning and slowly decrease the elavil while starting the neurontin at night. I was told that the neurontin does not get metabolized by the liver but bypasses to the kidneys so should not have a problem with combination.

Thanks for your reply and I'll let you know, if you want, how it goes tomorrow.

Shelby.

 

Re: to Shelby

Posted by Margit on March 19, 2001, at 16:37:58

In reply to Reply to Margit, posted by shelby on March 19, 2001, at 15:46:59

Shelby,
just out of curiousity, doesn't Elavil cause more dry mouth, since it has more anti-cholinergic effects than the Nortriptyline? And did you start the Nortrip before reducing Elavil?

 

Re: to Shelby

Posted by Lorraine on March 19, 2001, at 16:51:07

In reply to Re: to Shelby, posted by Margit on March 19, 2001, at 16:37:58

Neurontin is a mood elevator in addition to being an anti-convulsent. So my good pdoc told me when he increased my dose from 500 mg a day to 900 mg a day. I am taking it with Selegiline, which helped in many way but not with my mood. When I increased to 900 mg I got some good solid mood support on the Neurontin. (But I'm not dancing in the alleys because I'm still not where I wanna be and increasing my Neurontin will I think make me too drowsy.)

 

Re: Mood stabilizer only for depression?

Posted by Eric on March 19, 2001, at 19:27:13

In reply to Mood stabilizer only for depression?, posted by shelby on March 19, 2001, at 11:42:34

> My psy. doctor mentioned trying neurontin along with anti-depressents. I have been trying nortriptyline along with amitriptyline hoping to lower the amitriptyline while raising nortrip. I have been going by 10 mg. increments and changing the dose every 2 weeks.
>
> Everything was going along fine and I was down to 70 mg. elavil and 30 mg. nortrip. until I increased the nortrip. to 35 mg. since Thurs. I have been battling a killer headache that hardly responds to Tylenol, had a couple of nosebleeds and Friday night, was woken up with my heart beating too fast for a couple of seconds (never had this happen before).
>
> I phoned my psy. doctor but he was not available on the weekend and is still not available today (Mon.). Today I took just 30 mg. nortrip. and will take 70 mg. elavil tonight and hope this is okay. He is in tomorrow. So, there's the history.
>
> Would taking neurontin help in decreasing the elavil? He said it helps with irritability and anxiety Any interactions that I should be aware of? Can neurontin be taken alone instead of anti-depressants or is this trial and error?
>
> Thanks.


Lamictal would be a better choice if you decide to take the mood stabilizer only route. Lamictal has more antidepressant(mood lifting) properties than Neurontin.

 

Re: Mood stabilizer only for depression?

Posted by SLS on March 19, 2001, at 19:51:13

In reply to Re: Mood stabilizer only for depression?, posted by Margit on March 19, 2001, at 13:56:00

To Magit and Shelby:


How high was your heart-rate?

Aside from the measurement itself, did your increased heart rate cause you any discomfort?

- Scott


> I am also taking Nortrip. My pdoc titrated me up over a 4 month period to 70 mg. The reason it took so long was because of racing heart. So I stopped for a while and as my body adjusted we went 10mg up again. But 70mg seems to be the limit for me, yet my depression is not under control. I am also taking Xanax and 800mg Neurontin. I am also at the moment debating if I should up the Neurontin. My pdoc has been suggesting this numerous times, but I was to scared. I have gotten good responses from other people who are taking Neurontin, so tomorrow when I see my doc I will discuss it with him. May I ask why you are taking an old AD vs. an SSRI? In my case I can't tolerate them. I was wondering also if Neurontin has antidepressant effects and maybe even could help with OCD. But it is a new drug, and I guess will know a lot more in a few years. I am desperatly looking for options , too, since the Nortrip is drying out my mouth terribly, besides the heart racing. My pdoc tried to augment with a low dose of an SSRI, but it was a disaster. Didn't mean to go on like that. Hope you find a good combination that works for you and if you do could you let me know.

 

Re: Mood stabilizer only for depression? to Scott

Posted by Margit on March 19, 2001, at 20:54:07

In reply to Re: Mood stabilizer only for depression?, posted by SLS on March 19, 2001, at 19:51:13


Hi Scott,

my heart rate was between 95 and 110 during the last week. As far as discomfort, I only felt some discomfort on my left side for a couple of hours on morning.

 

Re: Mood stabilizer only for depression? to Scott » Margit

Posted by SLS on March 20, 2001, at 7:52:56

In reply to Re: Mood stabilizer only for depression? to Scott, posted by Margit on March 19, 2001, at 20:54:07

>
> Hi Scott,
>
> my heart rate was between 95 and 110 during the last week. As far as discomfort, I only felt some discomfort on my left side for a couple of hours on morning.


This is normal for these drugs. My best responses to medication involved tricyclic medications that elevated my heart-rate from 56 to 120. You are reacting to the drug exactly as you should. Please do not stop it for this reason alone. Unless you have a heart condition, I can't see any reason to. You can get an ECG to be sure that nothing else is going on.

I found that my heart rate decreased over time.

I hope this helps to ease your worries.


Sincerely,
Scott

 

Re: Mood stabilizer only for depression? to Scott

Posted by Margit on March 20, 2001, at 9:43:29

In reply to Re: Mood stabilizer only for depression? to Scott » Margit, posted by SLS on March 20, 2001, at 7:52:56

Hi Scott,
thanks for your reply. Which tricyclic did you take and how many mgs?
Thanks
Margit

 

Re: Mood stabilizer only for depression? to Scott » Margit

Posted by SLS on March 20, 2001, at 13:37:50

In reply to Re: Mood stabilizer only for depression? to Scott, posted by Margit on March 20, 2001, at 9:43:29

Dear Margit,


I have taken:

imipramine (Tofranil) - 300mg (450mg briefly)
desipramine (Norpramin) - 300mg
nortriptyline (Pamelor) - 100mg - I am currently titrating this drug.
amitriptyline (Elavil) - ?mg
protriptyline (Vivactil) - ?mg

These drugs have at least three properties that will cause the heart to beat faster. They raise levels of noradrenergic activity (NE) and reduce the level of cholinergic activity (ACh). In addition, tricyclics block a certain receptor known as the NE alpha-1. This is why you may become temporarily dizzy when you stand up. This is called orthostatic hypotension. Along with this temporary drop in blood pressure comes the heart's attempt to compensate for it by temporarily beating faster. Although tricyclic antidepressants increase heart rate, they do not raise blood pressure. You may also experience a feeling of heart palpitations, especially early in therapy. This too is usually nothing to worry about.

I am glad you are taking the time to investigate this stuff before making a decision. I know how easy it is to get scared by the new and strange feelings that sometimes occur at the beginning of drug treatment.

Tricyclics are very strong antidepressants, and can be combined with drugs like lithium, Wellbutrin, Prozac and the other SSRIs. They can even be combined with MAO inhibitors when rarely necessary.

Good luck.


- Scott

 

Update

Posted by shelby on March 22, 2001, at 21:36:11

In reply to Re: Mood stabilizer only for depression? to Scott » Margit, posted by SLS on March 20, 2001, at 13:37:50

I have not been on the board for the last couple of days and just now am catching up on the board.

Elavil is one of the more drying tricyclics and, for me, carb cravings. That is why I started on the nortriptyline to hopefully decrease the elavil.

Last Thurs. I got a really bad headache which continued through the weekend. Tylenol would not help. Monday I woke up with a tooth pounding but I put this down to clenching my teeth while sleeping. After talking to my doctor, I was told that headache is one of the side effects but would go away. I have had that symptom before so know the feeling. I phoned my dentist just to see if it was tooth related. Went in and found I have been walking around with an abcessed tooth!!

So at least I know that I can still play around with dosages and will do so after antibiotics for my tooth. I will probably try the neurontin along with the elavil at night and lower the dose of elavil. Will keep in touch.

Thanks for the replies. Good info.

 

Re: Update » shelby

Posted by SLS on March 23, 2001, at 8:28:30

In reply to Update , posted by shelby on March 22, 2001, at 21:36:11

Hi Shelby,

Regarding nortriptyline:

> So at least I know that I can still play around with dosages and will do so after antibiotics for my tooth

Nortriptyline (Pamelor) is perhaps the only tricyclic antidepressant that demonstrates a true therapeutic window. You can actually take too much and lose the antidepressant effect. You can play with dosages, but you have a limited range with an upper and lower limit within which you must stay.

The window for nortriptyline is rather narrow. The only way to be sure where you are within the window is to take blood tests to determine blood-levels. Nortriptyline has been the most heavily studied tricyclic drug with respect to therapeutic blood levels.

The range for therapeutic blood concentrations of nortriptyline lies between 50 and 150 ng/ml (nanograms per milliliter).

I have recently switched from desipramine to nortriptyline. After ten days (5 half-lives) at 100mg, my blood level was 123ng/ml. I will have a better idea next week as to how much flexibility there is in the therapeutic window for any one individual.


- Scott

 

Re: Update

Posted by sherry gomez on March 24, 2001, at 10:34:15

In reply to Re: Update » shelby, posted by SLS on March 23, 2001, at 8:28:30

> Hi Shelby,
>
> Regarding nortriptyline:
>
> > So at least I know that I can still play around with dosages and will do so after antibiotics for my tooth
>
> Nortriptyline (Pamelor) is perhaps the only tricyclic antidepressant that demonstrates a true therapeutic window. You can actually take too much and lose the antidepressant effect. You can play with dosages, but you have a limited range with an upper and lower limit within which you must stay.
>
> The window for nortriptyline is rather narrow. The only way to be sure where you are within the window is to take blood tests to determine blood-levels. Nortriptyline has been the most heavily studied tricyclic drug with respect to therapeutic blood levels.
>
> The range for therapeutic blood concentrations of nortriptyline lies between 50 and 150 ng/ml (nanograms per milliliter).
>
> I have recently switched from desipramine to nortriptyline. After ten days (5 half-lives) at 100mg, my blood level was 123ng/ml. I will have a better idea next week as to how much flexibility there is in the therapeutic window for any one individual.
>
>
> - Scott
.
> >Scott,

Is depakote Er good for depression? I take 1500mg along with topamax.....


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