Posted by SLS on July 13, 2009, at 5:06:59
In reply to Parnate/Elavil or Nortriptyline? FATIGUE! SLS?, posted by ColoradoSnowflake on July 12, 2009, at 19:56:10
> Hi- I'm still on 50mg Parnate, 200mg Provigil and 12 1/2mg Elavil. The Provigil helps with the fatigue but not nearly enough. I am just too tired to show up for life. My pdoc isn't back until Sept 1st. I wont make any major changes until I talk to him, but I want to be READY! Do you know if one can change from Elavil to Nortriptyline easily, or is it a big deal tapering down and drug cleanse and tapering up? Also, what side effects does Pamelor have? do you think it would help me sleep ? or I'd have insomnia and have to add some kind of sleep augmentation? 12mg of Elavil seems like a small amount to give me such fatigue! The Parnate itself must be giving me a lot of fatigue. I suppose I could take more Provigil, but it's so expensive I may not be able to take it at all unless I can find a cheaper way to get it.(Any ideas on that score?) That aside, what do you think? I was SO hoping the Parnate would work. Fatigue has always been my most awful symptom. Any ideas, Scott? or anyone else with this experience? I would VERY MUCH appreciate information!!
> Thanks!!! Gayle
What role was amitriptyline chosen to play?You might feel much less sedated on the nortriptyline. I hate the way amitriptyline makes me feel - sedation and malaise. Nortriptyline is much better in this regard. I don't know if there is an established protocol for switching TCAs while taking Parnate. However, I have done it several times in different ways. If I were taking such a small dose of amitriptyine, I would probably simply skip one day by not taking any amitriptyline and begin nortriptyline the next day. If you want, you can go several days without adding a TCA to see if the Parnate is to blame for daytime sedation or fatigue.
It might very well be that the Parnate is producing the fatigue. Nortriptyline will not make as effective a sleep medication as the amitriptyline. Nortriptyline can produce the same kind of side effects as amitriptyline, but not to the same degree. After you have been on it for awhile, you will probably not notice them anymore.
I need 80mg of Parnate for it to be worth taking. I also need 150mg of nortriptyline. Most people do well with 75mg. It depends how rapidly you metabolize the drug.
Currently:Parnate 80mg
nortriptyline 150mg
Lamictal 200mg
Abilify 20mg
lithium 150-300mg
- Scott
poster:SLS
thread:906439
URL: http://www.dr-bob.org/babble/20090709/msgs/906506.html