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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Bellame on December 14, 2007, at 18:09:39
My depression has really deepened--maybe the holidays (who knows?) Anyone my pdoc started me on 25mg of Nortriptyline today to augment the 40mg of prozac. I also take lamictal 200mg and seroquel 200mg--this is a lot of psych meds and it bugs me because I had gotten down to just prozac. Any thoughts on this combo, and esp. what about nortriptyline? It is such an old med that I wonder if it will help. I am miserable--no motivation, ache all over, and just crying all the time. And I usually love this time of year. Thanks for any info.
Posted by bleauberry on December 15, 2007, at 5:46:41
In reply to Nortriptyline starting--any info, posted by Bellame on December 14, 2007, at 18:09:39
I can say that combining an ssri with a tca is fairly common. My GP favors the ssri+tca combos as well as the ssri+antipsychotic combos.
Keep in mind that the very drugs we take to treat depression can worsen it too in the longer term, via indirect mechanisms. For example, prozac has flouride, which will affect the thyroid gland. There is ongoing research in how ssris cause your biochemistry to make less serotonin, so that even though you are boosting the serotonin you have, you are making less to begin with than before you starting taking the med. There is ongoing research in how ssris disrupt the natural conversion of tryptophan into serotonin and that it may be a longterm or permanent alteration in biochemistry. Nobody knows the longterm consequences of taking any of these meds. There are books written on how psychiatric drugs actually make depression worse in the long run. I have no opinions on it, but throw it out there for thought.
In any case, if one or two or three of the other meds you are taking are not helping you, there is not much sense logically in continuing to take them, other than avoiding the withdrawals of weaning off them.
I wish you could just try prozac and nortriptyline without the other meds. So many meds makes it hard to know what is doing what.
The old tca antidepressants do have a reputation of being more effective than ssris, and the combo is fairly common, so it seems worth a try.
Posted by Phillipa on December 15, 2007, at 13:37:37
In reply to Re: Nortriptyline starting--any info, posted by bleauberry on December 15, 2007, at 5:46:41
Flouride affects the thyroid is that why so many psych patients have thyroid problems? Phillipa
Posted by bleauberry on December 15, 2007, at 20:37:12
In reply to Re: Nortriptyline starting--any info » bleauberry, posted by Phillipa on December 15, 2007, at 13:37:37
Contrary to popular acceptance, flouride is not good. There are safer ways to prevent cavities. My dentist and my doctor were happy I installed a water filter on my sink to remove flouride, chlorine, and trace metals (main concern was copper and lead from pipes). Dentist specifically advised me to avoid flouride toothpaste.
Posted by garyengelm on December 17, 2007, at 12:11:11
In reply to Nortriptyline starting--any info, posted by Bellame on December 14, 2007, at 18:09:39
The Tricyclics have a reputation for working better, but they tend to have more side effects. At least thats what I've gotten from my research.
Regarding your cocktail: In my opinion, you've got quite a mix going on there. Imagine your brain like your tongue. If you mix salt, sugar, cinamon, and flour, how would that taste ?
On the other hand some people like chocolate mixed with peanut butter.
Your brain reacts similarly....when you start mixing too many meds, you never know what is causing what. If you introduce one at a time, than this is the only way to know whats causing what. This is what I reccomend you do. Just my opinion based on my own experience and research.
Good luck to ya...
Gary
Posted by linkadge on December 18, 2007, at 20:32:24
In reply to Re: Nortriptyline starting--any info, posted by garyengelm on December 17, 2007, at 12:11:11
I would say the TCA's have "different" side effects rather than more. For instance, I got no cognative/emotional blunting, insomnia, akathesia, or anhedonia on TCA's.
It depends how an individual reacts however.
Linkadge
This is the end of the thread.
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