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Dr. Bob is Robert Hsiung, MD,
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Posted by Laney on May 27, 2010, at 10:18:02
about drugs in general/symptoms/side effects, etc.
I have been on 100mg. sertraline (zoloft) for 6 wks. and I'm worse not better. Constant negative depressive thoughts, pessimism, burning eyes, pressure in head, etc. Like I said, I'm worse not better.
My question is should I take the advice of Dr. Gillman of Psychotropical and add like 25mg. of Nortrip. to the mix? Can it really make the difference? What are the side effects of nortrip? I don't want to be more sleepy or fatigued feeling at all.
I'm also starting to think about maybe switching to Lexapro or Celexa? But... if Nortip. is the magic bullet I'm willing to stay put.
I just can't imagine that adding Nort. to what I'm taking can make a huge difference. Shouldn't the SSRI be working at least somewhat before going forward?
Thanks guys,
Laney
Posted by ed_uk2010 on May 27, 2010, at 14:49:12
In reply to Need some advice. Those of you knowledgeable, posted by Laney on May 27, 2010, at 10:18:02
If you actually feel worse after taking 100mg of sertraline (a full therapeutic dose) for six weeks, I would recommend that you taper off it. I do not think it would be appropriate to increase the dose of sertraline because you are still taking paroxetine, another SSRI. I do not see any reason to continue sertraline if it is providing no benefit.
Nortriptyline could certainly prove useful for your depression. You need to start with a low dose because it may be potentiated by paroxetine. Initially, you may feel drowsy on nortriptyline, but this should decrease after a couple of weeks.
Nortriptyline is clearly an effective antidepressant in its own right. If you were able to stop paroxetine, I would recommend trying nortriptyline on its own. Unfortunately, since you obviously find it very difficult to reduce the dose of paroxetine, you may as well continue taking 10mg for the time being.
In future, if you wish to stop taking paroxetine, a transition over to fluoxetine (Prozac) might be helpful because fluoxetine is much easier to stop than paroxetine and it also reduces paroxetine withdrawal symptoms. Fluoxetine and paroxetine both interact with nortriptyline so you wouldn't be able to make this transition if you were taking nortriptyline.
Posted by Laney on May 28, 2010, at 0:41:47
In reply to Re: Need some advice. Those of you knowledgeable, posted by ed_uk2010 on May 27, 2010, at 14:49:12
Thanks Ed! I really appreciate you help! I really do. No, the sert. is not doing a thing. I'm afraid Dr. Gillman will think I need to start the Nort. anyway. But I think I will tell him and my P-doc that it is actually making things worse. You just know when somethings not right.
Thanks again.
Laney
Posted by desolationrower on June 3, 2010, at 15:30:59
In reply to Re: Need some advice. Those of you knowledgeable, posted by Laney on May 28, 2010, at 0:41:47
well personally, i found all ssris worthless
i take nortr. currently, i think it is somewhat helpful in keeping me from mental distraction, and avoiding depressive thoughts.
i find it stimulating, not hypnotic.i do take 25 of my 100mg per day at night, b/c of the evidence for improved sleep.
I would consider 5ht and norepinephrine to be about equivalent in their control of antidepressive effect. or more exactlyh, nris and sris both are somewhat effecitve fighting depression's symptoms.
have you experienced nri yet?
-d/r
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