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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by gpznos on February 1, 2013, at 9:11:36
Hi
For no obvious reason I went down in a new depression last November with a combo of 110 mg Nortriptyline and 37,5 mg Valdoxan (and 7,5 mg Mirtazapin). As some bloggers already have pointed out this could mean the Nortriptyline has pooped on me. (I am right now on 145 mg Nort + 600 mg Lithium + Vald and Mirt, not doing good)I am therefore in the need for a new main AD drug and I would like to know if it makes any sense to choose another TCA? - could they be to "close" to eachother?
I have thought about Desipramine og Imipramine - my pdoc speakes about Clomipramine but I think it is too hard with the SE.
Posted by jono_in_adelaide on February 3, 2013, at 19:55:27
In reply to Pooping out - TCA specialist needed, posted by gpznos on February 1, 2013, at 9:11:36
Maybe drop the nortriptyline and add Welbutrin XL 300mg in the morning - if nortriptylinr has pooped out, an unrelated drug might be the go
It might be that your depression has gotten worse, as poop out is less common with tricyclics than SRI's
I'd also consider dropping the Valdoxan and adding sertaline (Zoloft) start at 50mg, and increase to 100mg after 2 weeks or so.
Posted by gpznos on February 5, 2013, at 6:21:27
In reply to Re: Pooping out - TCA specialist needed, posted by jono_in_adelaide on February 3, 2013, at 19:55:27
> Maybe drop the nortriptyline and add Welbutrin XL 300mg in the morning - if nortriptylinr has pooped out, an unrelated drug might be the go
>
> It might be that your depression has gotten worse, as poop out is less common with tricyclics than SRI's
>
> I'd also consider dropping the Valdoxan and adding sertaline (Zoloft) start at 50mg, and increase to 100mg after 2 weeks or so.Thanks Jono
Very good points and ideas. I have been thinking about dropping the Valdoxan for a long time now, this will happen when I get a bit better/stabile.
I still dont know if there if anything to gain by swapping from one to another TCA - Marplan is also in my thoughts. Wellbrutin is also a possibility but I dont think my pdoc will aprove this.
I am going to him in 2 weeks time and will discuss all this with him.gpznos
This is the end of the thread.
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