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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Schlepo on March 20, 2019, at 19:29:57
I'm having a very bad time right now. After being somewhat stable on 75mg of Nortriptyline (down from 125mg a few months ago) and 2.5 mg of Olanzapine everything has finally unraveled. Problems started a few weeks ago when i noticed I felt a bit different (mainly when dreaming) upon starting my latest bottle of 75mg Nortriptyline. I still had some old 50mg and 25mg pills from an earlier prescription and everything seemed normal on those. Once those 25mg ran out I paired the 50mg with a newer prescription of 25mgs that I though I could depend on, but I started feeling crappy again. Went back on the 75mgs and things just went steadily downhill from there. Called my pdoc and was able to get a 10 day prescription for the non-generic. But due to delays I was only able to get them AFTER I had already slipped into the worst depression of my entire life that I have no idea I'll ever get back from. And if course not only does the non-generic do little for the depression, but triggered some anxiety on top of that! Now I'm on around 2mg of Olanzapine, which is controlling the anxiety, but not a great effect on the depression.
So now I'm wondering whether my depression is due to being on a lower dose of Nortriptyline than I was a few months ago, or whether there was actually something wrong with that bacth of 75mg tablets (a theory which the timing of everything seems to support.) Has anyone ever gone through this? What kinds of things can go wrong with the manufacture of medication? (I've never had anything like this in my 27 years of being on Nortriptyline, though did have a similar experience with one bottle of Clonazepam.) Can something actually contaminate a batch and permanently screw me up, or would it be more a matter of the medication just being weaker than normal. As I said, it could just be that my dosage is low (which was lowered due to my fears I was starting to have a paradoxical reaction to it), but I was stable on that dosage for some time, and everything started going downhill coinciding with starting that last bottle! Please help!
Posted by atypical on March 21, 2019, at 1:03:43
In reply to Nortriptyline Nightmare! HELP!, posted by Schlepo on March 20, 2019, at 19:29:57
Not sure about whether you have a defective batch. That is possible. But a resounding YES regarding differences in effectiveness of a med between manufacturers of medicine. I have had issues most recently with Lithium ER. The Roxane and Mylan versions do not work as well as the Glenmark version at the same dose. In fact, the drug information now includes a message about "narrow therapeutic index" and to be careful when switching manufacturers. In another case the generic version of a med actually feels stronger than the brand name, in which case I've slightly reduced the dose of the generic. Be careful when switching from brand to generic or from one generic manufacturer to another. It can mean the difference between stability and relapsing. Sometimes there are no problems.
Posted by Schlepo on March 21, 2019, at 14:01:37
In reply to Re: Nortriptyline Nightmare! HELP!, posted by atypical on March 21, 2019, at 1:03:43
Actually, I tried Pamelor a few times back before all my recent issues and always thought I felt better on it. Is there anything wrong with mixing a generic and non-generic in the same dosage? I still have the 25mg pills of generic nortriptyline, and could add one to the 75mg of Pamelor to see if an increased dosage helps fix everything.
Posted by Lamdage22 on April 17, 2019, at 5:38:21
In reply to Re: Nortriptyline Nightmare! HELP!, posted by atypical on March 21, 2019, at 1:03:43
It can take 2-3 weeks for your brain to realize it's getting less Nortriptyline. Withdrawal symptoms are often delayed. I am sorry about your situation and i hope this helps
This is the end of the thread.
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