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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Skeletor on May 8, 2020, at 11:30:06
Personal ecperience requested ;=)
Posted by linkadge on May 9, 2020, at 8:09:48
In reply to How strong is Amitriptyline's sedative effect?, posted by Skeletor on May 8, 2020, at 11:30:06
It's fairly potent, but it can reduce over time (as it is also a potent SNRI). I found mirtazapine more sedating (but also less effective as an antidepressant).
Linkadge
Posted by Skeletor on May 10, 2020, at 15:06:52
In reply to Re: How strong is Amitriptyline's sedative effect?, posted by linkadge on May 9, 2020, at 8:09:48
> It's fairly potent, but it can reduce over time (as it is also a potent SNRI). I found mirtazapine more sedating (but also less effective as an antidepressant).
>
> LinkadgeI am on Escitalopram 5mg, which is okay. That is 60% SERT occupancy. (I can't stand strong SRIs. Zoloft 50mg, 75mg and 100mg made me a zombie and anorectic)
Now I ve been thinking about adding something with 5HT2 antagonism. I once tried Mirtazapine, but that gave me RLS. Amitriptyline has 5HT2 antagonism and additionally it has some powerful NRI and antimuscarinic action. It seems to be quite a potent med, but sedation frightens me.
Posted by linkadge on May 11, 2020, at 18:49:16
In reply to Re: How strong is Amitriptyline's sedative effect? » linkadge, posted by Skeletor on May 10, 2020, at 15:06:52
If you're concerned about the sedative effect, you could add nortriptyline. Nortriptyline is less sedating, has 5-ht2 antagonism and might be more complementary (less SERT blockade).
Linkadge
Posted by Skeletor on May 12, 2020, at 17:06:56
In reply to Re: How strong is Amitriptyline's sedative effect?, posted by linkadge on May 11, 2020, at 18:49:16
> If you're concerned about the sedative effect, you could add nortriptyline. Nortriptyline is less sedating, has 5-ht2 antagonism and might be more complementary (less SERT blockade).
>
> LinkadgeHmm yes, that might be worth thinking about. It's just a pain that there are only 10mg and 25mg pills where I live. That makes higher dosing a pain in the *ss.
btw: What is your take on Aripiprazole?
Posted by linkadge on May 13, 2020, at 20:15:26
In reply to Re: How strong is Amitriptyline's sedative effect? » linkadge, posted by Skeletor on May 12, 2020, at 17:06:56
I haven't taken Aripiprazole, so I can't say.
As far as nortriptyline dosing, if you're augmenting escitalopram, you probably wouldn't need much more than 50-75mg.
Linkadge
Posted by Mtom on August 1, 2020, at 12:09:49
In reply to Re: How strong is Amitriptyline's sedative effect? » linkadge, posted by Skeletor on May 10, 2020, at 15:06:52
Interesting. I was taking Escitalopram, started low, lots of side effects, hoping they would go away I kept titrating up, got as high as 7.5 mg and side effects kept worsening - anxiety-jitteriness, nightmares and REM sleep disorder.
I started decreasing Esc dose then cross titrating with Mirtazapine, again starting low. I only got Restless Leg Syndrome a few tunes after starting Mirtazapine when my Escitalopram dose was still fairly high. RLS went away as I decreased Esc dose.
Mirtazapine caused worse nightmares initially but these eased over time.
I took Amitriptyline many years ago and sedation was worse than Mirtazapine, couldn't get out of bed in the morning. I "think" that eventually improved, but don't clearly remember, and only took it for 6-7 months. I had been undergoing intense situational stress causing anxiety and moderate depression, I fixed the situation and quickly felt better. I don't know if the Amitriptyline had helped as my stressful situation changed shortly after starting, but when I stopped Ami I remained feeling good for many years.
The Mirtazapine sedation reduced over time, still a bit sleepy on waking and sometimes later day fatigue and need a quick late afternoon nap, but can skip that with effort and the fatigue passes.
i started a new threat asking about Amitriptyline experiences because although Remeron has been better for some response and more tolerable side effects than SSRIs, I'm still far from full response.
> I am on Escitalopram 5mg, which is okay. That is 60% SERT occupancy. (I can't stand strong SRIs. Zoloft 50mg, 75mg and 100mg made me a zombie and anorectic)
>
> Now I ve been thinking about adding something with 5HT2 antagonism. I once tried Mirtazapine, but that gave me RLS. Amitriptyline has 5HT2 antagonism and additionally it has some powerful NRI and antimuscarinic action. It seems to be quite a potent med, but sedation frightens me.
This is the end of the thread.
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