![[dr. bob]](/dr-bob-sm.gif)
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 EERRIICC on June 6, 2004, at 0:06:31
If a trial with desipramine fails does it make sense to try nortriptyline? What is the difference between these two drugs?
Posted by Sad Panda on June 6, 2004, at 10:30:41
In reply to From desipramine to nortriptyline?, posted by EERRIICC on June 6, 2004, at 0:06:31
> If a trial with desipramine fails does it make sense to try nortriptyline? What is the difference between these two drugs?
>
>Nortriptyline has nearly as much NRI ability as desipramine, but it also is mildy sedating, anxiolytic & carries more side effects. I would bet that it would have more of an antidepressant effect since it's parent Amitriptyline is still one of the best ever AD's.
Cheers,
Panda.
Posted by SLS on June 6, 2004, at 11:07:34
In reply to Re: From desipramine to nortriptyline? » EERRIICC, posted by Sad Panda on June 6, 2004, at 10:30:41
> > If a trial with desipramine fails does it make sense to try nortriptyline? What is the difference between these two drugs?
> Nortriptyline has nearly as much NRI ability as desipramine, but it also is mildy sedating, anxiolytic & carries more side effects. I would bet that it would have more of an antidepressant effect since it's parent Amitriptyline is still one of the best ever AD's.
I think you might be right about that. I found nortriptyline to produce a qualitatively better antidepressant response than did desipramine. Unforturnately, I found that establishing a therapeutic dosage of nortriptyline was problematic. There was no stable therapeutic window for me. No one dosage allowed me to feel better for than more than a few days after a dosage change. 75mg was too low and 100mg was too high. I would experience a transient improvement immediately after a change of dosage, either up or down. No amount of finessing helped. Although this type of response pattern is uncommon, I am not unique in this regard. 75mg is the right dosage for most people. Sometimes, people who don't respond to nortriptyline will respond to desipramine and vice-versa. The range for therapeutic blood levels for nortriptyine are well studied and determined to lie within the range of 50-150 ng/mL.
- Scott
Posted by King Vultan on June 6, 2004, at 12:24:30
In reply to From desipramine to nortriptyline?, posted by EERRIICC on June 6, 2004, at 0:06:31
> If a trial with desipramine fails does it make sense to try nortriptyline? What is the difference between these two drugs?
Panda's and Scott's information is quite good. I actually went the other way, from nortriptyline to desipramine, as nortriptyline is my doctor's preferred tricyclic to start with. I just found nortriptyline way too sedating myself, and desipramine suited me much better, but I believe that most people would probably tolerate nortriptyline better than I do. I agree that it is definitely better for anxiety than desipramine is.Todd
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.