View Full Version : Experience With High Dose Nortriptyline


cwf1986
04-28-16, 03:31 PM
Okay it's not imipramine or desipramine, but it is a tricyclic.

I'm taking 125mg of Nortriptyline.

I find it great for cutting down on the procrastination aspect of adhd. I think ya'll might know what I mean when I say that it lowers that wall between thinking I need to do something and actually doing it.

It does a good bit for preventing 'mental fatigue' aka sustained attention once something has my attention, but doesn't help initiate focus and attention. It also doesn't help with switching attention. It does help me tune out distraction very well. So if focus was defined as a noise to signal ratio, it mostly helps cut out some of the noise.

It's also a little activating, but it's not an anxious energy at all. It's a very clean energy.

I still space out on it alone and it doesn't ease adhd restlessness. That is, I still fidget a lot and crave stimulation.

It also works great for anxiety and depression type symptoms. Much less worry and rumination and I don't get agitated quite as easy. My mood is also much more even throughout the day instead of lots of ups and downs in the same day. I also never get feelings of being overwhelmed, hopelessness, or despair while taking it.

I take it before bed and it helps me fall asleep and stay asleep and it helps me bounce out of bed when it's time to wake up.

After about a week of a dose increase, I don't have any side effects. Granted, I've seen many reports where they're god awful for some. During those first several days after a dose increase, I experience a ravenous appetite, low libido along with sexual function, slightly blurry vision, sedation, bloating, and constipation and urinary hesitation. I know that sounds awful, but they're real mild and only for a few days so it's pretty easy to put up with.

I was taking this dose before I started Vyvanse. If I had to choose between the two, I would only take the nortrip, but the Vyvanse works a lot better for ADHD. It's just that the nortrip helps so much with depression and anxiety and even helps with my allergies.

sarahsweets
04-28-16, 03:35 PM
Is this a drug thats normally prescribed for depression or something else? Or adhd?

cwf1986
04-28-16, 04:25 PM
In most guidelines I've looked, it's rated as 3rd or 4th line for treatment for ADHD. Typically, I've seen it prescribed at low doses (<50mg) for neuropathic pain, IBS, migraines, and higher doses (50-150) for depression and/or anxiety.

I was originally prescribed this for IBS type symptoms, but I told the doc that it helps with my anxiety too. Since I tolerated it so well and it helped so much and my EKG's were good, the doc and I decided it would be a good idea to increase the dose. So over about a period of 8 months, I've gone up to this dose and I think it's perfect at this dosage.

My understanding is that it probably works for ADHD in a vein similar to Strattera. It's strongest effects are on NE, but it also works at one of the serotonin receptors to significant but much lower degree. It also has effects on alpha, histamine, and muscarinic receptors that can play a role in reducing anxiety.

So if Wellbutrin, Strattera, or Desipramine are anxiety provoking, but do help with adhd symptoms and you can't do stims, it might be something to look into. It only started to signifantly work for adhd over 100mg for me, but there were hints of something to it for that at 75mg.

In summary, for me it helps with:
1)anxiety
2)depression
3)IBS type symptoms
4)allergies
Polypharmacy in a single pill!

One thing I forgot to mention is that it prevents the crash of stims since it's stimulating itself. I also don't get that feeling of the stim 'coming in waves' while its work with the nortrip.

A lot of docs are made nervous by tricyclics because of interactions and the potential cardiac effects of them. Just something to keep in mind.

I'm not a doc or provider of any kind so please take what I say with a big grain of salt.

Lunacie
04-28-16, 04:59 PM
In most guidelines I've looked, it's rated as 3rd or 4th line for treatment for ADHD. Typically, I've seen it prescribed at low doses (<50mg) for neuropathic pain, IBS, migraines, and higher doses (50-150) for depression and/or anxiety.

I was originally prescribed this for IBS type symptoms, but I told the doc that it helps with my anxiety too. Since I tolerated it so well and it helped so much and my EKG's were good, the doc and I decided it would be a good idea to increase the dose. So over about a period of 8 months, I've gone up to this dose and I think it's perfect at this dosage.

My understanding is that it probably works for ADHD in a vein similar to Strattera. It's strongest effects are on NE, but it also works at one of the serotonin receptors to significant but much lower degree. It also has effects on alpha, histamine, and muscarinic receptors that can play a role in reducing anxiety.

So if Wellbutrin, Strattera, or Desipramine are anxiety provoking, but do help with adhd symptoms and you can't do stims, it might be something to look into. It only started to signifantly work for adhd over 100mg for me, but there were hints of something to it for that at 75mg.

In summary, for me it helps with:
1)anxiety
2)depression
3)IBS type symptoms
4)allergies
Polypharmacy in a single pill!

One thing I forgot to mention is that it prevents the crash of stims since it's stimulating itself. I also don't get that feeling of the stim 'coming in waves' while its work with the nortrip.

A lot of docs are made nervous by tricyclics because of interactions and the potential cardiac effects of them. Just something to keep in mind.

I'm not a doc or provider of any kind so please take what I say with a big grain of salt.

I take two similar tricyclics, Sertraline and Amitriptyline.

The Sertraline was first and was amazing for my anxiety, taken in the am.

It hasn't done anything for my IBS, fibromyalgia pain, or Migraines.

So the doctor added the Amitriptyline, taken in the pm.

Still no help for my back pain, my migraines, my fibro pain, or my IBS.

I see the doctor again next week and will ask if I need both as they don't help more than the Sertraline did alone.

Little Missy
04-28-16, 06:57 PM
Is sertraline a tricyclic?:scratch:

AddAnxiousMe
04-30-16, 04:40 PM
Is sertraline a tricyclic?:scratch:

No, sertraline is the generic of Zoloft. Zoloft is an SSRI, it only affects serotonin. It also has a weak action on dopamine, but nothing to talk about.

cwf1986
05-06-16, 08:41 PM
I think my initial evaluation was a little premature. I was only a little over a week into the dose increase and it hadn't had time to kick in fully.

Now that it's kicked in, it makes me feel internally agitated and even angry. It's a good thing that it also helps inhibit knee jerk reactions or that would have seriously been a problem beyond just the unpleasantness of the feeling.

It's also causing a lot of physical tension to the point that my neck and upper back hurt by the end of the day. The tension can be bad enough that all I want to do is lounge so I don't become any more tense.

There's mild to moderate dry mouth now, but my sinuses are over dried up. Saline nasal spray has helped some.

The tension and anger isn't as bad without the vyvanse, but the vyvanse works better for the adhd. And the increase in agitation, tension, and anger with the nortrip alone isn't worth the benefits in decreasing worry and rumination.

It's also giving me really weird dreams and increased the frequency of nightmares. Both of which are causing restless sleep. I think now that I'm over the anti-histamine effects, it doesn't help me go to sleep anymore.

I'm going back down to 75mg and I'm going to talk to my doc about perhaps buspirone or an SSRI for anxiety/depression type symptoms.

Having said that, it isn't hard for me to see how this might be the right medicine at these higher doses.

sarahsweets
05-07-16, 09:14 AM
I think my initial evaluation was a little premature. I was only a little over a week into the dose increase and it hadn't had time to kick in fully.

Now that it's kicked in, it makes me feel internally agitated and even angry. It's a good thing that it also helps inhibit knee jerk reactions or that would have seriously been a problem beyond just the unpleasantness of the feeling.

It's also causing a lot of physical tension to the point that my neck and upper back hurt by the end of the day. The tension can be bad enough that all I want to do is lounge so I don't become any more tense.

There's mild to moderate dry mouth now, but my sinuses are over dried up. Saline nasal spray has helped some.

The tension and anger isn't as bad without the vyvanse, but the vyvanse works better for the adhd. And the increase in agitation, tension, and anger with the nortrip alone isn't worth the benefits in decreasing worry and rumination.

It's also giving me really weird dreams and increased the frequency of nightmares. Both of which are causing restless sleep. I think now that I'm over the anti-histamine effects, it doesn't help me go to sleep anymore.

I'm going back down to 75mg and I'm going to talk to my doc about perhaps buspirone or an SSRI for anxiety/depression type symptoms.

Having said that, it isn't hard for me to see how this might be the right medicine at these higher doses.

It took awhile, and it wasnt instant but buspar definitely helped my anxiety.

cwf1986
06-28-16, 07:57 AM
That buspar is good stuff. Simply a reduction in mental anxiety particularly with rumination and worry without any side effects. I'm glad I tried it. I tried that instead of an SSRI because I was worried about sides and am happy with the results.

The nortrip helps with anxious thoughts not bothering me as much, but does little to block them like the buspar does. And the clonidine is very calming. It works better with restlessness and calm than Xanax. The clonidine also helps with sleep a ton without making me groggy in the morning. By the time I took enough Xanax to help with anxiety, I'd be knocked out. No good for daytime use.

cwf1986
01-06-17, 05:10 PM
I guess I'll go ahead and make an update since experiences of people taking nortriptyline are hard to find on the net.

A few months ago, I got bumped up to 150mg Nortrip. I did this because it was either increase the adderall and I didn't want to do that because of the sides or increase the nortrip. I'm a fast metabolizer of nortrip so this puts my blood levels in the lower range of the therapeutic window.

I avoided the sides this time by taking 3 50mg doses spread about 6-8 hours apart a day.

It did help a lot with focus and keeping me on task. It helped with general restlessness and that feeling of unease. It helped with anxiety a good bit too. It didn't do anything for motivation or conscientiousness. But the adderall does an okay job with that.

After about a month, I didn't have any sides from the nortrip. What I had to put up with for that month was dry mouth, more prominent halos around lights to the point of everything being blurry around and within the halos at night, increased appetite, and sedation.

Snoopy10
04-13-17, 08:02 AM
I recently was prescribed nortriptyline for migraine prevention. It actually worked for that almost right away and also helped with monthly cramps but it made my anxiety worse and I started acting out of character, as I often do anytime I take a SSRI or SNRI. So I stopped taking it. It took over a month to leave my system and I know this for a fact because a month later and I still didn't have any monthly cramps. Anyway, if I could have tolerated it, it would have been a miracle drug.

cwf1986
05-20-17, 01:10 AM
Have you talked to your doc about this. Nortriptyline not uncommonly increases anxiety because of it's potent norepinephrine activity.

It's in the tricyclic class of antidepressants so there might be something with much less NE activity in that family that will still be able to help you.