thanks Mrs. D. I'm going to have to make a decison now. I had planned on the nortriptyline due to less side effects. I've used Elavil in the past but the side effects were hard to deal with.....much to think about now.

I know you said you don't tolerate that class of drugs well, to be truthful, just FYI, I don't believe it has done anything for my nerve pain, as it has been lately advertised for. As far as for my depression......I think you can guess by my last few posts how it working for that!

http://psychcentral.com/news/2009/06...tors/6761.html

Very impressive.........I think I am going to ask to change over to it.

Not only for symptomatic relief, but it sounds like it may do some repair work (if I am interpreting this correctly)

Thanks for the info.

I was on Elavil for 7 years for bladder pain. It worked very well. I took 50 mg. but it took me 5 months to work up to that dose. That is why I was considering trying the nortriptyline this time, less side effects. When I went off the Elavil 5 years ago to get pregnant, my bladder pain was significantly improved, might have been some repaired nerves? Who knows.

The doses typically used for PN are smaller than antidepressant ones. I would not expect much in the way of depression alleviation therefore.

Thanks for finding that article. I had to go out in this frigid weather, for medical tests at 7am (fasting). It was 6 degrees out!

They had told me that I wouldn't get an depression relief from the 50 mg. of Elavil I was on, but honestly, I can say, that the 7 years I was on Elavil were my happiest every. So for me, it did help. But I respond to mouse doses of all meds! Except Lyrica.

wouldn't it be reasonable to take a higher dose if one wanted to treat depression and neuro pain. I would assume it would work even better for neuro pain at a higher dose and also help depression. Is my thinking wrong?

Most doctors are afraid of high dose TCAs. This family of drugs can cause long QT syndrome, and affect the heart.

Low electrolytes (low potassium and low magnesium) can also bring this on when you are using a TCA.

more here:
http://www.azcert.org/

Any dose of TCA may do this, esp when mixed with other drugs on the lists. However, mostly it appears when people overdose (depression patients may take overdoses in suicide attempts), or when electrolytes get low from diarrhea/vomiting.

Recovering from an overdose of TCA is not easy, so doctors are afraid to use high doses.

50mg of Elavil is not a typical dose (or higher) for PN. Typically 10-25mg are the more common doses.

If a doctor goes higher, then he is seeking a bit of antidepressant action, as well.

You can be screened for long QT with an EKG.