Hi Customer (name blocked for privacy),
Pamelor is the brand name for Nortriptyline and this drug is in the tricyclic antidepressant category.One key point to always remember when antidepressant medications are being considered for changing from one antidepressant to another is keeping the antidepressants in the same category. The biggest concern regards the antidepressant category of drugs named "MAO inhibitors." Pamelor is not a MAO inhibitor nor is Lexapro. Lexapro is an antidepressant which is known as a "Selective Serotonin Reuptake Inhibitor and is also not a MAO inhibitor type of antidepressant. Wellbutrin is not a MAO inhibitor, this drug is an antidepressant which works by being a Dopamine Reuptake Inhibitor.
My advice is for you to contact your MD about making the change from Pamelor to Welbutrin or Lexapro. Most people do fine when they change from Pamelor to Wellbutrin. Welbutrin is not a drug that you can switch back and forth real well and must be tapered for the dosage and never should be taken if there is a history of seizure activity unless this drug is approved for usage by your MD. In fact, some patients have reported seizures with Wellbutrin and when Wellbutrin is abruptly stopped/not tapered according to MD instructions given based on your specific medical history, there can be some significant concerns regarding seizure potential.
I realize here you are asking if you can abruptly stop taking Pamelor and change over to Wellbutrin or Lexapro. I see nothing in the Lexi-Comps drug Information Handbook 13th Edition (most current which I have consulted to double check as a reference)which indicates there is a need to taper Pamelor. It appears that it would be OK for you to change over to Welbutrin or to Lexapro. However, if you choose to do this, I definitely advise that you discuss this with your Dr. first. This would be very prudent and definitely in your best interest because each one of these drugs work differently and one targets Dopamine, one targets Serotonin and there are therapeutic blood levels involved here which need to be considered. Your MD would likely want to know what the serum blood level of the Nortriptyline is before changing to Wellbutrin or Lexapro.
It is all a matter of dealing with the brains chemicals and what I would not want you to risk is changing from Pamelor when based on your lab values for the serum blood level one of the other 2 drugs you have mentioned might be more appropriate to treat you. The side effects that can happen are important considerations so this is why it is important for the Dr.to know what your Nortriptyline level is before making changes. Based on blood levels the lab studies would reveal would be the best determing factor to know which would help you the most, Wellbutrin or Lexapro.
So, my suggestion is that you not consider changing to either of the meds you have asked about until you discuss this with your Doc.
Just for future knowledge, whatever you do do not ever take Wellbutrin and stop this drug abruptly. The primary potential for and the reported side effect of abruptly stopping Wellbutrin can have some very serious consequences--seizure activity and sometimes it is not a situation of only one seizure but can even become a pattern of multiple seizures so I wanted to mention this to you because there are many people who abruptly stop Welbutrin and suffer the consequences.
I regret I am unable to tell you it would be OK to change to Wellbutrin or to Lexapro and discontinue using Pamelor, but for the reasons I have listed above, it would be and is definitely in the best interest of your health not to do this until you have had discussion with your Doc. Dealing with Serotonin and Dopamine, biochemical components of the brain are involved here. I would think that your Doc would definitely want you to have Nortriptyline blood levels drawn before any changes are made. If this level is low or not within therapeutic range to help with depression, then it might be that your Doc would prefer to change the dosage for you or change to another antidepressant of the two mentioned or the Doc might decide there is a different antidepressant altogether that might help you better.
I don't know if you are taking antidepressants for depression primarily or if you are taking them for pain management or an unrelated ailment aside from depression. Regardless of whatever reason you are taking antidepressants, I'd still err on the side of caution and prudence and not change until you have discussed the matter with your Doc and also have a serum Nortriptyline levels drawn. (Just means having some bloodwork done and the results are usually ready from the lab in under 24 hrs.)
If you have any more questions about any of the meds you have asked about, just let me know. I hope the information I have provided has been helpful. What I believe to be best for you is to discuss the situation with the Doc. I'd hate to think that you end up not having the right dose with the right drug being utilized. If my information has been helpful, please CLICK on the GREEN ACCEPT button. Also, positive feedback is always greatly appreciated. Thank you for your post. I will be on-line for a while if you need anything else. I wish you all the best, Susan
Edited by gotquest on March 17 2006 at 7:47pm
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SUSIE S.
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