Does increase in dosage of Nortriptyline have any side effects?

Posted on Wed, 24 Jun 2015 in Mental Health
Question: How will I know if I have to increase my nortriptylene and my klonopin? I'm taking 90 mgs. each night at bedtime around 12 midnight and I take a 0.5 mg of klonopin with it. During the day around 2-3 PM I take another 0.5 of klonopin. I have hyperventilation and when I take the afternoon klonopin sometimes I feel shaky and sometimesI feel better . It's so hard to adjust these meds to stop the hyperventilation totally. I go to a therapist and he tells me to experiment with the dosages. Do you think taking a little bit more of nortriptylene would help? This is so difficult to do to get back to normal breathing
Answered by Dr. Shubham Mehta 2 hours later
Brief Answer:
dose increment; diaphragmatic breathing.

Detailed Answer:
Welcome to HCM.
I understand your concerns.

The maximum dose of nortriptyline is 150mg (I hope you have access to our earlier conversation on 24th may).

In my opinion, you can increase the dose to 100mg and observe the effects.
I would not advise a dose increment of klonopin as it is highly addictive.

Also, I personally feel that hyperventilation would not remit with medicines alone.

You must practice diaphragmatic breathing:

1. Put one hand on your stomach below your ribs and the other on your chest.
2. Breathe in through your nose deeply. Let the air push your stomach out, but keep your chest still.
3. Exhale through pursed lips, and use the hand on your stomach to help push the air out slowly.
Repeat 3-10 times and take your time breathing in and out.

This should help you.

Kindly keep your doctor informed about the dose changes you make.

Hope you find my suggestions useful.

Do ask further for more doubts.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Shubham Mehta


Practicing since :2008

Answered : 2004 Questions


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