Posted by zeugma on May 1, 2004, at 5:37:28
In reply to Re: which plan sounds more reasonable » zeugma, posted by Sad Panda on May 1, 2004, at 3:57:52
> Hi Zeugma,
>
> I'd try cross tapering to Clomipramine from Nortriptyline since it's the easiest thing to do & probably the best drug that isn't a MAOI. If it is a failure, it should be easy to go back to Nortriptlyline and then try adding an SSRI or Effexor or even an MAOI to it. Imipramine is another TCA worth trying, but it lacks the potent 5-HT2A blockade that most of the TCA's have which I would consider to be an important part of their anxiolytic & good sleep effect.
>
> Downsides to Clomipramine are that it will have roughly double the strength/mg of side effects and half the antihistamie sedation.
>
> Cheers,
> Panda.
>Yes, I was thinking that one advantage would be the ease of tapering from nortriptyline to clomipramine. I also thought of imipramine (and amitriptyline), but I have not seen any reports that they might offer a substantially stronger anxiolytic effect than nortriptyline. I have a feeling though that my dr. may be more willing to prescribe lexapro. I didn't know that clomipramine was only half as sedating as nortriptyline. That is something to keep in mind.
poster:zeugma
thread:341936
URL: http://www.dr-bob.org/babble/20040429/msgs/342098.html