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Re: Imipramine vs desipramine vs clomipramine?

Posted by Sad Panda on July 27, 2004, at 5:23:44

In reply to Imipramine vs desipramine vs clomipramine?, posted by banga on July 27, 2004, at 0:10:08

> Hello!
> Can anyone elucidate what the differences are between these three drugs? Clomipramine is something my depression has responded to in the past (but if I go too high on it I gain weight), I have never tried the other two and wonder whether there would be a difference. The reason I ask is--not to become a "me too!" gal, but along with my depression and anxiety I have ADD-ish symptoms and wondered why desipramine not clomipramine has been suggested as possible treatment. Are the SE profiles different?
> In case youre wondering I am taking 15mg Lexapro, 25mg clomipramine, 40mg Geodon, 40mg amantadine.
> I'm surprised so little people take Geodon. Maybe because it's a stupid name for a drug.
> Anyways, thanks in advance for any thoughts....
> Banga

Imipramine was the first TCA. Clomipramine & Amitriptyline are slight alterations but completely different drugs.
Clomipramine is a potent NRI, potent SRI & potent 5-HT2A antagonist. It is possibly the best AD & is a good anxiolytic.
Amitriptyline is a potent NRI, moderate SRI, potent 5-HT2A antagonist & potent antihistamine. It is a very good AD, good anxiolytic & a great sedative.
Imipramine is a potent NRI & moderate SRI.
For side effects Imipramine is the cleanest & Amitriptyline the worst with Clomipramine in between.

Desipramine is the active metabolite of Imipramine & Nortriptyline is the active metabolite of Amitriptyline.
Desipramine is a potent NRI with a very mild side effects profile which makes it a good stimulant.
Nortriptyline is a potent NRI & moderate 5-HT2A antagonist, but has more side effects than Desipramine, but less than Imipramine. It's an anxiolytic & stimulant in one package.

You shouldn't really be using Clomipramine & Lexapro together as you run the risk of serotonin syndrome. Nortriptyline & Desipramine are very good when combined with an SSRI.





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