Posted by zeugma on August 15, 2004, at 19:39:41
In reply to Re: Questions about long term TCA (esp desipramine), posted by linkadge on August 15, 2004, at 15:44:52
I would take nortriptyline over the variety of more selective meds that I have tried over the years.
I remember my pdoc was in love with strattera, and urged me to drop nortriptyline in favor of it. Lowering nortriptyline brought back depression and I realized that the equation 'more selectivity=less side effects' is seriously flawed. It assumes that the newer meds are simply zeroing in on serotonin or norepinephrine or whatever and not doing anything else in the body. That proved not to be the case with Strattera, whose main metabolite, 4-hydroxyatomoxetine, was shown to be a kappa opiate partial agonist, resulting in fatigue and dysphoria for a lot of people, including myself.
The TCA's have been around for 50 years or so, so if they did anything of this insidious nature, it would long since have come to light.
Oh yes, I am growing another arm (j/k).
poster:zeugma
thread:377967
URL: http://www.dr-bob.org/babble/20040811/msgs/378026.html