Posted by Sad Panda on August 16, 2004, at 11:20:24
In reply to TRICYCLICS: Is there a best one?, posted by anxiety_free on August 16, 2004, at 6:57:15
> Hi! I currenly take imipramine @150mgs/day, along with a stimulant, two benzos, and propranolol. My question really is about the tricylic: is there a better one? I'm not psychotically depressed, I just want the most bang for my psychiatric buck. For depression/anxiety, what's GOOD and what's GREAT? Can tricyclis be mixed for max. impact? (ex: Pamelor+Elavil). Thanks for your help!
>
>I am actually thinking of Pamelor+Elavil for myself.
Clomipramine(Anafranil), Imipramine(Tofranil) & Amitriptyline(Elavil) are the best of the tertiary TCA's. Imipiramine is a good SRI & NRI with the least side effects of the three. Amitriptyline also is a good SRI & NRI + it adds a significant amount of 5-HT2A antagonism making it anxiolytic & improving sleep, it also has significant H1 antagonism to put you to sleep. Unforunately, it also has the worst side effects of all the TCA's. Clomipramine is a potent SRI & good NRI + it is a 5-HT2A antagonist. It's side effects are inbetween Imipramine & Amitriptyline. Since you are taking two benzos & a beta blocker, I would guess you have alot of anxiety, so both Clomipramine & Amitriptyline would be better choice & would lower your benzo intake, I would try Clomipramine.
Of the secondary TCA's, Desipramine & Nortriptyline(Pamelor) are probably the only two worth considering. Desipramine is an active metabolite of Imipramine, is stimulating with the least side effects, Nortriptyline is an active metabolite of Amitriptyline, it's is stimulating with 5-HT2A antagonism added making it like a stimulant & benzo in one. I am currently using Nort myself combined with Effexor.
Cheers,
Panda.
poster:Sad Panda
thread:378159
URL: http://www.dr-bob.org/babble/20040811/msgs/378242.html