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Re: Tricyclics - Q for SLS et. al. regarding ...

Posted by SLS on October 11, 2006, at 18:42:48

In reply to Re: Tricyclics - Q for SLS et. al. regarding ..., posted by blueberry on October 11, 2006, at 18:15:59

Hi Michael.

> Based on your descriptions, my best guess would be to go for desipramine. It's a bit more activating and less sedating than nortriptyline, though either one could be good for you.
> I would definitely stay clear of protriptyline...that's just because I tried it once and I was just stunned at how harsh the side effects were, I mean it was nasty stuff, more nasty than I can even find words to describe. Desipramine or nortriptyline are much friendlier.

Blueberry said exactly what I was going to say, only sooner, and in fewer words. I found protriptyline to be the most potent of the tricyclics with respect to anticholinergic/pro-noradrenergic side-effects. Another reason to go with the desipramine first is that you don't have to guess at therapeutic windows. You can actually miss the target and take and too much nortriptyline. I happen to be taking nortriptyline 100mg right now because I find it helps a little more with anhedonia. For me, it has more of a mood-brightening effect.

You know, several people have used a combination of amisulpride and selegiline for dysthymia with some success. I would be curious as to how combining Emsam with Abilify might be. In case I fail to think of it later, I thought I might mention it now.

- Scott




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