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Re: adjunctive meds to pair with paxil? » desolationrower

Posted by SLS on December 21, 2008, at 16:17:06

In reply to Re: adjunctive meds to pair with paxil?, posted by desolationrower on December 21, 2008, at 15:55:33

> > > If bupropion and venlafaxine both seems overstimulating, i'd probably not add a tca, its likely to have a similar effect.

> > What makes you say this?

> Do you think they wouldn't? It seems not to be an ideal choice. Even when they are sedating, they can still cause tachycardia anticholinergically.


I understand your concerns.

As "paradoxical" as it might sound, desipramine can effectively treat anxiety. This is not a function of any sedative effects that some people may experience early in treatment. If the anxiety is secondary to, and a symptom of, the depression itself, any drug that hits the right target for the depression will improve both the depression and the anxiety simultaneously. Personally, I find nortriptyline to be more calming than desipramine. However, I have responded to desipramine robustly in the past, and my anxiety resolved along with the depression. As an aside, it is interesting that Effexor can treat generalized anxiety disorder (GAD) so well.

Desipramine can certainly produce a "wired" feeling for some people. Very often, though, this disappears.

No guarantees. Trial and error.

Believe it or not, anticholinergic drugs can have antidepressant effects, as pro-cholinergic drugs can have depressogenic effects.


- Scott

 

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