Posted by SLS on September 17, 2012, at 7:23:41
In reply to Re: Need out of the box suggestions » phidippus, posted by ChicagoKat on September 16, 2012, at 18:17:39
> > I wouldn't do nortryptaline. Too much norepenephrine when combined with the Vyvanse. Go for the best TCA, Clomipramine.
> I'm curious...what makes Clomipramine the best TCA?
Clomipramine seems to produce a greater number of therapeutic responses than any other TCA. However, this difference might not be so significant as to make this drug your first choice. Clomipramine has a greater load of side effects than the other TCAs, so it may not be as tolerable as nortriptyline or desipramine. Because of this, I would recommend that you look at nortriptyline first before moving on to clomipramine. With nortriptyline, you can use blood-levels to arrive at a dosage that is therapeutic. Slow metabolizers generally require 75 mg/day while rapid metabolizers need 150 mg/day. It is almost as if intermediate dosages are ineffective due to the therapeutic window nortriptyline is known to exhibit.
If there is an OCD or intrusive thoughts thing going on, then clomipramine makes sense to try first.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1025287
URL: http://www.dr-bob.org/babble/20120912/msgs/1025856.html