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Let's talk about combing SSRIs and TCAs

Posted by TriedEveryMedication on June 21, 2018, at 23:47:33

So currently, I'm on 20mg of prozac and 20mg of desipramine. It seems pretty decent. SSRIs alone make me feel dopey out of it. Desipramine alone makes me a raging *ssh*l*. Together I find myself somewhat cheerful and having energy.

I'm having EKGs every couple weeks to check for QTc prolongation and I'm having blood tests done.

(According to epocrates, this should kill me, either with serotonin syndrome or prolonged heart QT intervals or whatever.)

supposedly, prozac is a potent blocker of p450 2d6, which supposedly is how desipramine is metabolized. I say "supposedly" because according to the literature, I should have an 800% AUC increase of desipramine in my blood stream.

Yet my blood tests are showing pretty low desipramine levels. Lower than if I were taking the 100mg therapeutic dose alone.

So what gives? Has anyone combined an SSRI and a TCA before?

how about an SSRI and moclobemide?




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