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Re: Effexor vs TCA+SSRI?

Posted by linkadge on September 10, 2020, at 17:17:10

In reply to Re: Effexor vs TCA+SSRI?, posted by undopaminergic on September 10, 2020, at 11:56:27

I'm going to take the opposite position. Effexor can be effective, but it's kind of hit or miss. Also, Prescorn mentions that it's not really dual acting. You need really high doses to get meaningful norepinephrine action (at which point it can be somewhat activating). Also the TCAs have many other AD mechanisms (5-ht2, 5-ht7, M1, H1) which may contribute to their effects.

Clomipramine for me was significantly more effective for anxious depression than effexor (by a wide margin). Amitriptyline + cipralex was also good. If you do augment sertraline, I would recommend nortriptyline over desipramine, but it's your call.





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