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Re: Effexor vs TCA+SSRI?

Posted by linkadge on September 12, 2020, at 5:57:22

In reply to Re: Effexor vs TCA+SSRI? linkadge, posted by PCB on September 10, 2020, at 20:45:00

Have you taken clomipramine? Was memory loss an issue? I took up to 75mg and only experienced a bit of morning haziness. I remember at the time I was first on sertraline (which wasn't cutting it) and was really depressed which caused me to fail a midterm exam in university (first time ever). We switched to clomipramine and the improvement was dramatic (although, in hindsight, the norepinephrine action may have improved ADHD like straterra is now - the sertraline wasn't helping in this regard). Long story short I aced the final exam and the prof replaced my midterm mark with the final mark (got an A+ in the course).

To answer your question, I know that (for me) nortriptyline + sertraline would work better than effexor. It's hard to say what would work better for you. I found nortriptyline + lithium worked better than SSRI + lithium. The latter seemed to amplify the serotonergic side effects (i.e. spacieness and apathy). On nortriptyline I started to develop some 'passions' again (i.e. deep interests in certain activities that gave me a reason to wake up in the morning). Now I'm on effexor (looking to switch off). It's ok, but I just feel kind of bla (although the straterra is improveing this). So my answer may be colored by the fact that the TCAs were treating undiagnosed ADHD.

Nevertheless, I do think that nortriptyline is a superior antidepressant. However, you could always start with effexor. I have never gone beyond 75mg (as it increased anxiety at that stage for me), but apparently it can become more effective at higher doses. Actually, I took effexor + nortriptyline too which, for depression, was very good. My sleep was a bit broken on that combo however. I replaced the nortriptyline with mirtazapine which improved sleep somewhat, but isn't as good for depression.





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