Posted by Crotale on June 20, 2008, at 12:46:19
In reply to To Scott - Nortriptyline Not Good For Atypical Dep, posted by bulldog2 on May 18, 2008, at 16:54:28
A number of the SSRIs tend to elevate TCA levels. Prozac and Paxil are particularly known for this as both block the liver enzyme cytochrome p450-2d6 (Luvox blocks cyp-3a4 which may also cause problems with elevated TCA levels). Something to watch out for with this combo. I believe Celexa is considered less likely to raise serum levels of other drugs.
SSRIs for atypical depression aren't 100% established as effective as are MAOIs. Personally I like the MAOI-TCA combo. Nardil should be okay with nortrip although desipramine might be a better choice. Avoid clomipramine, amitriptyline with MAOIs; I'd avoid imipramine and doxepin too. These are called tertiary amine TCAs; the chemical difference between a tertiary amine and its secondary amine metabolite is the loss of a methyl group on the side chain (N-demethylation). Most of the TCAs have a propylamine side chain (exceptions include amoxapine and trimipramine).
Err, what's Ixel?
poster:Crotale
thread:829828
URL: http://www.dr-bob.org/babble/neuro/20080418/msgs/835635.html