Posted by Brainbeard on May 24, 2010, at 11:20:35
I still adhere to the idea that a 5HT2A-antagonist comes in handy in an SSRI based cocktail. Hence I'm taking 25+mg amitriptyline with my 100mg of sertraline. Amitriptyline is a moderately strong 5HT2A-antagonist and also a 5HT2C-inverse agonist. It has the disadvantage of being a very strong antihistaminergic though. Doses higher than 25mg tend to give a feeling of being 'parallized', or at least inhibited, both physically and mentally.
I have recently discovered that there exists a lesser known typical antipsychotic with atypical properties: pipamperone. Pipamperone is a relatively strong 5HT2A-antagonist, as well as a D4-antagonist, although the clinical significance of the latter is uncertain. Its antagonism at other dopamine receptors is relatively weak, as are its antihistaminergic effects. It is being investigated as an add-on to citalopram, with good results, apparently (faster onset of therapeutical efficacy, to begin with.)
Then there is trimipramine, an interesting atypical TCA, which doesn't inhibit the reuptake of serotonin or noradrenalin but is a slightly more potent 5HT2A-antagonist than amitriptyline. It may be a little less antihistaminergic. And it may have other interesting properties, like MAO-B inhibition. It seems to be an effective antidepressant.
Which one would make the best choice for adding to my regimen instead of amitriptyline? What say you, fellow babblers?
Current meds: 10mg melitracene + 0.5mg flupentixol; sertraline 100mg; amitriptyline 25mg; gabapentin (Neurontin) 300mg; melatonin 0.3mg. PRN: diazepam (Valium) 2.5-5mg.
poster:Brainbeard
thread:948589
URL: http://www.dr-bob.org/babble/neuro/20100223/msgs/948589.html