Posted by matze on April 16, 2001, at 11:03:48
In reply to Re: tricyclics differences (sexual dysfunction), posted by JohnL on April 16, 2001, at 5:45:22
> > Hi,
> > Does anybody know the differences of the tricyclics
> > in causing sexual dysfunction?
> > Does for example imipramine cause more sexual dysfunction than nortriptyline?
> > I want to try a TCA after many antidepressant trials, that were not very effective.
> > I suffer from dysthymia.
> >
> > Thanks for response
>
> Since it is dysthymia you are trying to treat, then that implies you will need longterm medication. With that in mind, you want one that works real well and has few side effects, because you will have to live with it for a long time. The TCAs are proven workhorse antidepressants, but they do not really have a side effect profile conducive to longterm treatment. Even the mildest ones like Desipramine or Nortriptyline can have some side effects of dry mouth, urination frequency and difficulty, possible impotence and possible mild cognitive dulling. Sure all drugs have side effects, but none of the TCAs have ever been known as drugs with mild side effects. I would think for longterm treatment you might want to look instead at things with a mild side effect profile and things with a lot of success stories.
>
> I would suggest that a trial of Zyprexa, and then Risperdal, would be a better way to go. Choose your favorite AD so far, start just a low dose of it, and add Zyprexa to it. The reasoning is because:
> 1. We hear a lot of success stories with these drugs.
> 2. They are often wonderful antidepressants when antidepressants alone don't work.
> 3. Side effects are generally much milder.
> 4. Response time is often within days or a couple weeks at the most.
>
> On the back burner, Amisulpride and/or Adrafinil from international mailorder are also far superior to most antidepressants I have tried over the years. I think there are better choices for you before you leap into the TCA arena.
> JohnI currently take remeron 45mg + thyroxine 250mcg/day. I´m considering adding a new "thing" to this combination. Perhaps Lamictal, Zyprexa, Risperdal or Mirapex. I gained much weight on Remeron. Does the combination Zyprexa+ Remeron mean more body weight? Is risperdal perhaps better together with remeron? Anhedonia is my main problem with my dysthymic disorder. Can mirapex handle this problem better (because of dopamine)?
Many Questions but thanks for response (my English is not the best)Matze
poster:matze
thread:59949
URL: http://www.dr-bob.org/babble/20010411/msgs/60065.html