Posted by CalvaryHill on January 11, 2002, at 4:08:11
In reply to WHICH TRICYCLIC TO TRY?, posted by DINGBAT on January 11, 2002, at 3:50:54
There is more evidence that serotonin and norepinephrine are linked to depression/wellness than dopamine. Simple dopamine agonists (like pramipexole and pergolide) have fewer studies showing that they are effective in depression, and clinicians rarely prescribe dopamine agonists as first-line or second-line choices.
There are no known tricyclic agents that have effects on dopamine. The tertiary amine tricyclics are serotonergic and noradrenergic, an the secondary amine tricyclics are mostly noradrenergic.
The SNRI venlafaxine is dopaminergic at the highest doses which most people cannot tolerate. Sertraline has 10 times more effect on serotonin than on dopamine. And buproprion's effect on dopamine is miniscule compared to its effect on norepinephrine.
Your best bet is to try a secondary amine tricyclic with good reputation and benign side-effect profile such as desipramine and nortriptyline. They are available as generics and can be titrated to a therapeutic dose with moderate speed.
Good question,
CalvaryHill
poster:CalvaryHill
thread:89696
URL: http://www.dr-bob.org/babble/20020110/msgs/89697.html