Posted by SLS on February 12, 2005, at 12:58:06
In reply to Re: need TCA advice, posted by linkadge on February 12, 2005, at 12:03:08
> Where does clomipramine fit into the picture?
>
> The only reason I am concerned is that if I swich abruptly from a SSRI Zoloft to a NRI, like nortrip, this might be a big change.
>
> LinkadgeZoloft would result in an increase (doubling?) of nortriptyline levels via its inhibition of cytochrome P450 2D6. It might be problematic to taper the Zoloft while simultaneously titrating the nortriptyline. You could probably do it if you take this into account and titrate the nortriptyline more slowly until you finished tapering the Zoloft. Maybe start at 10mg and raise the dosage by 10mg every 5 days as you taper the Zoloft over a period of two weeks (total guestimate). Then move up to 75mg. Clomipramine possesses the most potent antidepressant properties of all the TCAs. I don't know about migraines, though. Clomipramine will produce side effects that seem to be a combination of those of a tertiary TCA and those of a SSRI. Clomipramine is imipramine with a chlorine attached to it.
- Scott
poster:SLS
thread:456737
URL: http://www.dr-bob.org/babble/20050212/msgs/456787.html