Posted by Quintal on December 8, 2006, at 20:35:07
In reply to Tricyclics, posted by yesac on December 8, 2006, at 11:53:06
>I hear Surmontil is good stuff, especially if you cant sleep..its kind of clozapine-ish, so if you've responded well to low dose atypicals, you might like it. If you hate neuroleptics..you migth want to leave it alone. It can actually improve the quality of sleep; most ADs suppress REM sleep.
You've got me thinking med_empowered. Surmontil (trimipramine) has been on my list for a while for this reason. I'm not convinced its much better than Remeron in any way though? I'm also worried about its D2 antagonism etc and the risk of EPS, which is absent with Remeron.
Anafranil (clomipramine) is the other TCA that stands out from the rest in my mind because of its strong seretogenic effects. It is licensed for social phobia in some countries and also for cataplexy (sudden attacks of sleep), which sounds interesting to me. It's supposed to be quite stimulating, though I've heard it helps with insomnia. Sexual dysfunction seems to be common and severe, probably due to clomipramine's strong inhibitory effect on serotonin reuptake? There are other meds such as cyproheptadine or Wellbutrin that can counteract that problem though.
Thinking about it, MAOIs often have fewer side effects and are more tolerable if you can live with the dietary restrictions, but I guess you've tried them already yesac? Have you tried augmentation strategies such as Lamictal, Wellbutrin etc?
Q
poster:Quintal
thread:711506
URL: http://www.dr-bob.org/babble/20061206/msgs/711705.html