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Re: SSRI's vs. TCA's » addinbc

Posted by Quintal on April 15, 2008, at 8:49:21

In reply to SSRI's vs. TCA's, posted by addinbc on April 14, 2008, at 20:06:24

I'm surprised you haven't taken any other class of antidepressant by now - you're certainly not out of meds. As far as tolerability goes, SSRIs aren't that great. It isn't really true that they have fewer side effects than older antidepressants, they're just different, and maybe less likely to end in fatality, but unless you're planning to OD that's not really an issue. Personally, I don't tolerate the SSRIs very well at all. The second antidepressant I ever tried was dothiepin (after I couldn't tolerate Paxil), and I felt so good that I came off it after a month or so. I went back to it and it worked well each time.

Ironically the antidepressant I responded best to - and had among the fewest side effects, was Parnate. It really depends on what side effects bother you most - for example I can't stand the anorgasmia and emotional numbness that SSRIs used to give me, but the dry mouth and urinary hesitancy of dothiepin didn't really bother me that much. It's been my experience that TCAs (with maybe the exception of clomipramine) don't cause emotional detachment like SSRIs. I'm considering adding lofepramine to my Lamictal shortly for exactly those reasons. I think desipramine, nortriptyline and lofepramine would be the most tolerable TCAs for most people.

Q


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