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Effexor + TCA - Advice Needed

Posted by FourFeathers on January 9, 2010, at 13:51:10

I am considering combining low dose Effexor with a TCA and would like some advice on which one.

I tend to be quite med sensitive and have been on the med merry go round for years. I have tried all of the SSRIs, Effex, Wellb, Strattera, Cymb, Nardil... I have never tried a TCA.

After years of trial and error it has become obvious that I do best with a medication with a decent norep effect (except for cymbalta which just made me flat). Strattera is calming but creates REM behavior issues. I cannot tolerate doses of Effexor above 75mg as it creates increased anxiety and blood pressure.

Unmedicated my bp is borderline (effect of underlying anxiety) and my heart tends to go quickly from 70bpm at rest to 140-160bpm with any exercise (5-10 mins of cardio). Beta blockers slow the heart but create cognitive side effects and terrible constipation. BTW...I am otherwise in good physical shape and not overweight or suffer other health issues.

Of the TCAs, I am currently considering nortriptyline or protriptyline as an augmentation to 37.5mg Effexor. Any advice as to a TCA that would be a logical trial which may also reduce bp and modulate my sympathetic nvervous system?

Thank you in advance.


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poster:FourFeathers thread:933036
URL: http://www.dr-bob.org/babble/20100103/msgs/933036.html