Posted by Brainbeard on February 23, 2010, at 8:59:10
In reply to Re: Tricyclic most like SNRIs?, posted by bleauberry on February 22, 2010, at 19:57:23
> Clomipramine is the one.
Clomipramine does seem to be the one for OCD or severe endogenous depression, and in low doses for panic disorder, but for other types of depression and/or anxiety, it has the disadvantage of offering all the typical side-effects of the tertiary amine TCA's PLUS one of the typical side-effects of the SSRI's, namely severe sexual dysfunction. This may not happen to everyone, but clomipramine is about as strong an SRI as Zoloft (sertraline), so you can expect the sexual dysfunction to be about as bad. This has often been overlooked in applauding clomipramine.
The sexual dysfunction is likely to be less on imipramine, although it is dose dependent. Of the tertiary amine TCA's, amitriptyline is probably the most friendly to sex life.
Anyway, when strong SRI, which comes at a price, isn't necessary, imipramine makes for a great SNRI+.
Nortriptyline isn't the noradrenergic TCA of choice for everyone, since desipramine, a much stronger NRI, has the benefit of being suitable to treat AD(H)D related disorders and in practice also seems to be able to treat certain types of pain more effectively than nortriptyline (my own experience as well as those of others).
poster:Brainbeard
thread:937524
URL: http://www.dr-bob.org/babble/20100216/msgs/937740.html