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Nortriptyline x Clomipramine

Posted by schleprock on August 20, 2012, at 11:49:50

OK, I sort of need the definitive answer beacause I might just try this. Thinking about moving from Nortriptyline to Clomipramine, because the latter I discovered is rumoured to be one of the best ADs for depression, and my Nortriptyline (150 mg) isn't as effective as it used to be (and switching between the same class doesn't scare me as much.) 2 Questions:

1. Is it somehow a forgone conclusion that switching from a pooped-out TCA to a different TCA will make little difference. Or are the mechanisms of these specific TCAs just different enough to justify a trial of one over the other. (I guess similar more common strategies of SSRI being swapped around for one another.)

2. Being on Nortriptyline for 20 years, should I expect anything severe in terms of withdrawel (I'd actually be switching from Pamelor, which I've been on a few months, to a generic Clomipramine, so I know that some symptoms will be involved.) Since both are TCAs, are their compositions similar enough that my body won't miss what's specefic to Nortriptyline too badly. And would tapering even be necessary?

Also, can anyone confirm that 150mg of Nortriptyline is equivalent to 300mg of Clomipramine, as those seem to be their maximum dosages.

On a side note, I mentioned augmenting my current Nortriptyline dose with Effexor and he said that it wouldn't make sense, because "it would be like just adding another pill of Nortriptyline." I'm not too sure what to make of that.


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poster:schleprock thread:1023735
URL: http://www.dr-bob.org/babble/20120818/msgs/1023735.html