Posted by schleprock on August 26, 2012, at 21:39:51
In reply to Re: Anyone ever try combining Lexapro witha Tricyclic?, posted by jono_in_adelaide on August 26, 2012, at 19:08:28
I've recently had a blood test, and my nortriptyline was only slightly above the reference range.
The reason that the combination of Nortriptyline and Lexapro intrigues me is mainly due to the conclusion of this article:
"Nortriptyline has superior pharmacological properties to all other TCAs as a psychotropic; it is potent as an NRI and has a wide margin between desired effects, side effects and toxicity. It is safe to combine it with either MAOIs (including moclobemide) or selected SSRIs (sertraline and possibly citalopram)."
"...to achieve the maximum efficacy from SNRI strategies, it may be necessary, and perhaps preferable, to combine two different drugs to achieve individual tailoring of the NRI/SRI ratio. For this purpose, nortriptyline has favourable characteristics, including minimal CYP450 interaction propensity and, because of this, it may be combined with sertraline without the need for therapeutic drug monitoring, except in special circumstances. All the other SSRIs are unsuitable for combination with TCAs (and many other drugs, particularly neuroleptics), with the possible exception of citalopram/escitalopram."
http://onlinelibrary.wiley.com/doi/10.1038/sj.bjp.0707253/full
Because I've heard that Lexapro (escitalopram) is more effective for depression and has a faster onset time, I find the option more attractive than Zoloft (sertraline.)
poster:schleprock
thread:1024261
URL: http://www.dr-bob.org/babble/20120818/msgs/1024272.html