Posted by jono_in_adelaide on December 11, 2012, at 19:53:32
In reply to Re: Augment Effexor or TCS or MAOI or other? » jono_in_adelaide, posted by SLS on December 11, 2012, at 2:31:56
"Perhaps you can provide evidence for why you would tell someone to abandon Effexor in favor of Zoloft + nortriptyline"
Because Effexor isnt working, and she needs to try somthing else.
A very well respected british/australian psychiatrist, Dr Ken Gillman has found in his practice over many years that Sertaline + Nortriptyline often sucseeds where Effexor has failed. I'm not saying Effexor doesnt work, I'm saying that real world evidence suggests that an NARI such as nortriptyline plus an SSRI such as sertaline gives a better ballance of NE/5HT reuptake than Effexor does.
It was a laymans suggestion, just the same as your suggestions were those of a layman, not a prescription from a mental health professional.
The poster is free to accept or reject my suggestions (and yours) as she pleases.
if everybody was to gett he most potent combination treatment, then all people with depression would be on tranylcypromine plus nortriptyline plus a low dose atypical plus lithium, but of course, not everybody needs that.
I feel that my suggestion of an SSRI plus a full dose of desipramine was an appropriate suggestion for a person who had failed on standard doses of Effexor and was concerned about weight gain on other treatments, you may feel that it wasnt appropriate, but att he end of the day, we are both just expressing laymans opinions
poster:jono_in_adelaide
thread:1032720
URL: http://www.dr-bob.org/babble/20121130/msgs/1032862.html