Posted by ed_uk2010 on May 30, 2013, at 18:22:30
In reply to Amitriptyline, Perphenazine and Effexor XR, posted by F_minor on May 30, 2013, at 11:03:40
>I am taking for years amitriptyline 25mg and Perphenazine 4 mg.
Are these meds helping at all? Amitriptyline is an antidepressant but perphenzine is an antipsychotic. Perphenazine is normally only recommended for long-term use in schizophrenia. For depression and anxiety, it is only recommended for short-term use. This is because long-term use can eventually cause a movement disorder called tardive dyskinesia, even when used at low doses. Tardive dyskinesia usually causes uncontrolled movements of the tongue/mouth/face but can affect other parts of the body too. Hopefully, you might be able to reduce perphenazine gradually and stop.
Tardive dyskinesia...
http://www.youtube.com/watch?v=W_3bbpFjI68
Rather than trying a different antidepressant, you could consider increasing amitriptyline. Most patients need more than 25mg to help their depression.
>What about serotonin syndrome?
Serotonin syndrome is very unlikely with this combination.
I assume you've already tried one or more SSRI antidepressants such as citalopram or sertraline? Although Effexor can be effective, it tends to cause more side effects than SSRIs and more severe withdrawal symptoms when it's stopped. For this reason it is not a drug of first choice. Among the SSRIs, sertraline might be a good choice because it can be combined with your current meds without an interaction. Some SSRIs interact with amitriptyline and so would not be suitable.
poster:ed_uk2010
thread:1044497
URL: http://www.dr-bob.org/babble/20130527/msgs/1044526.html