Psycho-Babble Medication Thread 1110522

Shown: posts 1 to 13 of 13. This is the beginning of the thread.

 

Are TCAs more effective than SSRIs?

Posted by Skeletor on June 6, 2020, at 20:07:00

Are TCAs more effective than SSRIs? In your experience...

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"Since the introduction of the SSRIs, it has been repeatedly observed that severely depressed inpatients, usually those with melancholia, show a more robust response to TCAs than to SSRIs. The first studies to demonstrate this were by the Danish University Antidepressant Group, which published 2 widely cited studies showing the superiority of the TCA clomipramine to 2 SSRIs, citalopram and paroxetine, in hospitalized patients who had depression.19,20 Subsequent studies replicated the finding that TCAs are superior to SSRIs in specific populations.... 21-23" - source: https://www.psychiatrictimes.com/articles/not-obsolete-continuing-roles-tcas-and-maois
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It would seem so, at least according to many studies... Gillman regularly mentions that his patients did substantially better on TCAs than on SSRIs (Sertraline might be an exception). Especially Amitriptyline, Clomipramine and Imipramine seem to be superior in effectivity. Is it wise to completely shun those very effective older antidepressants?

 

Re: Are TCAs more effective than SSRIs?

Posted by undopaminergic on June 7, 2020, at 3:44:34

In reply to Are TCAs more effective than SSRIs?, posted by Skeletor on June 6, 2020, at 20:07:00

> Are TCAs more effective than SSRIs? In your experience...
>

Absolutely. I've only used (and am using now) trimipramine (Surmontil), but it is the best drug classified as an antidepressant that I've ever tried.

> It would seem so, at least according to many studies... Gillman regularly mentions that his patients did substantially better on TCAs than on SSRIs (Sertraline might be an exception). Especially Amitriptyline, Clomipramine and Imipramine seem to be superior in effectivity. Is it wise to completely shun those very effective older antidepressants?
>

No, of course not. That would be just as stupid as avoiding MAOIs.

-undopaminergic

 

Re: Are TCAs more effective than SSRIs?

Posted by Lamdage22 on June 7, 2020, at 6:30:21

In reply to Re: Are TCAs more effective than SSRIs?, posted by undopaminergic on June 7, 2020, at 3:44:34

They are really effective wiping out your sex life. (Not that I have one in times of Corona) To me that is torture.

 

Re: Are TCAs more effective than SSRIs?

Posted by undopaminergic on June 7, 2020, at 7:27:36

In reply to Re: Are TCAs more effective than SSRIs?, posted by Lamdage22 on June 7, 2020, at 6:30:21

> They are really effective wiping out your sex life. (Not that I have one in times of Corona) To me that is torture.
>

TCAs? I haven't noticed. (S)SRIs on the other hand all do prolong the time to orgasm a lot -- that would include the TCA clomipramine, although I have no experience with it. At least some antipsychotics (eg. flupenthixol), at higher doses, can completely prevent orgasm.

Anyway, I think orgasms are overrated. Even a hit of crack cocaine lasts longer. That nothwithstanding, I think it is worth enjoying them if you can; they are free after all.

-undopaminergic

 

Re: Are TCAs more effective than SSRIs? » undopaminergic

Posted by linkadge on June 7, 2020, at 8:19:35

In reply to Re: Are TCAs more effective than SSRIs?, posted by undopaminergic on June 7, 2020, at 7:27:36

>(S)SRIs on the other hand all do prolong the time >to orgasm a lot

They can also cause genital anesthesia. I took clomipramine and found that the sexual side effects were less than with SSRIs. It may have been that it helped my depression more, or that some of the 5-ht2 antagonism helped counteract it.

I would agree that TCAs are more effective than SSRIs or SNRIS.

Linkadge

 

Re: Are TCAs more effective than SSRIs?

Posted by undopaminergic on June 7, 2020, at 9:04:51

In reply to Re: Are TCAs more effective than SSRIs? » undopaminergic, posted by linkadge on June 7, 2020, at 8:19:35

> >(S)SRIs on the other hand all do prolong the time >to orgasm a lot
>
> They can also cause genital anesthesia.

I agree you can call it that. In my case you could say the anaesthesia was partial.

-undopaminergic

 

Re: Are TCAs more effective than SSRIs?

Posted by Lamdage22 on June 7, 2020, at 10:44:33

In reply to Re: Are TCAs more effective than SSRIs?, posted by undopaminergic on June 7, 2020, at 9:04:51

Nortriptyline caused me to stay flaccid and anorgasmic. My doctor said the other Tcricyclics are the same so it is not worth trying.

 

Re: Are TCAs more effective than SSRIs?

Posted by undopaminergic on June 7, 2020, at 11:23:01

In reply to Re: Are TCAs more effective than SSRIs?, posted by Lamdage22 on June 7, 2020, at 10:44:33

> Nortriptyline caused me to stay flaccid and anorgasmic. My doctor said the other Tcricyclics are the same so it is not worth trying.
>

Ah, I see, then it must be the noradrenaline. I'm on trimipramine (Surmontil), which is not an NRI. I don't remember how reboxetine (Edronax) affected me sexually.

Trimipramine could be worth a try for you -- it has substantial antipsychotic properties as well. In fact, in my own experience, it is the most powerful AP, and I have experience with clozapine, which is kind of a gold standard for APs.

-undopaminergic

 

Re: Are TCAs more effective than SSRIs?

Posted by Lamdage22 on June 7, 2020, at 13:02:03

In reply to Re: Are TCAs more effective than SSRIs?, posted by undopaminergic on June 7, 2020, at 11:23:01

Well, I think I am on enough stuff and I am not really in the mood for experimenting. I am on such a sedating combo. I might not get out of bed at all on Trimipramine.

 

Re: Are TCAs more effective than SSRIs?

Posted by SLS on June 8, 2020, at 9:13:22

In reply to Re: Are TCAs more effective than SSRIs?, posted by undopaminergic on June 7, 2020, at 9:04:51

> > >(S)SRIs on the other hand all do prolong the time >to orgasm a lot
> >
> > They can also cause genital anesthesia.
>
> I agree you can call it that. In my case you could say the anaesthesia was partial.

My sex-drive completely ceased upon the introduction of prazosin. I've been off of it for several years, but it hasn't returned. That totally sucks. There has been no genital anasthesia, though.

- Scott

 

Re: Are TCAs more effective than SSRIs?

Posted by Lamdage22 on June 8, 2020, at 9:19:38

In reply to Re: Are TCAs more effective than SSRIs?, posted by SLS on June 8, 2020, at 9:13:22

Thanks for sharing. I will not try it then.

 

Re: Are TCAs more effective than SSRIs?

Posted by rjlockhart37 on June 8, 2020, at 18:07:22

In reply to Are TCAs more effective than SSRIs?, posted by Skeletor on June 6, 2020, at 20:07:00

in a general answer from what i've read over the years, yes, and also men are more responsive than women, it said women respond better to SSRI's. Trycylic antidepressants are bit stronger, but they have limited compared to the new antidepressants. But yes they are very effective. But side effects linger on around them more

 

Re: Are TCAs more effective than SSRIs?

Posted by linkadge on June 9, 2020, at 7:20:41

In reply to Re: Are TCAs more effective than SSRIs?, posted by rjlockhart37 on June 8, 2020, at 18:07:22

There are sex differences in the expression of depression. For example, women tend to experience more mental distress as a result of social isolation (this apparently occurs in rodents too, where male rodents show lower rise in cortisol as a result of isolation). However, men experience more mental distress as a result of job loss (laid off men are more likely to commit suicide than laid off women). This is all statistically speaking, of course.



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