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Re: SSRIs vs TCAs JohnL

Posted by not exactly on February 2, 2003, at 3:23:21

In reply to Re: SSRIs vs TCAs, posted by JohnL on December 31, 2002, at 6:45:33

John,

> My type of depression is in the melancholic anhedonic category

Mine too.

> TCAs were much more effective than SSRIs for this type.

I've found SSRIs to be useless or worse.

> I liked Desipramine better.

That's what I'm trying now.

> The dry mouth thing was way too extreme for me

I've noticed some anticholinergic side effects (drowsiness, constipation, clouded thinking - no dry mouth, tho), but so far they've been mild. Does anyone know if the TCA side effects diminish somewhat over time as your body gets used to the drug?

> I felt good improvement from Desipramine beginning the very first day.

After only 2 days, I've noticed some AD effect starting to kick in.

> My current cocktail works very well. It is 20mg Prozac plus 5mg Zyprexa plus 300mg Adrafinil

Have you tried modafinil (Provigil)? I have, but not adrafinil. I'm wondering how similar they are.

> My favorite of all time though is the European antipsychotic/antidepressant Amisulpride

I've heard of this one and would like to try it. How did you obtain it? Mail order? Would you recommend your source?

> Amisulpride has a side effect that I cannot deal with...impotence sets in at about day 5.

I wonder if Viagra (acute) or pramipexole (chronic) would fix that side effect.

> My brain chemistry problem seems to be highly correlated with the dopamine/norepinephrine system, but not much with serotonin.

Have you tried augmenting an AD with a dopamine-booster? I have had some luck with adding Ritalin. For example, it changed Wellbutrin from "acceptable" to "robust". If I'm not completely thrilled with desipramine (after giving it enough time to "do its thing", of course), I might try adding Ritalin again. Has anyone else tried TCA + Ritalin?

> For people whos bodies accept TCAs without harsh side effects, awesome!

I've got my fingers crossed...

- Bob


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URL: http://www.dr-bob.org/babble/20030130/msgs/138861.html