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Re: Lumateperone (Caplyta) for depression? TriedEveryMedication

Posted by SLS on January 14, 2023, at 17:34:39

In reply to Re: Lumateperone (Caplyta) for depression? SLS, posted by TriedEveryMedication on January 14, 2023, at 10:12:45

> > What medical conditions are you trying to treat?
> >
> >
> > - Scott
> >
> >
>
> Depression (much worse in the morning for some reason), extreme rumination, GAD
>

Your symptoms are consistent with melancholic (endogenous) depression. As such, it would be more likely to respond to a tricyclic than to a SSRI. GAD is something different. Believe it or not, Nardil is probably the most effective drug to treat that. Also, a SSRI should be better than a tricyclic for GAD. Of the SSRIs, Paxil (paroxetine) might be the most effective, but I would not make that my first choice. It is also the SSRI most likely to produce weight gain and sexual dysfunction. Additionally, it is the hardest SSRI to discontinue due to a withdrawal syndrome.

Regarding tricyclics, I favor nortriptyline because it is the most tolerable with respect to side effects. For me, it is a much better "mood brightener" than the other tricyclics. Of course, you might not respond to it. Clomipramine has anti-obsessional properties that are probably stronger than that of any other available drug. This might be a result of the combination of norepinephrine reuptake inhibibtion and serotonin reuptake inhibibion. Clomipramine acts liked of hybrid between a TCA and a SSRI. Unfortunately, it is a really "dirty" drug. The side effects also seem to be hybrids of these two types of drugs. Anticholinergic side effects are pretty strong and yield a great many side effects.

You might not need an anti-obsessional. Melancholic depression often presents with rumination.

https://pubmed.ncbi.nlm.nih.gov/3160746/


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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