Posted by yxibow on August 8, 2009, at 18:25:26
In reply to Tricyclics- why do psychiatrists (mine) avoid?, posted by alchemy on August 3, 2009, at 14:31:37
> I have tried about everything (the only MOAI was Emsam). Currently Lamictal, Xanax, Celexa, Wellbutrin, Synthroid.
> There have been many times he seems like we are running out of options. I'm not sure whether to bring up tricylics. Do they usually cause weight gain? Can they be used with SSRIs?I would agree in cases where they have seen patterns of suicidal ideation, tricyclics -can- be as liable as barbiturates.
As for other options -- I don't know how long you've been on the mixture you have to appreciate its misgivings or benefits.
But tricyclics are another option, and they're old and well studied. Of course being older they do have more side effects than SSRIs.
I wouldn't combine Anafranil (clomipramine) with any significant dose of an SSRI -- it risks serotonin syndrome.
As for other TCAs, they may be less serotonergic but certainly have NE effects.
How much Lamictal ? It is an antidepressant in its own right or certainly an augmenter for suicidality and other traits of depression.
-- Jay
poster:yxibow
thread:910004
URL: http://www.dr-bob.org/babble/20090801/msgs/910962.html