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Re: Some TCA/Wellbutrin Questions - Concerns » Althea8869

Posted by zeugma on February 27, 2004, at 19:38:31

In reply to Re: Some TCA/Wellbutrin Questions - Concerns » zeugma, posted by Althea8869 on February 27, 2004, at 17:23:42

Althea,

the only TCA I've ever taken is nortriptyline. I've also read that clomipramine is the most effective TCA (possibly most effective AD) but it also has a steeper side-effect profile than nortriptyline or desipramine. Nortriptyline has the 'therapeutic window', a plasma concentration range which defines the optimal concentration for a given person. If nothing else, it provides a strong placebo response when one undergoes the ceremony of having your blood drawn and sent to a distant lab for determination of what the ideal dose is for you. I know that after I went through all that last year and had my dosage adjusted as a result, I started feeling a whole lot better.

Clomipramine is clearly the most serotonergetic of the TCA's, and desipramine is the most noradrenergic and activating. Nortriptyline is somewhere in between but much closer to desipramine than clomipramine. Plus it has that famous therapeutic window.


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