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Re: SSRI substitute

Posted by King Vultan on May 3, 2004, at 8:09:13

In reply to SSRI substitute, posted by jms600 on May 2, 2004, at 16:12:21

> Hello,
>
> Can anyone recommend another antidepressant i.e. a Tricyclic or related drug etc, which is as effective as the SSRIs, but doesn't make you so apathetic and lethargic?? I've been on most SSRIs and all they seem to do to me is make me apathetic and lethargic. I just want to lie down and do nothing all day. Even Prozac makes me lethargic.
>
> I don't know what else to try. I was thinking of a Tricyclic but I really don't want the nasty anticholinergic side effects. I don't want to try any MAOIs due to the diet restrictions.
>
> Anyone else found SSRIs to cause apathy and lethargy? What did you switch to?
>
> Thanks!
>
>
>
>

I had the same problem on SSRIs and Effexor and tried three different tricyclics last year: nortriptyline, desipramine, and Vivactil (protriptyline). Of those, I had by far the best luck with desipramine. It was an activating and relatively effective antidepressant completely without the apathy I suffered on SSRIs. It has weak anticholinergic effects--similar in absolute terms to those of Paxil--but because it is a strong blocker of norepinephrine reuptake, you may expect to experience "pseudo" anticholinergic effects such as constipation, dry mouth, and urinary hesitation. I found these somewhat bothersome but tolerable.

Of the other two I tried, nortriptyline had a weaker antidepressant effect on me and was much too sedating. Vivactil was quite stimulating and was probably more effective than desipramine overall but had true anticholinergic effects that were significantly worse than those of desipramine. Because of the erectile and prostate issues I suffered while on it, I am unable to recommend it to anyone who is not female.

Todd


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poster:King Vultan thread:342531
URL: http://www.dr-bob.org/babble/20040429/msgs/342749.html