Posted by ed_uk2010 on May 3, 2014, at 5:09:24
In reply to Re: Brintellix 20mg: Fairly strong sexual side effect » ed_uk2010, posted by Chris O on May 2, 2014, at 15:58:48
>I've not explored much outside the SSRI class. And I'm suffering fairly roundly. So, I probably should challenge my risk avoidance in this area.
I'm not sure exactly what you've tried in terms on non-SSRI ADs.
Desipramine is a rather unique TCA. It does not generally cause weight gain, loss of libido or drowsiness. It can improve depression. It may be useful against panic at low doses but probably not generalised anxiety. The initial dose should be low and increased gradually. It is not recommended in those with coronary heart disease. Side effects may include increased pulse rate, mild constipation and increased sweating. Some people feel a bit agitated initially but this is by no means universal.
Nortriptyline is perhaps a little more broad spectrum. It is mainly useful for depression but can help some cases of anxiety. Nortriptyline can cause a certain amount of drowsiness (especially initially) and weight gain. It may be a bit more calming than desipramine. It often causes dry mouth and some constipation. It is started at a low dose and increased according to effectiveness and tolerability.
Mirtazapine (Remeron). Mirtazapine is often used as an add-on to SSRIs and related antidepressants to improve response. It tends to cause drowsiness but this should decrease in time. Weight gain can be an issue to watch out for. None of the above meds I've mentioned generally cause sexual dysfunction. Mirtazapine is usually taken as a single daily dose in the evening.
Aripiprazole (Abilify). 5-10mg of Abilify is increasing popular as an add to to antidepressants if response to monotherapy is inadequate. Restlessness and nausea can occur initially but tend to improve after a short while. Apart from the effect at dopamine receptors, some of the pharmacological properties of aripiprazole overlap with Brintellix.
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