SSRI's Vs. Tricyclics

[serina]

i have been on most of the SSRI's at some point for depression and i was just wondering if anyone had success with a tricyclic when SSRIS didn't work for them. i know they are older and have more potential side effects but i wonder why would they still prescribe them in some cases?? is it b/c they help some that SSRI's don't help??

I have also tried wellbutrin which sent my anxiety too high so i can't do that one either.

[liveweyerd]

sebrina...SSRIs work great for me. But my husband only really responds to trycyclics...and the difference since they switched him is astounding!

He had the same pproblem with Welbutrin.....so ansty, restless and agigtated it was a night mare.

But to answer your question.....becasue between hubby and me I think we have been on everything.......yes, try the tricyclic!

[pedagogue]

Each kind of anti-depressant has positives and negatives. Typically prescribers will try an SSRI / SNRI first because their side effect profiles 'tend' to be less severe, though there are various medical conditions that can make selection more complicated.

There can also be some economics involved. If something is still under patent, the doc is MUCH more likely to have free samples (drug reps influence) available. I believe most/all of the current TCAs are off-patent, so there are generics available, which may or may not influence a doc's chance of prescribing it. State hospitals, VAs, etc....they usually stick with generics, so you probably will be much more likely to get a generic from than, then say a GP or FP. MAOI's are typically a 3rd-line choice because they can be a pain to adjust to (because of the nutritional requirements, etc), however in the right cases...they can be very effective.

I believe in giving someone the best med for their situation, but sometimes economics effect that choice.

-p

[liveweyerd]

Thanks, didn't think of that....husband in on VA diability and his meds are free.
Are t

Are trycylclics more expensive than SSRI's


Plus, I just found out that what they switched him to is Effexor.

Also seroquel which I observe to be a bad choice! Prescribed for anxiety.

[pedagogue]

Probably in 99% of the cases a generic will be less expensive than a brand name. VA's (and related) can still have brand names, but there needs to be a proven medical reason for them to use a brand name formulary instead of a generic or older med. This is often an issue with other types of meds (like mood stabalizers and anti-psychotics), but they rarely get passed because the data supports the other drugs as more effective....though typically they have more s/e's.

TCAs sometimes get a bad rep. because they are 'older' and they have a diff side effect profile, but they can be quite effective, and not everyone has s/e's.

Effexor is an SNRI. SNRI's are often a second step because they act on both serotonin and on norepinephrine, instead of just serotonin like the SSRIs. If that doesn't work, they'll probably try a TCA next. Each type of drug has their own positives and negatives, and dependent upon your husband's medical history, your doc will figure out what works best in his situation.

-p

[reader]

I have been on antitriptylin and nortriptylin off and on for years. It does help my back pain and sleep, it does help depression. Worth a try and they are generic and reasonably priced!!!