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  1. They've even done Tranylcypromine + Amitriptyline ^^ https://www.ncbi.nlm.nih.gov/pubmed/30106881 How so?
  2. Nortriptyline seems to be a popular addon. SSRI + Nortriptyline MAOI + Nortriptyline
  3. Both are second-generation SSRIs, both exhibit minimal drug interactions via Cytochrome P450, both are the most prescribed SSRIs and are considered first line antidepressants. Who's been taking both and what were your experiences? (How did they compare to each other?). I am looking forward to read your experiences... Which one did you like more?
  4. With 75mg of Clomipramine you get like 95% SERT blocking... (One exception: rapid metabolizers). This should be more than enough for the run-of-the-mill patient.
  5. Apropos that stimulation / tickling. It felt more like some form of odd genital stimulation. I didn't have typical sexual arousal or sexy thoughts when it happened. It was really an unpleasant intrusive feeling that I had to get rid of via triple masturbation. It didn't feel like hypersexuality or normal (heightened) form of libido. It was like a tingling... it doesn't hurt you, but it is no pleasant feeling. Strange thing is that it also happened on higher dose of Promethazine (30mg), not only Mirtazapine.
  6. On 15mg of Mirtazapine I had RLS and some strange tickling feeling in my lower stomach. (I masturbated a lot to get rid of it.) On 15mg of Promethazine I am fine, but anything higher than 25mg and I get RLS and that tickling feeling. What is going on? Which mechanism is involved? https://academic.oup.com/sleep/article/43/2/zsz223/5610750 "It simply seems like histamine might have a role in RLS. Could it be as simple as that blocking histamine H1 receptors is bad for RLS? Or is it due to some kind of indirect interaction histamine has with dopamine?" It would seem that this antihistamine theory might be true at least to some degree, although there are so many theories on RLS that it is difficult to see through it. Especially when you have antihistamine properties and anti-Dopamine properties rolled into one drug. But Mirtazapine doesn't seem to have anti-Dopamine properties, so leaves the antihistamine action as culprit of RLS.... Promethazine has some anti D2 action, but it is ridiculously weak: D2=250, 5HT2A=170, H1=1 [nM] from Gillman's website. I doubt that it will do much in that regard.
  7. Supposedly it inhibits 80% of SERT transporter at 10mg... that is one hell of a potent drug. So with 75mg you probably would have 95% SERT inhibition. https://en.wikipedia.org/wiki/Clomipramine#Pharmacodynamics There is also the notion that many TCAs might be "overdosed" in general... Yes, that is a good combo. Makes sense to add Lamictal.
  8. Clomipramine can be rough at the beginning. Remember: it is the most potent SNRI + a strong anticholinergic. I would give it some more time. 75mg should be enough. No need to go higher if you don't have OCD.
  9. I welcome you to rate all the psychotropic drugs which you took in the past or are taking in the present. A short explanation of your experience with the drug(s) would be helpful, so that we better understand your rating. Oh, and please tell us which conditions you treat(ed). Thanks. Rating Scale is from 0 to 5... "zero" being the worst, "five" being the best. _______________________________________________________________________________ Sertraline 2 / 5 - subtle effects. Did help with psychosomatic ailments, derealization and cognition, but caused SSRI-typical apathy & indifference. Not sure if it did anything for my social anxiety and psychomotor agitation. At most minor effects. I did take it for two years. Mirtazapine 2 / 5 - elephant tranquilizer. Didn't like the severe sedation. Didn't sleep well on it, bad dreams. Caused RLS. Was good for appetite, weight gain and IBS. I was on it for two weeks. Promethazine Syrup / Drops 20mg / ml | 3 / 5 - I rather liked that one. At a lowish dose (15 drops or so) it has a nice calming effect on me, without sedating me too much. Lowers anxiety and agitated states. Brings order into chaos. Good for appetite and stomach. I take it occasionally. N-acetylcysteine (NAC) 2.5 / 5 - Is a good supplement. Heightened focus, less derealization, world seems more colorful. Interesting stuff. Definitely worth a try. .............................. Conditions treated: Anxiety, depressive states, psychomotor agitation, somatization disorder.
  10. Depends highly on how you metabolize it. You could rapidly metabolize Clomipramine into Desmethylclomipramine, and then desmethylclomipramine gets metabolized slowly ^^
  11. It has a tricyclic structure (btw: Sertraline also has a tricyclic structure) https://psychotropical.com/tca-intro/
  12. That's because Venlafaxine works predominantly on Serotonin. Its SNRI-label is more marketing than pharmacologically justified. Relative to other SNRIs, levomilnacipran, as well as milnacipran, differ in that they are much more balanced reuptake inhibitors of serotonin and norepinephrine.[8][9][10] To demonstrate, the serotonin:norepinephrine ratios of SNRIs are as follows: venlafaxine = 30:1, duloxetine = 10:1, desvenlafaxine = 14:1, milnacipran = 1.6:1, and levomilnacipran = 1:2.[8] The clinical implications of more balanced elevations of serotonin and norepinephrine are unclear,[8] but may include improved effectiveness, though also increased side effects.[9][10][11] - source: https://en.wikipedia.org/wiki/Levomilnacipran#Pharmacodynamics The strongest and most balanced SNRI is Clomipramine: https://en.wikipedia.org/wiki/Clomipramine It probably is the most effective non-MAOI antidepressant.
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