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I need a new TCA


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I've been doing well on lofepramine (except for the chest pains and tachycardia at 140mg, had to go down to 105mg). Now I'm in the USA relatively long-term and need something that is available here. Unfortunately I will have to go through a GP as I'm still on a waiting list for a pdoc.

It looks like desipramine is the closest equivalent, but I'm worried about the cardiac side effects, and this minor detail: Desipramine has been shown to be genotoxic in fruit flies and associated with an increased risk of breast cancer in women

Would nortryptiline be a better bet? Or something else entirely? I don't want something that is too strong on serotonin as those tend to make me apathetic and vegetative or just more depressed. Wellbutrin and Lofepramine are the ADs that have worked for me, and I couldn't seem to tolerate the anxiety/agitation on Wellbutrin the second time around.

I'm really grateful for any thoughts.

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I've been taking nortriptyline since the early part of this year, and so far I've liked it. I don't know much about the ways medications work on receptors, etc., so can't help you there. I'm on a number of meds, so it's hard to know what side effects are from which ones, but at this point, I don't have any unmanageable SEs (of course, I am desperate for meds to work, so I tolerate a lot).

What about mail ordering lofepramine from a country that ships to the US?

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Poeple have been taking desipramine since the 1950's so it the med were not safe we would know about it now. As a noradrenergic effecting med, it can have cardiac effects like a faster pulse, but so do all the noradrenergic effecting TCA's.

nf

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Thanks everyone, this is tough.

Unfortunately, I can't mail order because my doctor won't refill the prescription if I'm not living in the UK.

I may have to try welly again if I can't get a TCA, so maybe the SR would be an option. It's good to know it's a bit less intense than the XR....

Nortryptiline supposedly has the least cardiac effects of the TCAs, but I wonder if its action on serotonin is also significant enough to consider?

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