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The most sedating antidepressants?


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It looks like i only tolerate sedating antidepressants. I've been on paroxetine since 2.5 years. I cant tolerate activating antidepressants.

Any suggestions ? I would like to add another antidepressant for mood and panic disorder.

Following ADs did not work for me

Fluoxetine,Escitalopram, Fluvoxamine, Desvenlafaxine, Vilazodone, Sertraline,Clomipramine,Trazodone, Venlafaxine,Buspirone,Tianeptine

Edited by clinic
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Trimipramine is another one that is pretty sedating. It also increases REM sleep rather than suppressing it like most antidepressants.

It also has antipsychotic properties (D2 and 5-HT2A antagonism) as well.

Edited by mikl_pls
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Related to mirtazapine, is mianserin available where you live? It's related to mirtazapine. Neither mirtazapine nor mianserin are reuptake inhibitors; rather, they antagonize serotonin and noradrenergic receptors in order to enhance release of serotonin and norepinephrine, as well as indirectly enhance 5-HT1A signaling. 

Amoxapine is somewhat sedating (for me anyway). It's a tetracyclic antidepressant that is a metabolite of the typical antipsychotic loxapine. It is a relatively potent and selective norepinephrine reuptake inhibitor with little serotonin reuptake inhibition. It also has antipsychotic properties (5-HT2A and D2 antagonism), and metabolizes into compounds that have even more potent D2 antagonism. That being said, loxapine, which is similar to clozapine in low doses (except without the risk of agranulocytosis, seizures, etc., and requirement to get frequent blood testing done), could be an idea for an adjunct to clozapine, as it would confer antidepressant properties as well with its metabolite amoxapine.

Maprotiline is another tetracyclic antidepressant that is pretty sedating. I've personally never taken it before, but it has pretty strong affinity to the H1 receptor. No antipsychotic properties like trimipramine or amoxapine or anything though. It's probably the most selective norepinephrine reuptake inhibitor, with almost no serotonin reuptake inhibition at therapeutic doses, but it isn't as potent a NRI as desipramine.

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Mirtazapine (30-45mg) made me fall asleep on my chair at work for about an hour. Every day, untill I switched it.

My colleagues were taking pictures of me sleeping.

I used to blame it on the Benzo I was taking at the time but it was Mirtazapine after all.

Just a note: I cannot recommend Mirtazapine because it gave me depersonalization which was scary as hell. Of coure, YMMV.

Edited by HydroCat
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