Sertraline + Nortriptyline OR Clomipramine?

[Skeletor]

Sertraline standalone makes many people somewhat apathetic, indifferent and unmotivated, and that's why doctor Gillman suggests augmenting it with Nortriptyline OR alternatively taking Clomipramine standalone for the full SNRI effect...

Did anyone here try both combos? I am getting back on antidepressants and not sure how to proceed... but if I had to choose, I would preferably go for one of the two possibilities.

[Iceberg]

Well I’d say the sertraline + nortyptaline might be harder to start because lots of docs wouldn’t start two ADs from scratch at the same time. 

Also depends on history. Did you go through most of the SSRIs previously? 

Edited March 14, 2020 by Iceberg

[Skeletor]

22 hours ago, Iceberg said:

Also depends on history. Did you go through most of the SSRIs previously? 

No, and I don't want to go through the SSRI roulette...

[Iceberg]

Do you have a pdoc comfortable with skipping straight to the TCAs?

[Skeletor]

19 hours ago, Iceberg said:

Do you have a pdoc comfortable with skipping straight to the TCAs?

I hope so 😁

I am visiting the mental institution of a local hospital. Maybe they are more open to prescribing TCAs... at least I hope so. 

[mikl_pls]

I'd go with sertraline + nortriptyline. Clomipramine has way harsher side effects.