Safest Tricyclic Antidepressants?

['peataphysique]

Here is what Ray thinks of amitriptyline:

Me:
Hi Dr. Peat,

I wanted to know if amitriptyline would be a safe option for treating depression/anxiety in your opinion. My doctor is recommending that I take it.

Thanks.
Ray:
I think it's safe. Compare the structure with cyproheptadine. Have you tried niacinamide, pregnenolone, and thyroid?

Me:
I currently take cyproheptadine. From my understanding, amitriptyline and cyproheptadine have opposing effects on serotonin. Is this true, and could this be problematic, if so?

Thanks.

Ray:
Both of those are appetite stimulants that tend to cause weight gain. Serotonin tends to cause anorexia. The drug industry generates noise in the process of selling drugs, and "serotonin" is one of their favorite noises.

Help with depression-amitriptyline

So how does Imipramine and doxepin compare for example?

I've got a lot of tianeptine left but I want to save it as a last resort because it is really expensive and I have to order it from overseas. I want to make sure if I can buy some cheap safe tricyclic on a local pharmacy first.

 

[thomas00]

Why not get your metabolism in order and use thyroid and/or preg. like Ray suggests?

 

[JudiBlueHen]

I have experience with both TCAs and SSRIs. I can tell you that the TCAs are more gentle and more easily discontinued, though all require a slow taper to discontinue. Personally I liked nortriptyline and doxepin best, but amitriptyline is OK too. Whereas SSRIs caused me to become angry, irritable, and clench my teeth within a week. So I think if you need the AD, you are safer to use a TCA. Also, there are many more years of experience with them and they are generally inexpensive.