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Topics:
Psychiatry • Consultation-Liaison Psychiatry • General Outpatient Psychiatry • Major Depressive Disorder • Psychopharmacology
What is your approach to augmenting treatment for depressive disorders in those continuing to take a tricyclic antidepressant at baseline due to historical effectiveness?
How does the presence of a TCA impact your augmenting medication choices? Which herbal supplements carry more risk when combined with a TCA? Which are still safe? What is your approach to medication side effect monitoring?
Answer from: at Community Practice
Depends on the risk of suicidality. If there is any history or any hint of a possibility of it, I do not continue with a TCA. I would augment with a dopamine agonist. I only use TCA to help with multiple comorbidities, such as migraines, insomnia, neuropathic pain, along with depression - knowing I ...
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Answer from: at Community Practice
While there is some data that support TCAs potentially being more effective than SSRI medications (at least in biological males), the side effects and need for laboratory monitoring of the higher doses used in depression often make the medications less useful options relative to SSRI and newer SNRI ...