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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Is The Best Medicine For Extreme Depression?

Thanks for taking my question.. I ve been on amitriptyline (increasing from 50mg to 150mg) for about 25yrs. My depression has become much worse this past year. My G.P. has prescribed Mirtazapine. I m still weaning off amitriptyline. Will commence Mirtazapine in 10 days. In your opinion, do you think this is a good switch, or would you recommend another medication? thank you, Daryl Camino.
Mon, 27 Apr 2015
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Psychiatrist,  's  Response
Hello thanks for asking from HCM for your health related queries

I can understand your concern. You have been taking Amitriptyline which is a Tricyclic anti-depressant. Now you have weaned off the drug because of poor improvement and are going to start Mirtazapine. Mirtazapine is a relatively safer drug and have better efficacy than Amitriptyline for depressive symptoms. In my opinion switch to Mirtazapine would be a good idea and this drug should improve your symptoms also.

If you have reduced the doses of Amitriptyline then you can start with Mirtazapine without any fear. Take the drugs as per your prescribed doses only. No need to change to some other medicine as of now.

Thanks, Hope this helps you. Take care
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What Is The Best Medicine For Extreme Depression?

Hello thanks for asking from HCM for your health related queries I can understand your concern. You have been taking Amitriptyline which is a Tricyclic anti-depressant. Now you have weaned off the drug because of poor improvement and are going to start Mirtazapine. Mirtazapine is a relatively safer drug and have better efficacy than Amitriptyline for depressive symptoms. In my opinion switch to Mirtazapine would be a good idea and this drug should improve your symptoms also. If you have reduced the doses of Amitriptyline then you can start with Mirtazapine without any fear. Take the drugs as per your prescribed doses only. No need to change to some other medicine as of now. Thanks, Hope this helps you. Take care