Protriptyline
[Vivactil] First-line tricyclic, low sedation/anticholinergic/hypotension risk. More noradrenergic.
Major Depression
Nortriptyline
[Pamelor] First-line tricyclic, low sedation/anticholinergic/hypotension risk. More
noradrenergic.
Desipramine
[Norpramin] Second-line tricyclic, low sedation/anticholinergic/hypotension risk. More
noradrenergic.
Doxepin
[Sinequan/Silenor] Treats sleep in low-dose (esp early am awakening), depression in higher
doses (tricyclic).
Amitriptyline
[Elavil] Third-line tricyclic, mix of serotonin/noripineprhine, more anticholinergic side effects.
Useful for pain and IBS.
Venlafaxine
[Effexor] Not ideal among the SNRIs (hypertension, WD risks, weight gain), but very effective for some and treats hot flashes in low doses.
Milnacipran
[$ Savella] Approved for fibromylagia in US and depression abroad (parent compound of
levomilnacipran).
Levomilnacipran
Most noradrenergic of the SNRIs, good for fatigue, with side effect profile similar to bupropion. Isomer of milnacipran (used in fibromylagia). Depression [2].
Duloxetine
[Cymbalta] Approved for child anxiety. Risk of urine retention (but treats urine incont). Liver
risk.