Our expert says:
This is a very understandable question, but doesn't realy have the sort of clear answer you are seeking. Trepiline is an old antidepressant, of the tricyclic family, and has been used for years. It is economical, and ha suited many people. It is rather more toxic than the more modern ADs, with more people experiencing side-effects, and more dangerous in overdose than the more recent alternatives.
As always, there is wide individual variation in how each of us respond to any particular AD : only around 70 % respond best to the first one tried, so one may need to try one properly for 2-3 weeks, before deciding to stay with it or change to a different one. Similarly, on any individual drug, some people experience side-effects they find intolerable, and others experience none or only mild and temporary side-effects.
Cymgen is a generic version of the expensive recent AD Cymbalta, and is also effective in many people, though definitely not suiting all, and usually has less side-effects in most people that Trepilin, but not in everyone.
I wonder whether you are being treated by a GP rather than a specialist psychiatrist, because for a first episode, newly diagnosed Depression, I'd thing it very odd indeed to start with a combination of these two ( indeed ANY two ) ADs, rather than trying one at a time. It doesn't make sense in terms of general clinical experience nor research-based practice, and I find the proposal very puzzling.
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