Discuss with: psychiatrist. May want to go up on the amitriptyline a bit or switch this to doxepin, pamelor (nortriptyline) or imipramine. Mirtazpine is a tetracyclic SSRI / noradrenergic agent that works well with most of these tricyclics (and may even offset any side effects. The amitriptyline is the most anticholinergic of your meds (dry mouth / elevated heart rate etc) and i tend to use agents that are less so (Pamelor)
Answered 5/18/2016
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