I am at a loss as to why he would prescribe and SSRI and a tricyclic together! Trepiline is actually amitriptyline and the two drugs should not be used concurrently:
From the MIMS database accessed by all doctors in Australia:
SSRIs - The serotonin syndrome (alterations in cognition, behaviour, autonomic nervous system function and neuromuscular activity) has been reported with amitriptyline when given concomitantly with other serotonin enhancing medicines including SSRIs.
and from another source: Addition of SSRI to tricyclic (such as amytriptyline) raises the tricyclic drug level by 400% and can cause serious complications.
Both Prof Halmagyi and a neurologist at Prince of Wales hospital told me I should dump the SSRI first, have a 4 week wash out period with no drugs and then trial the tricyclic.
I'd ask your doc what he's been smoking lately!
Cheers ... Scott