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Re: 'Bloody' Clomipramine » Brainbeard

Posted by ed_uk2010 on August 5, 2010, at 18:00:18

In reply to 'Bloody' Clomipramine, posted by Brainbeard on August 5, 2010, at 15:24:23

>Clomipramine blood levels should always be taken.....

Perhaps you could post a link to a study which demonstrates that measuring clomipramine blood levels improves clinical outcome.

>(high blood levels) which could occur even with low doses in a slow metabolizer and/or a rapid absorber...

It is certainly true that blood levels can vary greatly between individuals, mainly due to differences in metabolism. I am not aware of the phenomenon of a 'rapid absorber'.

>......to avoid toxicity, which could occur even with low doses in a slow metabolizer.

In general, the most appropriate way to avoid toxicity is to start at a low dose (eg. 10mg/day) and to increase the dose gradually whilst carefully monitoring for adverse effects.

>blood work is imperative for any responsible doctor prescribing TCAs

In that case, I can only assume that the majority of doctors are irresponsible.

>Clomipramine doesn't have numerous active metabolites; it has only one active metabolite (just like the other tertiaty amine TCA's), which is desmethylclomipramine, a potent NRI.

Thank you Brainbeard, I am well aware that desmethylclomipramine is a potent NRI. Clomipramine does, however, have numerous metabolites. I would not like to presume that desmethylclomipramine is its only active metabolite. Not enough research has been done in this area.

Thank you for your comments.

 

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