Posted by Brainbeard on October 5, 2010, at 10:38:29
In reply to Re: Clomipramine's Tail Is Smashing My Little Future » Brainbeard, posted by Roslynn on October 4, 2010, at 15:48:43
> Hi Brainbeard,
>
> Thank you for your message. I fear adding nortrip would increase my already terrible dry mouth. (I've taken it before.)
>
> Just for some background, my med combo is Clomipramine 50mg, Prozac 60mg, Seroquel 100mg, lithium 300mg and ativan 2-4 mg as needed. I am desperately trying to get off the seroquel as it causes me a lot of mental confusion.
>
>
>Dudette, if you're on 60mg of Prozac, your clomipramine is boosted like a rocket. Your blood levels of desmethylclomipramine, the metabolite working on noradrenaline and mostly responsible for dry mouth and cognitive blurring, are bound to be very high. Desmethylclomipramine gets eliminated through 2D6 enzymes, and Prozac is a major 2D6 inhibitor. So your dose of clomipramine is in fact a very high one. Did you have your blood levels checked? Your doc oughta check on them with this combo.
With 60mg of Prozac, 5-10mg instead of 25-50 of nortriptyline may already be enough for better sleep, since nortriptyline is also metabolized through 2D6.
Current meds: clomipramine 225mg, fluvoxamine (Luvox) 50mg, amitriptyline 10mg, bethanechol 25-50mg.
PRN: oxazepam 5-10mg
poster:Brainbeard
thread:964485
URL: http://www.dr-bob.org/babble/20100926/msgs/964774.html