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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Althea8869 on March 3, 2004, at 19:24:33
I've had no success with SSRI's or any of the other new medications(remeron, lex, etc). I'm seeing my doc in a few days and i'm torn between suggesting Clomipramine or Desipramine as the next step.
(my doc's pretty good at listening to my suggestions)
I would really appreciate any thoughts from those that have tried one or both of these TCA's.Thanks in advance.
Posted by Keith Talent on March 3, 2004, at 20:19:15
In reply to Anyone With Clomipramine(Anafranil) Experience?, posted by Althea8869 on March 3, 2004, at 19:24:33
Clomipramine was the best antidepressant I've ever been on. The problem is that most patients can't have an orgasm while taking it. It's the only drug out there that really potently blocks reuptake of both serotonin and noradrenaline. Desipramine only does the latter - might be fine for you, but there's only one way to find out.
Posted by Thereishope on March 3, 2004, at 21:07:30
In reply to Anyone With Clomipramine(Anafranil) Experience?, posted by Althea8869 on March 3, 2004, at 19:24:33
Althea, we seem to be on the same path :) We've spoken before and like yourself I also can not tolerate the SSRIs. I'm looking forward to meeting with my doctor on Fri. March 5 to discuss coming off Wellbutrin and trying a TCA. I've researched desipramine & pamelor, but not anafranil. Hmmm... I guess I'll do that before Friday.
Please keep me posted on the outcome of your appointment and your decision.
Thanks!
> I've had no success with SSRI's or any of the other new medications(remeron, lex, etc). I'm seeing my doc in a few days and i'm torn between suggesting Clomipramine or Desipramine as the next step.
> (my doc's pretty good at listening to my suggestions)
> I would really appreciate any thoughts from those that have tried one or both of these TCA's.
>
> Thanks in advance.
Posted by Althea8869 on March 3, 2004, at 22:01:54
In reply to Re: Anyone With Clomipramine(Anafranil) Experience?, posted by Keith Talent on March 3, 2004, at 20:19:15
Thanks Keith.
I'll worry about the orgasms after I get the depression under control. Ironic in that I broke off my engagement just 2 months ago and now I really should be doing the singles thing again, but I just dont feel like meeting anybody or doing anything.Which path???....if I take anafranil and it works then i'll feel like doing the singles thing, but wont be able to have orgasms, or not take the anafranil, not feel like doing the singles thing, and be able to have orgasms.
Two roads diverged in a wood.......and I chose the antidepressant.
Posted by Althea8869 on March 3, 2004, at 22:10:58
In reply to Re: Anyone With Clomipramine(Anafranil) Experience? » Althea8869, posted by Thereishope on March 3, 2004, at 21:07:30
Thereishope - (i really like that screen name).
It will be interesting to compare notes as we move forward. Thats really the beauty of this board - so much opportunity to both learn from and try to help each other. The process is somewhat cathartic for me.I'm seeing my doc monday, but I may be able to see him tomorrow because I see my CBT tomorrow and theyre in the same building. I can probably sneak in between some of his other patients.
I'll post you on the outcome of our discussion whenever it happens and you let me know what your doc says. I'll be interested to see which way each of them individually pushes with regard to the TCA's. See if they have been reading the same reports that we have.
We'll talk soon.
Take care & bon chance.
Posted by Thereishope on March 4, 2004, at 15:01:06
In reply to Re: Anyone With Clomipramine(Anafranil) Experience » Thereishope, posted by Althea8869 on March 3, 2004, at 22:10:58
Althea my appointment is at 1:15 so I'll post sometime afterward.
:)
> Thereishope - (i really like that screen name).
> It will be interesting to compare notes as we move forward. Thats really the beauty of this board - so much opportunity to both learn from and try to help each other. The process is somewhat cathartic for me.
>
> I'm seeing my doc monday, but I may be able to see him tomorrow because I see my CBT tomorrow and theyre in the same building. I can probably sneak in between some of his other patients.
>
> I'll post you on the outcome of our discussion whenever it happens and you let me know what your doc says. I'll be interested to see which way each of them individually pushes with regard to the TCA's. See if they have been reading the same reports that we have.
>
> We'll talk soon.
> Take care & bon chance.
Posted by Thereishope on March 5, 2004, at 15:42:51
In reply to Re: Anyone With Clomipramine(Anafranil) Experience » Thereishope, posted by Althea8869 on March 3, 2004, at 22:10:58
Althea do you have any good news to share?
I just came from my doctor's office, and we've decided to try Wellbutrin SR 200mg for a little while and see what happens. I'm giving it a week. I'm going to think positive, since someone here posted that their doctor recommended the SR over the XL.
Since my problem is anxiety which triggers my depression, my doctor mentioned possibly adding a benzo. along with the Wellbutrin. What do you think about this addition?
Although some of her patients are taking TCAs she didn't feel that I would do well with the side effects. She also mentioned TCAs causing possible heart issues that would require constant monitoring? Anyone knows anything about this?
I told her that I was tired of feeling spacey all the time an after being on this med. for almost a year this feeling should be gone. She felt that my spacey feeling was still from my anxiety, that is why she mentioned the benzo.
I also think that I'm perimenopausal, so I need to get that checked out. I wonder if that is why I'm experiencing some of my symptoms.
After reading all of this does anyone have a plan "B" for me should I need to switch from the Wellbutrin completely?
Thanks!
God Bless
> Thereishope - (i really like that screen name).
> It will be interesting to compare notes as we move forward. Thats really the beauty of this board - so much opportunity to both learn from and try to help each other. The process is somewhat cathartic for me.
>
> I'm seeing my doc monday, but I may be able to see him tomorrow because I see my CBT tomorrow and theyre in the same building. I can probably sneak in between some of his other patients.
>
> I'll post you on the outcome of our discussion whenever it happens and you let me know what your doc says. I'll be interested to see which way each of them individually pushes with regard to the TCA's. See if they have been reading the same reports that we have.
>
> We'll talk soon.
> Take care & bon chance.
Posted by Althea8869 on March 5, 2004, at 16:22:24
In reply to Re: Anyone With Clomipramine(Anafranil) Experience » Althea8869, posted by Thereishope on March 5, 2004, at 15:42:51
Thereishope,
Interesting new tack. I've never heard of switching from wellbutrin XL to wellbutrin SR. Id be curious to know the logic behind this. I would think that if someone is not repsonding to a medication then simply switching the dosing regimen would seem silly. But Im not a doctor so what do I know.
Regarding adding a benzo, Im taking .5mg/day klonopin with the wellbutrin and I cant really say if its helped or not. I can say that the wellbutrin has not helped with certainty, so side effects be damned, Im walking out of my appt monday with either clomipramine or desipramine. I've always been a bit lucky with side effects anyway.
If you take a low dose benzo(go with one of the weaker ones like klonopin, not xanax), dont worry too much about withdrawl or other side effects. Ive never exceeded .5mg (except when I get on an airplane) and I've always been able to take it on an 'as needed' basis. If i miss a dose for two or three days I often wont realize it.
Definitely think positive. You never know with these things. It certainly wont make things worse, and in a strange way thats always a good thing.
Take care of yourself and post me during the week on how you are faring.
Posted by Dave1 on March 5, 2004, at 18:05:34
In reply to Anyone With Clomipramine(Anafranil) Experience?, posted by Althea8869 on March 3, 2004, at 19:24:33
Posted by Dave1 on March 5, 2004, at 18:10:31
In reply to Anyone With Clomipramine(Anafranil) Experience?, posted by Althea8869 on March 3, 2004, at 19:24:33
Hi,
If you try a TCA, make sure you insist that your doctor add Li and Thyroid Hormone to it if it doesn't work alone. When I took anafranil it didn't work, but then I added lithium and it helped me for about a week.
Bye,
Dave
Posted by Thereishope on March 5, 2004, at 18:43:51
In reply to Re: Anyone With Clomipramine(Anafranil) Experience » Thereishope, posted by Althea8869 on March 5, 2004, at 16:22:24
I was just sitting here thinking about one of your previous posts recommending a low dosage of Klonopin for anxiety. I'll contact my doctor next week about adding Klonopin.
I've taken the 200mg. of the SR...the verdict is still out until probably next Friday.
So you are only taking Wellbutrin & Klonopin?
I'm interested in hearing about your response to the TCA. Keep posting :)
> Thereishope,
>
> Interesting new tack. I've never heard of switching from wellbutrin XL to wellbutrin SR. Id be curious to know the logic behind this. I would think that if someone is not repsonding to a medication then simply switching the dosing regimen would seem silly. But Im not a doctor so what do I know.
>
> Regarding adding a benzo, Im taking .5mg/day klonopin with the wellbutrin and I cant really say if its helped or not. I can say that the wellbutrin has not helped with certainty, so side effects be damned, Im walking out of my appt monday with either clomipramine or desipramine. I've always been a bit lucky with side effects anyway.
>
> If you take a low dose benzo(go with one of the weaker ones like klonopin, not xanax), dont worry too much about withdrawl or other side effects. Ive never exceeded .5mg (except when I get on an airplane) and I've always been able to take it on an 'as needed' basis. If i miss a dose for two or three days I often wont realize it.
>
> Definitely think positive. You never know with these things. It certainly wont make things worse, and in a strange way thats always a good thing.
>
> Take care of yourself and post me during the week on how you are faring.
>
>
>
Posted by Althea8869 on March 5, 2004, at 19:43:03
In reply to Re: Anyone With Clomipramine(Anafranil) Experience » Althea8869, posted by Thereishope on March 5, 2004, at 18:43:51
Right now, just klonopin(.5mg) and wellbutrin XL(150mg), im titrating down on the wellbutrin now.
One other thing i've been thinking seriously about is giving Lamictal a try. Im not bi-polar, but I have heard some amazing things about this drug. My stepmother has suffered from depression for 30+ years and tried absolutely everything out there. Then her doc said, why not try this, gave her Lamictal and within 3 weeks the improvement was so profound that she actually considered stopping it immediately because she didnt believe anything safe could make her feel this good. Its been almost a year and things have only improved.
I'll post you on how things go monday. Fingers crossed.
Good luck to you and take care.
Posted by francesco on March 5, 2004, at 20:50:12
In reply to Anyone With Clomipramine(Anafranil) Experience?, posted by Althea8869 on March 3, 2004, at 19:24:33
Anafranil was the first med I've tried and it has been the best so far. I was on 75 mg and I have been on it for several years. I'm likely to have ADHD rather than depression and I may be in the bipolar spectrum so my reactions could be not typical.
Effects: constipation and sedation at first, sedation fades away with time,
constipation improves,
weight gain (24 lbs.),
decreased libido (some women seem to have an opposite reaction)
delayed orgasm
mind-sharpening
binge eating sometimes
alertness
some emotional flattening (maybe it's what helps)
assertivenessLess common and I hope very subjective reactions:
alcohol craving
some social phobiaEverytime I quit it I had a pleasant hypomaniac reaction. Easy to withdraw
Posted by Althea8869 on March 5, 2004, at 22:47:04
In reply to Re: Anyone With Clomipramine(Anafranil) Experience? » Althea8869, posted by francesco on March 5, 2004, at 20:50:12
Francesco - thanks so much for the info. Always happy to add more data to my war chest. For the most part, very few people seem to have had a bad time with this med. It seems broadly efficacious - based on both anectdotal evidence(this board) as well as what ive been able to find on PubMed and other sites.
I guess what im trying to say is thanks - everytime i hear this from someone I become more hopeful.
Take care.
Posted by francesco on March 28, 2004, at 9:55:13
In reply to Re: Anyone With Clomipramine(Anafranil) Experience » francesco, posted by Althea8869 on March 5, 2004, at 22:47:04
How is going on Anafranil ?
Posted by Althea8869 on March 28, 2004, at 10:03:33
In reply to Re: Anyone With Clomipramine(Anafranil) Experience » Althea8869, posted by francesco on March 28, 2004, at 9:55:13
My doctor felt Desipramine was a safer route so I am giving that a try. I'm up to 150mg/d and I have to say that I am noticing some definite improvement. Its been gradual and its only been 9 days since I started, so I think I have reason to be hopeful. Tomorrow I am going to begin augmenting with SAM-e and 5-htp. They should work on the serotonin side of this while the Desipramine works the NE.
Im hopeful. I guess thats all I can be.
Thanks for asking.
Take care.
Posted by zeugma on March 28, 2004, at 10:12:57
In reply to Re: Anyone With Clomipramine(Anafranil) Experience, posted by Althea8869 on March 28, 2004, at 10:03:33
Althea,
I also was curious about your progress. I'm especially interested in the fact that you are adding SAM-e to your desipramine. I was under the uimpression that SAM-e worked on both serotonin and dopamine? During the winter vacation when I was severely depressed and fatigued I shelled out a lot of money for a package of SAM-e, then decided not to take it when I read some cautions about mixing it with conventional AD's. Not contraindications, but cautions. I felt like I had enough problems at the time without worrying about unpredictable adverse reactions! If your dr. thinks SAM-e could be a useful augment to desipramine that is a good sign. Good luck with the med and the augments, and keep us posted!
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