![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 35. Go back in thread:
Posted by Brainbeard on May 31, 2010, at 7:32:10
In reply to Advice please re. clomipramine/anafranil, posted by kizzie2 on May 27, 2010, at 4:42:14
Clomipramine - damn fine med.
Clomipramine already has very significant SRI (serotonin reuptake inhibition) at low doses, even at 10mg. It also is a strong NRI, also a noradrenergic med. It is a strong anticholnergic, which accounts for many of its side-effects but can also have an antidepressant effect. Then, like other TCA's, it may interact with the opioid system in a beneficial way. And, like mentioned above, it is a mild 5HT2A-antagonist, which may improve sleep, appetite and mood and reduce anxiety. Oh, and it is a potent inhibitor of a group of enzymes responsible for both the breakdown of melatonin and caffeine - so you could become more sleepy on clomipramine, while your cup of joe could last one heck of a lot longer.
An explanation for your experience could be that below a certain dose, serotonin receptors aren't saturated enough anymore to keep its antidepressant effects up. When I hear your story, I'd say: why not get back on a dose high enough to reap the benefits and low enough to avoid severe side-effects!!
Posted by bulldog2 on June 3, 2010, at 18:19:28
In reply to Re: Advice please re. clomipramine/anafranil, posted by hopefullynow on May 29, 2010, at 2:26:17
> > So it helps anxiety also that is fantastic. How long did you say you've been on it? So much news about this med lately. Phillipa
>
> Hello,
> Yes, clomipramine helps a lot anxiety.I had done things while i'm on Anafranil that were beyond my power to handle stress and social interactions before.
>
> For example last weekend i took part of a wedding where i was the godfather and i was perfect, i mean, at the church I had a lot of things to take care, then at the party i danced, I received congratulation from a lot of unkown people, so shortening i had a looot of fun even in a situation that normal people consider a stresful situation.Anafranil is amazing!
>
> It chaged drastically the way I am, I am no longer a freak who avoided any stressful situation or social interactions.
>
> Sorry for rambling...:)
>
>Hi Hopefully
I notice you mentioned high pro lactin on clomipramine. Any thoughts of a dopamine agonist to counter high prolactin which elevvate dopamine.
Regards
Bulldog2
Posted by hopefullynow on June 4, 2010, at 2:11:39
In reply to Re: Advice please re. clomipramine/anafranil, posted by bulldog2 on June 3, 2010, at 18:19:28
Hello Bulldog,
I'm very happy that you posted again in the clomipramine thread.How are you?Regarding prolactine, i think that we don't have much options besides DA agonists.I tried last week bromocriptine at a low dosage for a few days and it reversed somehow the AD effect of Anafranil, it made me nervous, anxious and easy startled.Im thinking of trying an less harsher DA agonist, maybe Requip or Mirapex.Tried Wellbutrin for this purpose and it did nothing.Not more alternatives, what do you think, an stimulant maybe?
All the best!
> Hi Hopefully
>
> I notice you mentioned high pro lactin on clomipramine. Any thoughts of a dopamine agonist to counter high prolactin which elevvate dopamine.
>
> Regards
> Bulldog2
Posted by Brainbeard on June 4, 2010, at 2:19:58
In reply to Re: Advice please re. clomipramine/anafranil » bulldog2, posted by hopefullynow on June 4, 2010, at 2:11:39
There are other dopamine agonists worth looking into:
There's piribedil, brand name Trivastal, Servier's D2/3-agonist, which doesn't cause sleep attacks unlike most other synthetic dopamine agonists and also has some cognitive enhancing qualities. It may not be a very strong proilactin suppressor though.
Then there's lisuride, an ergot-derived dopamine agonist that doesn't cause cardiac valve trouble like most ergot derived DA agonists can, and which is also a potent 5HT1A-agonist, which potentiates SRI. Lisuride is actually a chemical cousin of LSD, but without the hallucinogenic effects of the latter.
Finally, aripiprazole (Abilify) has also shown to be able to counter drug-induced hyperprolactinemia.
Posted by bulldog2 on June 6, 2010, at 10:44:36
In reply to Re: Advice please re. clomipramine/anafranil » bulldog2, posted by hopefullynow on June 4, 2010, at 2:11:39
> Hello Bulldog,
> I'm very happy that you posted again in the clomipramine thread.How are you?
>
> Regarding prolactine, i think that we don't have much options besides DA agonists.I tried last week bromocriptine at a low dosage for a few days and it reversed somehow the AD effect of Anafranil, it made me nervous, anxious and easy startled.Im thinking of trying an less harsher DA agonist, maybe Requip or Mirapex.Tried Wellbutrin for this purpose and it did nothing.Not more alternatives, what do you think, an stimulant maybe?
>
> All the best!
>
>
> > Hi Hopefully
> >
> > I notice you mentioned high pro lactin on clomipramine. Any thoughts of a dopamine agonist to counter high prolactin which elevvate dopamine.
> >
> > Regards
> > Bulldog2
>
>My p-doc had mentioned requip which might be gentler than the bromocriptine. I tried bromocriptine years ago and hated the way it made me feel. Also ritalin or adderall do wonders for some as an augment. Than there's another agonist miraprex which works for some.
My p-doc originally mentioned an agonist for the clomipramine and now has backed off. Wants me to wash out and try marplan an maoi.
Posted by bulldog2 on June 6, 2010, at 10:53:12
In reply to Other DA agonists: piribedil, lisuride. Abilify?, posted by Brainbeard on June 4, 2010, at 2:19:58
> There are other dopamine agonists worth looking into:
>
> There's piribedil, brand name Trivastal, Servier's D2/3-agonist, which doesn't cause sleep attacks unlike most other synthetic dopamine agonists and also has some cognitive enhancing qualities. It may not be a very strong proilactin suppressor though.
>
> Then there's lisuride, an ergot-derived dopamine agonist that doesn't cause cardiac valve trouble like most ergot derived DA agonists can, and which is also a potent 5HT1A-agonist, which potentiates SRI. Lisuride is actually a chemical cousin of LSD, but without the hallucinogenic effects of the latter.
>
> Finally, aripiprazole (Abilify) has also shown to be able to counter drug-induced hyperprolactinemia.Brainbeard some excellent advice. Now you being a genius I'm sure you can answer this. Which dopamine receptor is implicated with raising or lowering prolactin. If I knew the answer to that I could make a good choice. I tried trivetal and it had a nice feel but pooped out rather quickly.
If abilify at low doses could bring down the prolactin it would make a great choice as it is also an ad augmentor.
So tell me about this lisuride. There's a lot of talk in meds about this agonist. Does it strongly hit the prolactin receptors? What other good things does it do?
The impression I get is dostinex, miraprex and requip are good prolactin suppressors. But I would like to pick one that also has some ad properties. Sorry for the long post.
Posted by Brainbeard on June 6, 2010, at 13:31:18
In reply to Re: Other DA agonists: piribedil, lisuride. Abilify? » Brainbeard, posted by bulldog2 on June 6, 2010, at 10:53:12
I really know next to nothing about the relation between dopamine receptors and prolactin. They are inversely related, for sure.
Ergot derived dopamine agonists like bromocriptine can cause cardiac valve problems. Synthetic dopamine agonists like Mirapex and Requip are infamous for causing sudden sleep attacks.
Lisuride must be a strong prolactin suppressor. It may be a mood and cognition enhancer and an anxiolytic. Some human rat should try it soon.
Abilify might be a great option, but it seems to be a rather capricious drug.
Posted by kizzie2 on June 14, 2010, at 7:25:15
In reply to Advice please re. clomipramine/anafranil, posted by kizzie2 on May 27, 2010, at 4:42:14
Thank you so much everyone for replying. Im so sorry I havent replied sooner. I got confused with the site and didnt realise that my question had been answered. Sorry!!
I am now on 60mg with the aim of going down to 50mg and staying on that for a few months then going down to 25mg and staying on that longer term. Hopefully 25mg will be a good maintenance dose for me. It seemed to work for me before.
Thanks again for your help.
Kizzie
Posted by KarenRB53 on October 7, 2010, at 9:06:30
In reply to Re: Advice please re. clomipramine/anafranil, posted by hopefullynow on May 27, 2010, at 13:58:34
> Hello,
> Anafranil is a very potent AD, even in small doses.I am currently on Anafranil 100mg/day and in the very beginning i started with 10 mg pills.
>
> I felt an robust improvement even at this small dose.What I felt when i increased to 100 mg/day, was that the major improvement were at relative small doses 50-75 mg, when i reached 150 mg/day the side effects couteracted the feelin good sensation and the diffenece in efficacity was minimal.
>
> Anafranil is a very potent AD which targets serotonin in the first place and norepinephrine in the second.Thru his 5-HT2a antagonism it should target dopamine, but i don't think it does too much as long as I encounter elevated prolactine levels.
>
> For me Anafranil is the foundation of the treatment but I had to introduce in my regimen an norephrinergic agent to reach remission.First was maprotiline, but being too sedating, now i'm experiencing with low dose Wellbutrin with nice results.
>
> Best regards!How much Wellbutrin are you using and is it immediate releae, SR or XL?
Posted by hopefullynow on October 8, 2010, at 9:06:12
In reply to Re: Advice please re. clomipramine/anafranil » hopefullynow, posted by KarenRB53 on October 7, 2010, at 9:06:30
hy, unfortunately Wellbutrin was a big disapointment, i begun to take 150 mg in XL (actually Zyban - brand) form and after about a week the energy and motivation faded out into an more pronounced lethargy and somnolence.I raised the dose to 300 mg/day and again for a few days i felt better, then the lethargy came back and that was too much, i was unable to tolerate that state.I was feeling exactly like i was on a moderate to big dose of an antypsychotic.I really dunno why i reacted so strange, apparently i'm not the only one.Now i'm back to Maprotiline and i feel fairy normal.
Regards!
Posted by kizzie2 on October 11, 2010, at 6:43:33
In reply to Re: Advice please re. clomipramine/anafranil, posted by hopefullynow on October 8, 2010, at 9:06:12
Hi
Sadly things are still not stable for me.
I am currently on 50mg a day.
I have had a couple of periods of about 2 weeks where I have felt much better. But these dont last and then the depression/anxiety return badly.As I was very well on 25mg during 2008 and 2009 I am thinking of reducing slowly to 25mg to see if there is more consistency.
For some reason I feel that at 50mg the anafranil INCREASES my obsessive anxiety. I know it is used as a treatment for OCD patients so this would seem to be impossible - but it really does seem to be the case with me.
Because I have had such a difficult year I am having lots of thoughts that there is no way i can improve from this now. But I know i have to keep telling myself that there other possibilities.
Thanks for reading.
Kizzie x
Posted by hopefullynow on October 11, 2010, at 6:58:54
In reply to Re: Advice please re. clomipramine/anafranil, posted by kizzie2 on October 11, 2010, at 6:43:33
Hi there,
I'm sorry to hear that you're not stable at 50 mg/day.I think that clomipramine, as every AD, tends to lose its efectivness over time because it decreases noradrenergic and dopaminergic activity ( even that on paper its noradrenergic metabolite seems to be powerfull-it is not, comparing to serotonergic activity).That obsesivness/anxiety/agitation (which i know well)seems to be some form of akathisia, i dunno.All i know is that when i introduced an noradrenergic agent (nortryptiline/maprotiline/wellbutrin) my anxiety/agitation state disapeared.If i'd be in your place i'd try a tiny amount of nortryptiline...Good luck and keep us updated
Regards
> Hi
> Sadly things are still not stable for me.
> I am currently on 50mg a day.
> I have had a couple of periods of about 2 weeks where I have felt much better. But these dont last and then the depression/anxiety return badly.
>
> As I was very well on 25mg during 2008 and 2009 I am thinking of reducing slowly to 25mg to see if there is more consistency.
>
> For some reason I feel that at 50mg the anafranil INCREASES my obsessive anxiety. I know it is used as a treatment for OCD patients so this would seem to be impossible - but it really does seem to be the case with me.
>
> Because I have had such a difficult year I am having lots of thoughts that there is no way i can improve from this now. But I know i have to keep telling myself that there other possibilities.
>
> Thanks for reading.
>
> Kizzie x
Posted by kizzie2 on October 11, 2010, at 12:23:28
In reply to Re: Advice please re. clomipramine/anafranil, posted by hopefullynow on October 11, 2010, at 6:58:54
Hi - thank you for reply. Apologies for my ignorance but when you say 'decreases noradrenergic and dopaminergic activity ' - does that mean that anafranil/clomipramine can actually increase symptoms of depression (loss of enthusiasm/motivation) over time?
This definately seems to be the case with me and have wondered if it could be down to the medication.
Thanks
Kizzie
Posted by hopefullynow on October 11, 2010, at 13:38:51
In reply to Re: Advice please re. clomipramine/anafranil » hopefullynow, posted by kizzie2 on October 11, 2010, at 12:23:28
yes, decreasing noradrenergic and dopaminergic activity leads to apathy, lack of enthusiasm, drive, energy or libido.Serotonergic TCA's seems to be kinder than SSRI's in this area, but over time they appear to lead to this kind of state of numbing.Best approach would be to add to clomipramine (which hopefully abolish depresion on you)some NA/DA agent like nortryptiline, wellbutrin, desipramine...Dopamine agonists doesn't seem to do something solid on the long run.If they work, they pop up in a short time.
For me, clomipramine at 50mg/day had/have a robust response and continous efficacity in treating depression but left me somehow numb.Adding Maprotiline (NA TCA), the numbing/amotivational state was reversed.Hope it helps,
regards
> Hi - thank you for reply. Apologies for my ignorance but when you say 'decreases noradrenergic and dopaminergic activity ' - does that mean that anafranil/clomipramine can actually increase symptoms of depression (loss of enthusiasm/motivation) over time?
>
> This definately seems to be the case with me and have wondered if it could be down to the medication.
>
> Thanks
>
> Kizzie
Posted by Brainbeard on October 11, 2010, at 15:49:33
In reply to Re: Advice please re. clomipramine/anafranil, posted by hopefullynow on October 11, 2010, at 13:38:51
Adding nortriptyline to clomipramine for noradrenergic reuptake inhibition (NRI) is like adding sugar to candy, since clomipramine's metabolite, desmethylclomipramine, is a much stronger NRI than nortriptyline; it's at least ten times as strong. (See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014120/pdf/0707253a.pdf for receptor affinities in Ki; the lower the number, the stronger the affinity.)
In fact, as you go higher on clomipramine, the SRI/NRI ratio (2:1 according to Gillman (see mentioned article)) will become smaller and smaller, perhaps approaching 1:1 eventually, since the NRI metabolite has a much longer half-life than the mother drug and will therefore accumulate more in the blood over time.
Desipramine could be a little stronger than desmethylclomipramine.
I haven't seen numbers for maprotiline.
Posted by hopefullynow on October 12, 2010, at 8:03:58
In reply to Re: Advice please re. clomipramine/anafranil, posted by Brainbeard on October 11, 2010, at 15:49:33
Hy Brainbeard,
On paper yes, desmethylclomipramine looks strong, but at higher doses of clomipramine, the sedation and somnolence feel stronger.
I have used to follow a small test in order to qualify a noradrenergic meds regarding their potency: because i train regularly for over a decade, I know my body and my unmedicated muscular tonus.On clomipramine on any dosage over 50 mg/day, I feel weak, trembling, lazy, so not much norepinephrine going on.Au contraire, modest doses of maprotiline added to clomipramine, reversed the weakness, motivation or drive.The same when I added wellbutrin or high doses remeron to clomi.Sometimes I prefer to let alone the studies and abstracts(which i read regularly) and listen to my body.> I haven't seen numbers for maprotiline.
Me neither.It seems it's too old to present interest :(.regards
Posted by kizzie2 on October 13, 2010, at 9:10:14
In reply to Re: Advice please re. clomipramine/anafranil » Brainbeard, posted by hopefullynow on October 12, 2010, at 8:03:58
thank you for information - really useful x
Posted by Brainbeard on October 13, 2010, at 12:59:59
In reply to Re: Advice please re. clomipramine/anafranil » Brainbeard, posted by hopefullynow on October 12, 2010, at 8:03:58
Hi the hi,
I've posted an answer several times, but somehow the posting failed.
Thing is, sedation and somnolence can actually be side-effects of noradrenalin reuptake inhibition. They are well known side-effects of atomoxetine (Strattera), an almost pure NRI. Seroquel is probably so sedating because its metabolite is an NRI. Same goes for Geodon, which can knock you out flat: among the many things it does, is pronounced NRI.
Trembling can be a sign of *increased* muscular tone. My trembling gets much worse when I drink coffee. Adrenalin basically puts you in a 'fight or flight' mode. It increases pulse, yields dry mouth, leads to constipation and urinary retention.. You're not going to take a shite or a pee in the middle of dealing with a hungry lion. All these things are present with clomipramine, and they're all a sign of NRI, although of course the anticholinergic action contributes too.
So your conclusion that there's 'not much norepinephrine going on' seems a tad too fast.
> Hy Brainbeard,
>
> On paper yes, desmethylclomipramine looks strong, but at higher doses of clomipramine, the sedation and somnolence feel stronger.
> I have used to follow a small test in order to qualify a noradrenergic meds regarding their potency: because i train regularly for over a decade, I know my body and my unmedicated muscular tonus.On clomipramine on any dosage over 50 mg/day, I feel weak, trembling, lazy, so not much norepinephrine going on.Au contraire, modest doses of maprotiline added to clomipramine, reversed the weakness, motivation or drive.The same when I added wellbutrin or high doses remeron to clomi.Sometimes I prefer to let alone the studies and abstracts(which i read regularly) and listen to my body.
>
> > I haven't seen numbers for maprotiline.
> Me neither.It seems it's too old to present interest :(.
>
> regards
>
>
>
>
Posted by hopefullynow on October 13, 2010, at 13:32:00
In reply to Re: Advice please re. clomipramine/anafranil, posted by Brainbeard on October 13, 2010, at 12:59:59
hy :)
thanks for letting me know ;)
> Hi the hi,
>
> I've posted an answer several times, but somehow the posting failed.
>
> Thing is, sedation and somnolence can actually be side-effects of noradrenalin reuptake inhibition. They are well known side-effects of atomoxetine (Strattera), an almost pure NRI. Seroquel is probably so sedating because its metabolite is an NRI. Same goes for Geodon, which can knock you out flat: among the many things it does, is pronounced NRI.
>
> Trembling can be a sign of *increased* muscular tone. My trembling gets much worse when I drink coffee. Adrenalin basically puts you in a 'fight or flight' mode. It increases pulse, yields dry mouth, leads to constipation and urinary retention.. You're not going to take a shite or a pee in the middle of dealing with a hungry lion. All these things are present with clomipramine, and they're all a sign of NRI, although of course the anticholinergic action contributes too.
>
> So your conclusion that there's 'not much norepinephrine going on' seems a tad too fast.
>
>
>
> > Hy Brainbeard,
> >
> > On paper yes, desmethylclomipramine looks strong, but at higher doses of clomipramine, the sedation and somnolence feel stronger.
> > I have used to follow a small test in order to qualify a noradrenergic meds regarding their potency: because i train regularly for over a decade, I know my body and my unmedicated muscular tonus.On clomipramine on any dosage over 50 mg/day, I feel weak, trembling, lazy, so not much norepinephrine going on.Au contraire, modest doses of maprotiline added to clomipramine, reversed the weakness, motivation or drive.The same when I added wellbutrin or high doses remeron to clomi.Sometimes I prefer to let alone the studies and abstracts(which i read regularly) and listen to my body.
> >
> > > I haven't seen numbers for maprotiline.
> > Me neither.It seems it's too old to present interest :(.
> >
> > regards
> >
> >
> >
> >
>
>
Posted by mogger on October 14, 2010, at 1:19:52
In reply to Advice please re. clomipramine/anafranil, posted by kizzie2 on May 27, 2010, at 4:42:14
You must try inositol, 18 grams a day. It is awesome for obsessive thoughts and depression. Very powerful and side effect free.
Posted by Gab2010 on January 11, 2011, at 14:25:07
In reply to Re: Advice please re. clomipramine/anafranil, posted by Brainbeard on October 13, 2010, at 12:59:59
Hi Brainbeard and everyone,
I saw your postings regarding Clomipramine and was wondering if you would be willing to give me your opinion as you are all very knowledgeable and I am quite desperate! I'm new to this site too and wasn't sure where to post so please forgive if there are duplicates. Anyway, I've been on 12mgs of Prozac for the past few months for PTSD, depression/anxiety, OCD. I've had some relief from my symptoms (which is wonderful!) but I also have interstitial cystitis, a chronic pain condition which the Prozac seems to have aggravated. My psychiatrist has since switched me to Clomipramine, starting at 12mgs daily, as the anticholinergic effects are good for the IC and I've tried so many different meds before. I'm on day ten of taking the 12mgs Clomipramine and have been absolutely crawling out of my skin with anxiety and racing thoughts!! My doc said that the Prozac is still in my system and the extra seratonin stuff can be contributing to the agitation, and gave me Xanax for short term relief - however it just seems to make me feel more disoriented. I am seeing him next week, but I wanted to do some research of my own. Help? Any info/input is so very much appreciated! How long would this last, theoretically, before the good effects would kick in? Is this potentially dosage-dependent (eg, if I were to go up to 25mgs, might I see a shift?) .. or is it because there's still Prozac in my system, and how long would that take to get out? Have you ever heard of anyone just staying anxious on the Clomipramine and not responding to it? I am sorry to bother you with so many questions; it's just that I'm rattled because I'm in the midst of such a drastic increase in my anxiety and OCD symptoms. It would be so much easier if I knew how long it would last so I could just tell myself, 'okay, it's only another week of this...' etc etc. I know these are low doses of meds as well, but I tend to be quite sensitive to them. Thank you so, so, SO much!!
Posted by Brainbeard on January 12, 2011, at 14:42:41
In reply to Re: Advice please re. clomipramine/anafranil, posted by Gab2010 on January 11, 2011, at 14:25:07
Hi.
Clomipramine can exacerbate anxiety and inner turmoil at first. The Prozac lingering on in your blood will inhibit the breakdown of clomipramine's noradrenergic metabolite, which can result in too much stimulation.
You could get stable somewhere around the third or fourth week. For panic, only a little clomipramine can be enough. For everything else, you'll probably need more than 12(.5?) milligrams. The extra anxiety can reappear with every raise in dose. Dosage changes included, it took me at least two months to become stable on clomipramine. I have been as stupid as lowering the dose recently, only to have my OCD come back with a vengeance. I'm raising the dose again, but am still unstable.
My main side-effects are dry mouth, orthostatic hypotension = getting very dizzy when moving from a sitting/lying to a standing position and trouble getting an orgasm. Oh yeah, and brain fog. Sometimes I wonder if it's the clomipramine or I'm really that dumb.
Clomipramine is old-school, unmarketed, superior. Hope it can help you.
Posted by Gab2010 on January 12, 2011, at 17:45:51
In reply to Re: Advice please re. clomipramine/anafranil, posted by Brainbeard on January 12, 2011, at 14:42:41
Hi Brainbeard,
I can't thank you enough for your reply - it was very helpful to hear your experience. I guess your info re the prozac knocks out my other theory, which was to stay on the prozac while adjusting to the clomipramine to try to buffer the side effects. Still a bad idea? (I'm guessing my doc must have known this, which would have been why he just swapped over instead). I guess I was just trying to think of a way to switch meds without feeling like I'm white-knuckling it for two months, but maybe I'm a bit SOL.
I'm wondering what the (roughly) equivalent dose of Clomipramine would be to the 12mgs of Prozac that I was on? I would agree that I will end up needing more CL than this starting dose. I feel so torn because it took me a solid two months to stabilize after going on the prozac, and while I'm switching because of the cystitis issue, I just don't know if I can hang in there and deal with another two months of stabilization. I've also noticed a sharp increase in depression (could be induced by dealing w the added anxiety, though)... And since I've done the med-merry-go-round before, I feel like I don't have too many more options.
You said that the CL is superior - do you mean also as compared to Prozac? Have you experienced the difference between being on an SSRI and the CL?
I smiled at your brain fog comment as I have felt the same way - but rest assured, you seem awfully coherent and intelligence intact.
Again, can't thank you enough for your helpful info!!!
Best,
Gab
> Hi.
>
> Clomipramine can exacerbate anxiety and inner turmoil at first. The Prozac lingering on in your blood will inhibit the breakdown of clomipramine's noradrenergic metabolite, which can result in too much stimulation.
>
> You could get stable somewhere around the third or fourth week. For panic, only a little clomipramine can be enough. For everything else, you'll probably need more than 12(.5?) milligrams. The extra anxiety can reappear with every raise in dose. Dosage changes included, it took me at least two months to become stable on clomipramine. I have been as stupid as lowering the dose recently, only to have my OCD come back with a vengeance. I'm raising the dose again, but am still unstable.
>
> My main side-effects are dry mouth, orthostatic hypotension = getting very dizzy when moving from a sitting/lying to a standing position and trouble getting an orgasm. Oh yeah, and brain fog. Sometimes I wonder if it's the clomipramine or I'm really that dumb.
>
> Clomipramine is old-school, unmarketed, superior. Hope it can help you.
>
Posted by Brainbeard on January 16, 2011, at 9:57:05
In reply to Re: Advice please re. clomipramine/anafranil » Brainbeard, posted by Gab2010 on January 12, 2011, at 17:45:51
Hi Gab,
Most welcome. I'm having the flu @ da moment.
Prozac and clomipramine are very different; SRI-wise, a clomipramine dose equivalent to 12mg Prozac may be 20mg clomipramine, perhaps even less.
Prozac washes out of your system very slowly all by itself, so there's no need to keep taking it. It takes about a month to leave your system after the last dose.
> You said that the CL is superior - do you mean also as compared to Prozac? Have you experienced the difference between being on an SSRI and the CL?
Compared to most other meds. Yes, I've been on Paxil for three years, and on shorter trials of most of the other SSRI's. Clomipramine doesn't make me listless as the SSRI's do.
>
> I smiled at your brain fog comment as I have felt the same way - but rest assured, you seem awfully coherent and intelligence intact.
>Haha. Thanks.
Posted by creepy on January 19, 2011, at 11:24:40
In reply to Re: Advice please re. clomipramine/anafranil, posted by Gab2010 on January 11, 2011, at 14:25:07
I have read other posts from people having increased pain perception with prozac (say that 5 times fast!). I also read somewhere that the number of opioid receptors increased during prozac treatment. So you may be on to something.
There are other ADs out there which may help and have the benefit of reducing pain as well. Typically the SNRIs are recommended for depression with pain. But people with pain resulting from depression itself (liek me) will probably benefit from anything that alleviates depression.
Im not a fan of the SNRIs due to the discontinuation effects and short half-life.
If you want to take a second drug to augment the antidepressant and help pain, desipramine is good stuff.
If you want to move to another AD, I know Ive had wonderful results with PTSD by taking lexapro and zoloft. Clomipramine will have a lot more side effects but the TCAs may work better on anxiety symptoms. Depends on your individual response.
My doc says shes seen many people with PTSD hyper-respond to meds and have more side effects. She doesnt think its all psychosomatic either.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.