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Re: Switching from Nardil to Anafranil Greywolf

Posted by ixus on April 18, 2005, at 15:49:23

In reply to Switching from Nardil to Anafranil, posted by Greywolf on April 18, 2005, at 12:42:56

> I posted here quite often last year while I was struggling to find a pharmo solution for severe depression. I'm bipolar, complicated by a rather intractable OCD problem of many years.
> I've got a great doc who's very open-minded and willing to try anything reasonable. Over the last decade and longer, I've tried every SSRI/SNRI/NDRI, etc., etc., etc., out there. They generally have not been very effective even at higher doses, and most of you can appreciate the various SEs.
> Last year, I started on Nardil. It was great in terms of low SEs, the dietary restrictions were no big deal, and the efficacy at 60mg/day was decent. I still have all the BP symptomology--severe episodes of depression, occasional euphoric states lasting hours to days--but the intensity is toned down appreciably.
> So, things are livable with the BP, though not a life that'll knock your socks off. Unfortunately, the OCD has come to the fore very strongly over the months I have been taking Nardil, and it's become a real daily hindrance. Obsessional thoughts abound, repeated compulsive acts (often related to making myself re-do things because the completed (and perfectly fine) act was accompanied by some type of negative thought) occur throughout the day. Frankly, it's exhausting.
> I recently consulted with my doctor about the OCD in particular. He has suggested dropping the Nardil (can't take both together) and starting up with Anafranil (clomipramine). It will likely have the some of the SEs I've experienced with anti-depressants (and probably a diminished effectiveness re: depression), but it will focus on the OCD aspect that is seriously interfering with my life.
> Which brings me to my questions:
> 1. Does anyone know of an OCD med that can be safely used in conjunction with Nardil?
> 2. What has been your experience on Anafranil? (I had one course of it years ago, but in combination with lithium and an AD I can't remember--which didn't work out too well).
> Thanks for your thoughts.
> Greywolf

Hi Greywolf,
I have read somewhere that AD + low dose of AP +/-benzo works nice for BPD. Maybe you should consider higher Nardil dose ( >= 1mg/kg ). Low dose of olanzapine or risperidone may be helpful as AP.
I have positive outcome of clomipramine usage in MD, however it did nothing for OCD, I had terrible GAD on it.




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