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Re: Anyone tried Anafranil

Posted by Keith Talent on June 4, 2004, at 10:56:50

In reply to Anyone tried Anafranil, posted by linkadge on June 2, 2004, at 21:51:01

Linkadge,

I've said to many people at Psycho-Babble, and I'll say it again, that clomipramine was THE best antidepressant I've ever been on. It's no wonder that it is used to successfully treat some of the most severely depressed inpatients. But it made me so much better than I could no longer tolerate the side effects.

> Does this med produce tachycardia to the same extent that meds like despiramine and nortrypaline do?

In my experience (but I have never taken desipramine), yes.

> How were other side effects.

The worst was anorgasmia, which caused me to stop taking it. It also caused some short-term memory impairment.

Oh, and by the way, Pluto:

> Nortryptiline and desipramine, both have high affinity on noradrenaline

What does this mean? Do you mean that these drugs mainly work by inhibiting noradrenaline reuptake? Or that they have alpha-1 receptor antagonism as a side effect?

> while clomipramine mainly targets serotonin.

Again, what does that mean? Blocking the serotonin transporter? Blocking serotonin-2 receptors? In point of fact, clomipramine is an extremely potent serotonin reuptake inhibitor and a moderately potent noradrenaline reuptake inhibitor. Its active metabolite, desmethylclomipramine, is an extremely potent noradrenaline reuptake inhibitor (about as powerful as desipramine at this). After steady-state concentrations of both clomipramine and its desmethyl- metabolite have been reached (about a week or two), the concentration of the desmethylclomipramine is substantially higher. Therefore, it is misleading to state, as you did, that "clomipramine mainly targets serotonin".

> Tachycardia is a problem with noradrenergic drugs.

Very vague. Beta blockers are "noradrenergic drugs" but they can cause severe bradycardia. I suppose you mean drugs that inhibit noradrenaline reuptake.

> If you are too concerened with it, try to add prazosine or doxazosine at low doses.

Are you for real? Prazosin and doxazosin are alpha-1 antagonists (the tricyclics possess this property to varying degrees and it causes postural hypotension, impotence and can contribute to tachycardia). They cause vasodilation on the arterial side, which will lead to, not ameliorate, (reflex) tachycardia! Also, you forgot to mention that tricyclic-induced tachycardia is in large part due to muscarinic acetylcholine receptor antagonism (reducing the parasympathetic influence on the heart, and altering the balance in favour of sympathetic input to the heart).

Linkadge,

If you are in the midst of a Major Depressive Episode of any severity, I commend this drug to you. If you're treatment resistant or getting to the point of needing admission, I would especially urge you to consider clomipramine.

Best of luck, mate,

Keith.


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poster:Keith Talent thread:353222
URL: http://www.dr-bob.org/babble/20040602/msgs/353727.html