Posted by Vincent_QC on February 13, 2009, at 7:05:32
In reply to Not tolerating Clomipramine well, which TCA to try, posted by incubusfan5 on February 10, 2009, at 11:45:24
> After only three days on Clomipramine, I've decided I can't do a trial of it due to the side effects. I became so weak/lethargic, all I could do was lay down and watch tv. I need to attend class and do homework, so this is a problem.
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> I suffer from the full gammut of depresson, GAD, SAD, OCD, and inattentive ADD. My doctor seems to think nortryptaline has the least amount of side effects, but doesn't think it would be helpful with OCD like the Clomipramine would. I know my mom took imipramine in the past with success, before later switching to Paxil.
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> I've tried multiple SSRIs, but never Luvox, which is indicated in OCD. If all other SSRIs have failed, is Luvox still worth trying? Any opinions of which tricyclic would be best besides Clomipramine? Sedation is no good for me.
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> Thanks.Hi incubusfan5,
I just to know some basic facts...What was the dosage of Clomipramine you take at the begining ?I just started the Clomipramine yesterday at 20mg/day for one week, after also severals try of AD's (All the SSRI's, SRNI's, MAOI'S - Nardil-Parnate, as well as anticonvulsive drugs like Gabapentin , lyrica...) name all of them, I try everything avaible in the Canada to treat my Social anxiety with general anxiety,BDD (body dismorphic disorder), panic disorder and depression...nothing improve me, with the exception of the Rivotril but only the first months I was on it...after I became addicted and the rest is history...
Normally i'm very sensible to the side effects of new drugs I try... The only one AD I try 2 times and when I never get any side-effects and never feel anything weak or strange on it was the Zoloft, I Was able to take more than the maximum dosage of it for a lot of months without improving at all, in fact I only gain a lot of weight on it...
So it's why I ask you what was your start dosage for Clomipramine, because people who suffer from GAD and SAD often have more difficulties finding the good drug to help them because all the AD seem to do the inverse effect at the begining of the treatment, mean more anxiety and less social interraction...
I drop out several tries of drugs because I was unable to wait until the bad side-effects disepear...
The Clomipramine seem to be the best choice for you since you have OCD...it's the most selective of all the TCA's for the SE, with less effect on the NE and a weak effect on the DA...but it's not the best choice for the ADD, since you need something who will hit more the NE for this...but if you have GAD and SAD, it's probably better to stay on the Clomipramine...
Did you ever try a MAOI before? The parnate seem to be the best choice for you...if you dont have heart problems of course since it can give hypertension...but for MY experience, the Parnate hit more the NE at first, in MY case, I can't tolerate NE action of a drug cause my blood pressure always get higher....Another time, I drop the Parnate because I was feeling a lot tired on it and I had hypertension crisis often...but it was GOOD for my anxiety (social and general)...
For now i'm only at 20mg of Clomipramine day for one week, will be at 50mg the weeks after and me and the PDoc will see how I react...I dont feel any negatives side-effects at all at this low dosage...that's a miracle because normally I always feel something (exception of the Zoloft of course)...
What I can say for now, is that I'm already in a panic disorder state since more than 2 weeks...I have severals panic attacks that occurs everywhere (my car, alone in front of my LapTop, in my bed...and of course in social situation)...So The Clomipramine don't worse my state for now, I don't feel sedation from it as well...in fact I think we are all different for the sedation effect...I take it at bedtime with a low dose of Seroquel (50mg) to prevent insomnia and be able to sleep more at night (around 5-6 hours), the 50mg of Seroquel begin to loose some of is power so I will ask for 75mg...
I'm not sure if I can mix the Clomipramine of the Seroquel together but for now everything is fine, it can't be worse anyway...I had to take 30mg of Valium each day now because I feel too much anxious....before I was only at 20mg...the strange sensation I feel inside my head make me crazy...I feel A LOT ANXIOUS and I fear a seizure so I take more Valium pills...but they do nothing...That's weird this sensation (like someone play with my brain and pus it really hard)...
Anyway, take care of you and do what you feel it's the best for you...maybe your start dosage was too high also, cut the pills by half sometimes help to reduce the side-effects...anyway I think TCA's , like all the SSRI's, take more than 2-4 weeks before some improvements occurs...
I wish you a good luck and also I hope everything will be fine ;-)
Have a nice day!
Vincent ;-)
poster:Vincent_QC
thread:879244
URL: http://www.dr-bob.org/babble/20090213/msgs/879833.html