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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by TheOutsider on October 1, 2004, at 15:48:30
I have been taking Anafranil (Clomipramine) for two months, reached the dosage of 150mgs two weeks ago.
Although I think it has helped depression and anxiety it has had many side effects and has not helped my social anxiety or ADD type symptoms.I recently spoke with my National Health Service Pdoc (who I do not particularly like), he said that I had to be on it for six months to really know if it would work or not. Is this correct-opinions please!
Posted by King Vultan on October 1, 2004, at 17:03:59
In reply to Do I realy have to stay on Anafranil for 6 months?, posted by TheOutsider on October 1, 2004, at 15:48:30
> I have been taking Anafranil (Clomipramine) for two months, reached the dosage of 150mgs two weeks ago.
> Although I think it has helped depression and anxiety it has had many side effects and has not helped my social anxiety or ADD type symptoms.
>
> I recently spoke with my National Health Service Pdoc (who I do not particularly like), he said that I had to be on it for six months to really know if it would work or not. Is this correct-opinions please!
No, I would say that 6 to 8 weeks at a dosage that is regarded as therapeutic should be sufficient. You also have the right to not put up with intolerable side effects, keeping in mind that any med you try will have side effects of some type.Many people experience relief from social anxiety and OCD with drugs that work heavily on serotonin as this one does, but this is really a poor choice for ADD type symptoms. For that, you generally need a med that is more dopaminergic. I personally did not have good luck with SSRI-type drugs for my social phobia and have had better luck with some of the more noradrenergic tricyclics, as well as the MAOIs. These drugs also tend to be at least somewhat better for ADD type symptoms, but the most effective drugs for this condition are generally ones from the stimulant class.
Todd
Posted by TheOutsider on October 2, 2004, at 7:33:57
In reply to Re: Do I realy have to stay on Anafranil for 6 months?, posted by King Vultan on October 1, 2004, at 17:03:59
a
Posted by TheOutsider on October 2, 2004, at 12:32:17
In reply to Re: Do I realy have to stay on Anafranil for 6 months?, posted by King Vultan on October 1, 2004, at 17:03:59
So I need to be on a dose of 150mgs for six to eight weeks? I've already been on 150mgs for two weeks and I've been on a 100 miligrams for three weeks, is 100 miligrams a therapuitic dose?
Posted by King Vultan on October 2, 2004, at 23:37:26
In reply to Re: Do I realy have to stay on Anafranil for 6 months?, posted by TheOutsider on October 2, 2004, at 12:32:17
> So I need to be on a dose of 150mgs for six to eight weeks? I've already been on 150mgs for two weeks and I've been on a 100 miligrams for three weeks, is 100 miligrams a therapuitic dose?
Because this is a tricyclic antidepressant, probably the most expedient thing to do is to take advantage of the opportunity to have your blood plasma level tested to see how much of the drug is actually in your system. My reference shows that the therapeutic blood plasma level for this drug is 150-300 ng/ml.Todd
Posted by rod on October 3, 2004, at 6:45:16
In reply to Do I realy have to stay on Anafranil for 6 months?, posted by TheOutsider on October 1, 2004, at 15:48:30
> I have been taking Anafranil (Clomipramine) for two months, reached the dosage of 150mgs two weeks ago.
> Although I think it has helped depression and anxiety it has had many side effects and has not helped my social anxiety or ADD type symptoms.
>
> I recently spoke with my National Health Service Pdoc (who I do not particularly like), he said that I had to be on it for six months to really know if it would work or not. Is this correct-opinions please!
Well, I just can tell you, what many other doctors told me. Your doctor is right. Many others have told me the same, that they had some patients who fully responed after up to 6 month. These patients are few, but they do exist. And some long term studies confirm these findings. But its up to you to stay on it or try another. If its already doing a good job on the worst of your depsression and you cn function, I would give it a try. And I konw this is quite a long time... Its up to you>So I need to be on a dose of 150mgs for six to eight weeks? I've already been on 150mgs for two weeks and I've been on a 100 miligrams for three weeks, is 100 miligrams a therapuitic dose?
The standard rule is to wait for 2 month even after a dosage increase. So you are on 150mg for 2 weeks and should wait anohter 6 wqeeks to see if it works.
Thats what many experineced pdocs told me... make up your own mind.
Roland
Posted by skotch1 on October 3, 2004, at 19:46:20
In reply to Re: Do I realy have to stay on Anafranil for 6 months?, posted by TheOutsider on October 2, 2004, at 12:32:17
My dosage is 100mg... I've been on it almost two years and it is amazing for OCD... good luck
Posted by Keith Talent on October 4, 2004, at 6:44:53
In reply to Do I realy have to stay on Anafranil for 6 months?, posted by TheOutsider on October 1, 2004, at 15:48:30
> I have been taking Anafranil (Clomipramine) for two months, reached the dosage of 150mgs two weeks ago.
> Although I think it has helped depression and anxiety it has had many side effects and has not helped my social anxiety or ADD type symptoms.One-hundred and fifty milligrams is a "maybe, maybe not" kind of dose for many patients. From what I understand, 300 mg for four to eight weeks would give a definitive answer. Six months sounds ludicrous.
You need to know whether you do or do not have ADHD - if yes, your psychiatrist should prescribe a stimulant first. People here tend to say that dextroamphetamine or dexmethylphenidate (Focalin) or the high-tech extended-release methylphenidate (Concerta) are the best. I don't know personally, not having ADHD.
The social anxiety/Social Phobia needs clomipramine (or an SSRI) + as much clonazepam as needed (say 4 or 8 mg/day total, in two divided doses) + maybe a low dose stimulant (if the dose is too high, the benefits will be unsustainable; also, if you have ADHD, this fits nicely) + some cognitive therapy from a professional who knows what he/she is doing (for both the Major Depressive Disorder and the Social Phobia).
Personally, clomipramine is my all-time best antidepressant. I'm just looking into getting my doc to add a muscarinic cholinergic agonist like bethanecol to combat the anticholinergic side effects. I think that stimulants tend to help with the anorgasmia.
This is the end of the thread.
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