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Author Topic: Clomipramine Needing Some Assurance  (Read 266 times)

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Offline BusuB

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Clomipramine Needing Some Assurance
« on: December 05, 2013, 06:57:52 PM »
I keep reminding myself that I've only been on clomipramine for the past 5 weeks and I've been having good days... but today is... not so good. Been feeling jumpy and anxious all day.  It's calmed down a bit in the last 30 minutes or so, but are these bad days normal this far into treatment?
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Offline Abraham2007

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Re: Clomipramine Needing Some Assurance
« Reply #1 on: December 05, 2013, 08:09:03 PM »
I keep reminding myself that I've only been on clomipramine for the past 5 weeks and I've been having good days... but today is... not so good. Been feeling jumpy and anxious all day.  It's calmed down a bit in the last 30 minutes or so, but are these bad days normal this far into treatment?

You could should ask your doctor about staying on a benzodiazepine (benzo)  temporarily, as you transition on to the Clomipramine, as the Clomipramine finally settles in your system. Once the AD takes into effect, then gradually wean off that benzo.  On the benzo, you'll feel much calmer, instead of anxious as you wait for the Clomipramine to kick in.

Since you came to Anxiety Zone, you're probably an anxious person in general, but your body can't produce the GABA on its own, so your brain should turn to the benzo for help, until the AD takes into affect.

It can take up to twelve weeks for you to feel the impact of a trycylic antidepressant.   You're only on week five, so you need to give your brain more time for adjustment to the TCA.

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Offline insights

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Re: Clomipramine Needing Some Assurance
« Reply #2 on: December 05, 2013, 10:43:14 PM »
are these bad days normal this far into treatment?

Yes, it may take 12 weeks for antidepressants to kick-in and the TCAs tend to be slower starters than the SSRIs. Dose is also critical. How much are you taking?

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline BusuB

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Re: Clomipramine Needing Some Assurance
« Reply #3 on: December 06, 2013, 12:41:53 AM »
Bah! Twelve weeks? I'm at 75 mg at the moment.
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Offline insights

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Re: Clomipramine Needing Some Assurance
« Reply #4 on: December 06, 2013, 02:26:39 AM »
Bah! Twelve weeks? I'm at 75 mg at the moment.

That is down at the low end of the therapeutic dose range so you may need to go higher, but you first need to give the 75mg a few more weeks to prove itself or not.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online stevo1111

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Re: Clomipramine Needing Some Assurance
« Reply #5 on: December 06, 2013, 08:53:06 AM »
First, rest assured, for anxiety disorders, the data suggests that Clomipramine is among the very best! A very underutilized medication these days.

Second, based on my own success with Clomiprame supplemented with methyl folate, I feel obligated to suggest it to you.

More and more empirical research is coming through that supplementing an antidepressant with Methyl folate (sold as the medical "food" Deplin) greatly increases their efficacy in people with the MTHFR mutation. The methylation cycle is necessary for the production of neurotransmitters. With all sorts of down regulation and that business that no one really understands, correcting the issue is at best a guess. The data is shaky at best on how many folks have this mutation, but I am among the low percentage who is homozygous, meaning I can't process folic acid into it's methylated form, nearly at all. My gut tells me a decent portion of us who don't have an amazing response to antidepressants may have a methylation issue. I went through 7 antidepressants before I landed on Clomipramine. I was on it for about 1 month at minimum therapeutic dosage before adding in methylfolate, 7.5mg a day. Within a week of adding it in it was like night and day. By itself, Clomipramine worked ok, just like the other antidepressants I tried. I definitely could not have a panic attack, but it didn't touch my generalized inner tension.

Methyl folate is not an additional medication, its a B vitamin, and has no side effects to speak of. I would strongly suggest asking your Pdoc about it. You can buy it online as 5-mthf, probably branded as metafolin. It costs me about $1 a day U.S. to supplement my antidepressant with it. Also, I'm not a hippie who believes in the power of dandelion root or healing crystals, so I recommend 5-mthf based on personal experience, peer reviewed studies, and other empirical responses I've encountered.

Best,

S
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