Posted by Brainbeard on July 29, 2009, at 15:45:38
In reply to Clomipramine vs Amitryptaline, posted by Meltingpot on May 17, 2009, at 11:25:34
Hi,
I've been on both clomipramine and amitriptyline, but the latter only in very small doses, which work for chronic pain. Clomipramine as a stand alone med was a great antidepressant for me, but it caused a kind of sensitivity to sunlight that hurt my eyes, which was too much for me. I then combined it with fluvoxamine (Luvox), which raises clomipramine levels about tenfold while lowering the levels of its noradrenergic metabolite. I took 150mg of Luvox and just 10mg of clomipramine and it worked amazingly well. I did have bouts of tiredness, though, but I felt great so I wasn't bothered about it.
400mg of clomipramine is an unusually high dose. The normal maximum dose is 250mg for outpatients and 300mg for inpatients! For many people, 400mg could be deadly ad would at least be dangerous. Only when you have a pretty quick liver would you be able to handle such a high dose well. Clomipramine inhibits its own metabolism, which is why its blood levels become exponentially higher from doses of 250mg and above, which is why 300mg is the maximum recommended dose.
Amitriptyline would be a poor choice if you don't wanna be sedated: it's one of the most sedating TCA's with a very strong affinity for the H1-receptor.
If you want a more activating TCA with less sedation, I can recommend imipramine. Imipramine is a very good SNRI, but its serotonin reuptake inhibition is not as strong as clomipramine (it ranges somewhere between fluvoxamine and citalopram (Celexa), actually). It is an activating antidepressant for me at just 25mg, although you would probably need more if you use it as a stand alone drug. Its active metabolite is desipramine, which is a very potent NRI. Imipramine is even used for ADD, which tells something. It has a much lower affinity for the H1-receptor than amitriptyline and clomipramine.
Oh, it does raise my pulse strongly, but that gets better over time. Can also raise blood pressure, though lower it as well on higher doses.Hope this helps some.
poster:Brainbeard
thread:896239
URL: http://www.dr-bob.org/babble/neuro/20090701/msgs/909184.html