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Dr. Bob is Robert Hsiung, MD,
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Posted by linkadge on April 10, 2010, at 12:46:11
In reply to How Is Clomipramine Different From An SSRI?, posted by bulldog2 on April 10, 2010, at 12:24:22
Clomipramine's metabolite is preferentially a NRI. So overall, clomipramine has some potent noradrenergic activity.
Other mechanisms with potential theraputic effect are:
- opioid receptor activity (like other TCA's)
- 5-ht2 receptor antagonism (AD augmentation)
- 5-ht7 antagonism (augments hippocampal serotonin levels)
- antihistamine action (anxiety)
- anticholingeric function (anxiety / depression)
- interaction with receptor channnels (anxiety, and affect stabilization)etc.
Linkadge
Posted by Phillipa on April 10, 2010, at 12:48:45
In reply to Re: How Is Clomipramine Different From An SSRI?, posted by linkadge on April 10, 2010, at 12:46:11
I heard from a former babbler that this med had horrible side effects. True or false? Phillipa
Posted by bulldog2 on April 10, 2010, at 13:20:11
In reply to Re: How Is Clomipramine Different From An SSRI?, posted by linkadge on April 10, 2010, at 12:46:11
> Clomipramine's metabolite is preferentially a NRI. So overall, clomipramine has some potent noradrenergic activity.
>
> Other mechanisms with potential theraputic effect are:
>
> - opioid receptor activity (like other TCA's)
> - 5-ht2 receptor antagonism (AD augmentation)
> - 5-ht7 antagonism (augments hippocampal serotonin levels)
> - antihistamine action (anxiety)
> - anticholingeric function (anxiety / depression)
> - interaction with receptor channnels (anxiety, and affect stabilization)
>
> etc.
>
> Linkadge
>
>
>
>
>
>
>Thank. Excellent info. Right now my p-doc and I and considering your recent med trial. He likes it. I have climbed slowly on elavil to 30 mg with virtually no problems and I like the way it feels. At 30 really doesn't feel that dirty.Probably will add in the stimulant soon.
However it seems as if clomipramine might be more powerful than elavil. I was wondering if clomipramine might be more powerful than the other tcas on a mg per mg basis. I've heard of it's terrible sides but I was wondering if it might be more tolerable if one goes up slowly and has a goal of a low dose. I generally do not require high doses on these meds.
For purposes of pain control does any tca have more opioid activity than the others?
Posted by manic666 on April 10, 2010, at 13:46:39
In reply to Re: How Is Clomipramine Different From An SSRI?, posted by bulldog2 on April 10, 2010, at 13:20:11
jesus, i have just been reading about clomipramine//pesonally i would sooner take a chance with a cobra bite than take that //my opinion wwwwhoooooo //????????
Posted by bulldog2 on April 10, 2010, at 14:13:54
In reply to Re: How Is Clomipramine Different From An SSRI?, posted by manic666 on April 10, 2010, at 13:46:39
> jesus, i have just been reading about clomipramine//pesonally i would sooner take a chance with a cobra bite than take that //my opinion wwwwhoooooo //????????
Can you elaborate a bit? Can always stay with the elevil.
Posted by linkadge on April 10, 2010, at 16:14:49
In reply to Re: How Is Clomipramine Different From An SSRI?, posted by bulldog2 on April 10, 2010, at 13:20:11
In my experience clomipramine *was* superior to amitriptyline in terms of both improved efficacy and fewer side effects.
Clomipramine was just one hell of a potent antidepressant (better than parnate, effexor, remeron+effexor, all the SSRI's, etc. etc.)
The only reason I am on amitriptyline vs. clomipramine is that clomipramine is genotoxic and amitriptyline is not.
Right now however I find methylphenidate alone is working better for my depression than either elavil or cipralex.
Linkadge
Posted by linkadge on April 10, 2010, at 16:17:05
In reply to Re: How Is Clomipramine Different From An SSRI? » manic666, posted by bulldog2 on April 10, 2010, at 14:13:54
I would not say that clomipamines side effects are bad at all. For me, they were *far* more tollerable than those of an SSRI.
Zero anxiety, insomnia, apathy, (some sexual dysfunction), no loss of energy, interest. Basically some dry mouth, a litle initial sedation, and an elevated heart rate.
Linkadge
Posted by bulldog2 on April 10, 2010, at 16:33:58
In reply to Re: How Is Clomipramine Different From An SSRI?, posted by linkadge on April 10, 2010, at 16:17:05
> I would not say that clomipamines side effects are bad at all. For me, they were *far* more tollerable than those of an SSRI.
>
> Zero anxiety, insomnia, apathy, (some sexual dysfunction), no loss of energy, interest. Basically some dry mouth, a litle initial sedation, and an elevated heart rate.
>
> LinkadgeThat sounds very promising. If I am having some response to elavil at 30 mg and will probably stop at 50 mg my hope would be that I might have a better response to clomipramine in the 30mg to 50 mg range.
Posted by viper1431 on April 10, 2010, at 21:58:34
In reply to Re: How Is Clomipramine Different From An SSRI?, posted by linkadge on April 10, 2010, at 16:17:05
> I would not say that clomipamines side effects are bad at all. For me, they were *far* more tollerable than those of an SSRI.
>
> Zero anxiety, insomnia, apathy, (some sexual dysfunction), no loss of energy, interest. Basically some dry mouth, a litle initial sedation, and an elevated heart rate.
>
> LinkadgePretty much sums up my experiance with it as well.
Posted by manic666 on April 11, 2010, at 3:58:48
In reply to Re: How Is Clomipramine Different From An SSRI?, posted by viper1431 on April 10, 2010, at 21:58:34
thats fair enough , better to hear it from user,s than read it//it was the organ faliure sh*t that screwed me on the company leaflet//if it goes wrong.paralysis of the large intesttine//goes on to say life threating//induction of schizophrenia///if you have a heart prob it makes it worsen///an you can give it your dog/// you both can go to weight watcher togeather as it ups the weight//it goes on to say that it works better than any ssri, but the side effect prob is 10 times more dangerouse to some//so its the old swings an roundabout game///good look
Posted by ed_uk2010 on April 11, 2010, at 7:07:13
In reply to see you at the vetinary clinic, posted by manic666 on April 11, 2010, at 3:58:48
> thats fair enough , better to hear it from user,s than read it//it was the organ faliure sh*t that screwed me on the company leaflet//if it goes wrong.paralysis of the large intesttine//goes on to say life threating//induction of schizophrenia///if you have a heart prob it makes it worsen///an you can give it your dog/// you both can go to weight watcher togeather as it ups the weight//it goes on to say that it works better than any ssri, but the side effect prob is 10 times more dangerouse to some//so its the old swings an roundabout game///good look
Tricyclic antidepressants have been around for a long time. The manufacturer's leaflets have a long list of side effects, including a lot of rare ones as well as all of the common ones. Although clomipramine causes side effects frequently, most of the side effects are not serious.
Clomipramine needs to be started at a low dose and increased gradually. The initial dose should be 10mg or 25mg at night, for those who have never taken a TCA before.
Posted by hopefullynow on April 11, 2010, at 9:31:23
In reply to Re: see you at the vetinary clinic, posted by ed_uk2010 on April 11, 2010, at 7:07:13
Personally I feel that clomipramine is the best of the TCA's as relieving depression, pain, low affect, anxiety or anhedonia (mental, not low energy).It is the foundation of my treatment, even at 25 mg/day it have a dramatic effect on my affect.I find it increasing my feelings(not decreasing like SSRI's), I feel more in love with my family, i become more carring, tender.It helps me with pain tremendously, I did sports all my life and have a lot of injuries, back, knees, pains, all are massive decreased.
As a side note, when I'm depressed i can't reach the "runner's high", no matter how vigurous I excercise, I workout obsessive to reach this state, but I can't reach it.Clomipramine, it seems that reverts my opoid system to normal, so after my morning workout I can feel that wonderful post-exercise feeling all day, as normal.
In my opinion, when Clomi works, the side effects like dry mouth or transient somnolence are nothing besides the normalcy it gives me.Personally, I like it combined with a NRI for increased hedonic and energy effect.
Posted by manic666 on April 11, 2010, at 11:05:24
In reply to Re: see you at the vetinary clinic, posted by hopefullynow on April 11, 2010, at 9:31:23
thanks sounds cool how it works for you that way///i could do with the pain releaf you get/stay safe
Posted by Justherself54 on April 11, 2010, at 11:12:35
In reply to Re: see you at the vetinary clinic, posted by ed_uk2010 on April 11, 2010, at 7:07:13
My pdoc started me at 50 mg, which is unusual for him. We usually start off slowly. I'm wondering if he wants to ramp it up quickly to try to get the anti-depressant effect working, as I was one step from a stay at the crisis unit.
I'm very sedated, but nothing like the other TCA's I've tried. If the sedation doesn't go away, I hope there is something we can augment with to help with that, but it's too early in the game to worry about it.
As for the really dangerous side effects, after waking up pain free, I'm not even going to research them. Now that's a first for me.
Posted by hopefullynow on April 11, 2010, at 12:07:55
In reply to Re:clomipramine, posted by Justherself54 on April 11, 2010, at 11:12:35
> My pdoc started me at 50 mg, which is unusual for him. We usually start off slowly. I'm wondering if he wants to ramp it up quickly to try to get the anti-depressant effect working, as I was one step from a stay at the crisis unit.
>
> I'm very sedated, but nothing like the other TCA's I've tried. If the sedation doesn't go away, I hope there is something we can augment with to help with that, but it's too early in the game to worry about it.
>
> As for the really dangerous side effects, after waking up pain free, I'm not even going to research them. Now that's a first for me.The sedation will go away eventually, maybe not entirely but to a decent degree.Of course you can augument clomipramine with something noradrenergic if sedation is bothering.I found that th side effects subside after a few weeks.Anyway, 50 mg is a little bit too much for a starting dose, maybe your pdoc wants you to get an anti-depressant effect quicker.Good luck and don't give up on clomi.
Posted by bulldog2 on April 11, 2010, at 13:10:10
In reply to Re:clomipramine, posted by Justherself54 on April 11, 2010, at 11:12:35
> My pdoc started me at 50 mg, which is unusual for him. We usually start off slowly. I'm wondering if he wants to ramp it up quickly to try to get the anti-depressant effect working, as I was one step from a stay at the crisis unit.
>
> I'm very sedated, but nothing like the other TCA's I've tried. If the sedation doesn't go away, I hope there is something we can augment with to help with that, but it's too early in the game to worry about it.
>
> As for the really dangerous side effects, after waking up pain free, I'm not even going to research them. Now that's a first for me.Linkadge used ritalin low dose with his amitriptyline and seemed pleased with the results.
Posted by Phillipa on April 11, 2010, at 19:56:23
In reply to Re:clomipramine, posted by Justherself54 on April 11, 2010, at 11:12:35
Wow so sorry it's that bad I really am. Please get well. Love Phillipa
Posted by Phillipa on April 11, 2010, at 20:10:59
In reply to Re:clomipramine, posted by Justherself54 on April 11, 2010, at 11:12:35
I looked and saw that three divided doses might lessen sedation. And that once a dose is decided on for maintenance that taking all at night to avoid sedation. Love Phillipa
Posted by g_g_g_unit on April 13, 2010, at 5:59:19
In reply to Re:clomipramine » Justherself54, posted by Phillipa on April 11, 2010, at 20:10:59
dang, all this clomipramine love is making me regret passing over it when given the chance to try it .. i always figured it would be a sedating/hunger-inducing/mentally numbing
Posted by Justherself54 on April 13, 2010, at 12:55:12
In reply to Re:clomipramine, posted by g_g_g_unit on April 13, 2010, at 5:59:19
Hi GG..I'm not sure if it's a love story yet! I'm still pretty sedated, but it seems to be lifting..still no pain..although I'm not sleeping very well..and no appetite..on the flip side, I'm out of my pj's, did my hair and makeup for the first time in weeks and am going to try to go get some groceries. I had to get a friend to shop for me last week as I just couldn't get it together to go out.
I'm going to give this med the best trial I can.
Posted by bulldog2 on April 13, 2010, at 16:08:59
In reply to Re:clomipramine » g_g_g_unit, posted by Justherself54 on April 13, 2010, at 12:55:12
> Hi GG..I'm not sure if it's a love story yet! I'm still pretty sedated, but it seems to be lifting..still no pain..although I'm not sleeping very well..and no appetite..on the flip side, I'm out of my pj's, did my hair and makeup for the first time in weeks and am going to try to go get some groceries. I had to get a friend to shop for me last week as I just couldn't get it together to go out.
>
> I'm going to give this med the best trial I can.Sounds like you're making progress. What dose are you on and what dose are you aiming for? Good luck!
Posted by Justherself54 on April 13, 2010, at 18:29:23
In reply to Re:clomipramine » Justherself54, posted by bulldog2 on April 13, 2010, at 16:08:59
I'm at 50 mg. I have to call pdoc on Thursday to discuss whether we'll try an increase or just stay at 50 mg. for a bit longer. I have to drive for a couple of hours tomorrow. That's usually a killer for my coccyx and I have a lot of trouble getting out of the vehicle after driving. As the pain still hasn't returned, it'll be interesting to see how I make out..whether or not I'll have the same pain during driving or hopefully, none at all.
Posted by Phillipa on April 13, 2010, at 20:15:43
In reply to Re:clomipramine » bulldog2, posted by Justherself54 on April 13, 2010, at 18:29:23
You are very brave. I commend you. And hopefully no pain. Good luck!!!!! Post back and let us know? Love Phillipa
Posted by bulldog2 on April 14, 2010, at 15:16:00
In reply to Re:clomipramine » bulldog2, posted by Justherself54 on April 13, 2010, at 18:29:23
> I'm at 50 mg. I have to call pdoc on Thursday to discuss whether we'll try an increase or just stay at 50 mg. for a bit longer. I have to drive for a couple of hours tomorrow. That's usually a killer for my coccyx and I have a lot of trouble getting out of the vehicle after driving. As the pain still hasn't returned, it'll be interesting to see how I make out..whether or not I'll have the same pain during driving or hopefully, none at all.
I think adrafanil makes a 75 mg sr. A killer for my coccyx was snow shoveling. I was at the end had a heavy shovel full and felt my whole lower back spasm. Next morning woke up with sciatica. There were two more snowstorms and I reinjured my lower back each time. Now it won't heal. Need opana-er (sustained released oxymorphone) in the morning plus percocet to just get out of bed. This was the winter that did me in! Good luck with the clomipramine.
Posted by conundrum on April 14, 2010, at 19:55:06
In reply to Re:clomipramine, posted by bulldog2 on April 14, 2010, at 15:16:00
I think you mean Anafrinil which is Clomipramine. Adrafinil is Olmifon. Just trying to prevent confusion. :)
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