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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by kizzie2 on March 7, 2011, at 10:57:30
Hi everyone - sorry this is my 2nd question in as many weeks.
I have just had to reduce down to 35mg 2 weeks ago from 50mg anafranil because drowsiness was affecting my driving to work too much.
I have been on ad's for 11 years since being treated originally for PND with seroxat.
I dropped the 15mg over a few weeks by splitting capsules (have had withdrawal probs in the past).
Unfortunately my anxiety has increased and have started having unpleasant obsessive thoughts and lows. My aim is to try and stick it out and hopefully things will calm down. (In 2007/8/9 I was very weel on 25mg and below anafranil).
I know some of you are very knowledgable about equivalent doses and also how they are absorbed in the body. So just wondering where I am now at 35mg in comparison to seroxat/prozac. And also will there be a significant difference in rate of absorption (I think thats what I mean) at 35mg rather than 50mg.
I hope these questions make sense - thank you for your help.
Kizzie x
Posted by tensor on March 7, 2011, at 14:23:19
In reply to Is 35mg anafranil still an 'actual' dose?, posted by kizzie2 on March 7, 2011, at 10:57:30
> Hi everyone - sorry this is my 2nd question in as many weeks.
>
> I have just had to reduce down to 35mg 2 weeks ago from 50mg anafranil because drowsiness was affecting my driving to work too much.
>
> I have been on ad's for 11 years since being treated originally for PND with seroxat.
>
> I dropped the 15mg over a few weeks by splitting capsules (have had withdrawal probs in the past).
>
> Unfortunately my anxiety has increased and have started having unpleasant obsessive thoughts and lows. My aim is to try and stick it out and hopefully things will calm down. (In 2007/8/9 I was very weel on 25mg and below anafranil).
>
> I know some of you are very knowledgable about equivalent doses and also how they are absorbed in the body. So just wondering where I am now at 35mg in comparison to seroxat/prozac. And also will there be a significant difference in rate of absorption (I think thats what I mean) at 35mg rather than 50mg.
>
> I hope these questions make sense - thank you for your help.
>
> Kizzie xAt that dosage it will still be a strong inhibitor of serotonin reuptake, but that's only one of many mechanisms of action. If you need 50mg, have you tried to split the dose over the day? Also, the drowsiness usually wears off with time.
You can't really compare Seroxat or Prozac with CMI.
/Mattias
Posted by Roslynn on March 8, 2011, at 14:46:30
In reply to Re: Is 35mg anafranil still an 'actual' dose? » kizzie2, posted by tensor on March 7, 2011, at 14:23:19
Hi, I don't know the answer to your question but I am taking anafranil and having a lot of drowsiness since my pdoc tried to increase me to 100mg. I don't know if I can continue to take it at that strength. I seem to do much better around the 50mg in terms of tolerating the med.
Good luck to you!
Roslynn
Posted by Brainbeard on March 10, 2011, at 8:40:27
In reply to Is 35mg anafranil still an 'actual' dose?, posted by kizzie2 on March 7, 2011, at 10:57:30
35mg of Anafranil would roughly equal 5-10mg of Seroxat and 20mg of Prozac. SRI-wise, that is.
Absorption won't differ much between 35 or 50mg.
Posted by kizzie2 on March 10, 2011, at 9:19:24
In reply to Re: Is 35mg anafranil still an 'actual' dose?, posted by Brainbeard on March 10, 2011, at 8:40:27
Thanks Brainbeard - that is very helpful
Posted by kizzie2 on March 10, 2011, at 9:21:02
In reply to Re: Is 35mg anafranil still an 'actual' dose? » kizzie2, posted by tensor on March 7, 2011, at 14:23:19
Thank you for replying - unfortunately the drowsiness doesnt wear off in time with me (even over many many months). I have also tried splitting the dose and taking at different times of the day but it doesnt seem to make any difference.
Posted by kizzie2 on March 10, 2011, at 9:22:16
In reply to Re: Is 35mg anafranil still an 'actual' dose?, posted by Roslynn on March 8, 2011, at 14:46:30
Hi - my pulse became very fast (and blood pressure low) on 100mg so I wasnt able to take that dose. Good luck to you too!
Posted by kizzie2 on March 10, 2011, at 13:00:35
In reply to Re: Is 35mg anafranil still an 'actual' dose?, posted by Brainbeard on March 10, 2011, at 8:40:27
Hi brainbeard - sorry another question from your post. Would you mind explaining to me why the equivalent in seroxat is lower than in prozac. I dont really understand how ad's work but obviously know that prozac and seroxat are both ssri's so would have assumed the would be the same. Would be really interested in the answer.
Its so useful to have this site to get info like this :-)
Thanks!
Posted by Brainbeard on March 10, 2011, at 14:55:28
In reply to Re: Is 35mg anafranil still an 'actual' dose? » Brainbeard, posted by kizzie2 on March 10, 2011, at 13:00:35
> Hi brainbeard - sorry another question from your post. Would you mind explaining to me why the equivalent in seroxat is lower than in prozac.
It's because for SRI (serotonin reuptake inhibition, i.e. boosting the neurotransmitter serotonin), Seroxat is much more potent than Prozac. Clomipramine (Anafranil) is also a rather potent SRI. Prozac is much less potent as an SRI.
There have been studies showing that even 10mg of clomipramine can be enough to help with panic disorder. You could try and see how low you can go without losing benefit.
Posted by bleauberry on March 13, 2011, at 8:37:16
In reply to Is 35mg anafranil still an 'actual' dose?, posted by kizzie2 on March 7, 2011, at 10:57:30
It doesn't matter what an "actual" dose is. What matters, and all that matters, is how you personally feel on any particular med at any particular dose. Genetics, body weight, metabolism, other unseen yet undiagnosed complications....all of these play a role.
Keep in mind, most of the doses recommended were arrived at by researchers and pharmaceutical companies who had mostly cherry-picked patients. They were not, for the most part, fair representation of average patients sitting in waiting rooms.
My Lyme doctor starts patients at 1mg Lexpro, and that ends up being the final dose for some of them.
Ultimately however, deserves mention, their depression dissolves on antibiotics not antidepressants. A lot of curing of depression happens outside of psychiatry, since psychiatry is not involved in the cure. It only attempts at make guesses that might minimize symptoms.
My best dose of Nortriptyline was 3.5mg, along with 6mg Zoloft. Oh yeah, forgot Milnacipran....18mg. None of these are even close to a supposed starter dose.
Posted by kizzie2 on March 13, 2011, at 10:42:16
In reply to Re: Is 35mg anafranil still an 'actual' dose?, posted by Brainbeard on March 10, 2011, at 14:55:28
Thanks so much for explaining that.
Posted by kizzie2 on March 13, 2011, at 10:43:24
In reply to Re: Is 35mg anafranil still an 'actual' dose?, posted by bleauberry on March 13, 2011, at 8:37:16
Thanks - thats a good reminder that the only thing that matters is each persons individual response to a medication
Posted by kizzie2 on March 16, 2011, at 10:44:21
In reply to Re: Is 35mg anafranil still an 'actual' dose?, posted by Brainbeard on March 10, 2011, at 14:55:28
Hi - my dr has suggested that if I cant stabilise on this dose of anafranil this time (I have in the past) then he would look to switch me to cipralex or citalopram.
I just wondered if you knew what the equivalent of these two drugs would be to 35mg anafranil please.
(Here the drs dont tend to go into details like this. they just tend to give a standard dose to everyone.)
Thanks for your help
Posted by Brainbeard on March 16, 2011, at 14:50:26
In reply to Re: Sorry another equivalents question ... » Brainbeard, posted by kizzie2 on March 16, 2011, at 10:44:21
35mg Anafranil would (very) roughly be equivalent to about 40mg citalopram SRI-wise, but probably to about 20mg citalopram effectiveness-wise.
> Hi - my dr has suggested that if I cant stabilise on this dose of anafranil this time (I have in the past) then he would look to switch me to cipralex or citalopram.
>
> I just wondered if you knew what the equivalent of these two drugs would be to 35mg anafranil please.
>
> (Here the drs dont tend to go into details like this. they just tend to give a standard dose to everyone.)
>
> Thanks for your help
Posted by kizzie2 on March 20, 2011, at 12:06:01
In reply to Re: Sorry another equivalents question ..., posted by Brainbeard on March 16, 2011, at 14:50:26
thank you thats really useful! Very different to what i thought (I thought 35mg would be equivalent of about 10mg citalopram)
Posted by Brainbeard on March 20, 2011, at 15:32:41
In reply to Re: Sorry another equivalents question ... » Brainbeard, posted by kizzie2 on March 20, 2011, at 12:06:01
> thank you thats really useful! Very different to what i thought (I thought 35mg would be equivalent of about 10mg citalopram)
Maybe my estimation was a little high, but the fact of the matter is that citalopram is a relatively weak med whereas clomipramine is very strong.
Posted by Kizzie2 on March 22, 2011, at 8:38:40
In reply to Re: Sorry another equivalents question ..., posted by Brainbeard on March 20, 2011, at 15:32:41
Understood. thanks for your help!
Ps. I have posted another question about anafranil/clomip and would be very interested in your response if you see it.
This is the end of the thread.
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