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Re: Clomipramine vs. Nardil » Phoenix1

Posted by Crotale on June 19, 2008, at 23:19:05

In reply to Re: Clomipramine vs. Nardil » Crotale, posted by Phoenix1 on June 19, 2008, at 18:24:51

> I went as high as 90mg on Nardil, but was at 75 when things hit the fan.

Ah. Why (if I may ask) did you keep increasing it after, as you say, things hit the fan?

> I had a hypertensive crisis that the ER misdiagnosed as conversion disorder. The treatment delay resulted in a form of encephalopathy called PRES. (See my earlier posts here: http://www.dr-bob.org/babble/20080519/msgs/830220.html )

I'm confused; I thought the PRES was the result of too-rapid discontinuation of Nardil. (I sympathize; I had a terrible time when I had to go off Nardil extremely rapidly.)

Well, anyway, it sucks that you got misdiagnosed with "conversion disorder." That's just the sort of thing doctors do to psych patients.

> I still have neurologic sequelae. Since they don't know what caused the hypertensive crisis (I'm sure it wasn't dietary), and PRES is extremely rare, they won't let me go back on Nardil.)

It seems to me that it wasn't the Nardil but too-rapid discontinuation of the Nardil that caused the PRES....

How bad was the hypertensive crisis? (That is, how high was BP?)

> I'm finding that even 10mg of Clomipramine is quite sedating, but the sedation doesn't help my anxiety.

I found that with the sedation from TCAs also. (The sedative effect is mainly, I think, because they are antihistamines.) I had better luck with secondary-amine TCAs (desipramine, nortriptyline, etc.) -- less sedating and less anticholinergic side effects (constipation, dry mouth, etc.) -- although I ended up having to go off desipramine b/c of a seizure (unfortunately, because it was working rather well for me).

> I also feel spaced out, quite like my previous SSRI experiences. But I guess I have to give it some more time. I think my biggest fear is that it will actually be effective, but that I will be miserable with the side effects...

If it is effective, a different TCA might work as well with milder side fx...just a thought. Best of luck to you.

Crotale


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poster:Crotale thread:835192
URL: http://www.dr-bob.org/babble/20080617/msgs/835577.html