Posted by tom2228 on March 19, 2014, at 12:05:21
In reply to Re: TCAs calming vs. sedating/ nortrip vs. Saphris SLS » tom2228, posted by phidippus on March 19, 2014, at 11:14:00
> What did you think of the idea of Clomipramine?
>
> EricI am concerned about how potently serotonergic it is and that it might feel like an SSRI and have the related side effects like apathy, sexual dysfunction
Regarding the "obsessive ruminations"/ GAD there is a part of this aspect of me that is ego-syntonic; I am a very cognitive person and hate the mind-numbing apathy "blah" feeling that I associate with SSRIs and that isn't there with the MAOI.
I realize that I'm generalizing and that the feeling of these drugs often doesn't match up with what we expect based on our perception and interpretation of binding affinities, etc.
Otherwise it does seem relatively kind regarding sedation compared to other TCAs.. well, with respect to H1; it's the least kind at a1. On that note, I'm not quite sure about trying nortrip first anymore.. Having taken Zyprexa last night I am reminded about how much I hate sedation. According to Stahl sedation and cognitive functions are mediated by the same histaminergic, alpha-adrenergic, and anticholinergic (when combined with anitihistaminergic effects). I'd rather have the calming aspects mediated through something other than H1 which brings us back to clomipramine. This is driving me crazy! As if.
Also it would take a 2-week washout to try clomi and I seriously cannot take that. The safety of starting desip/ protrip/ nortrip with less of a washout will be part of my argument of just adding the TCA to the MAOi.
That and if the new pdoc is not cool with the combo, I would ask if the MAOI could be added back slowly if a TCA alone failed -- this would not be possible with clomi.Have you tried clomipramine? If so, how was it with the "SSRI" side effects I talked about above?
poster:tom2228
thread:1062693
URL: http://www.dr-bob.org/babble/20140307/msgs/1062767.html