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Re: clomipramine insomnia - does it ever go away? » TriedEveryMedication

Posted by SLS on January 25, 2023, at 8:24:31

In reply to clomipramine insomnia - does it ever go away?, posted by TriedEveryMedication on January 25, 2023, at 5:15:30

> tried a single 25mg capsule at bed time, it kept me up all night and even though I didn't take any more, it kept me up the next night too.

I don't like using you as an example of my pet peeves with how the Psycho-Babble mentality has reduced your chances of getting well, but I will.

When your life depends on the successful treatment of a seemingly intractable illness, why would you stop taking a drug just because it kept you awake one night after the very first dose? Did you fall to the ground writhing in pain? For God's sake - for *your* sake, *go back* to following your doctor's instructions. Adhere to the fundamentals of clinical psychophadrmacology that have proven effective for decades. Even if the insomnnia doesn't resolve by itself, then treat the insomnia. You don't have a better choice if this stuff has the potential to work.

Try to tolerate startup side effects. If the side effects persist, even after an antidepressant response, deal with it. Don't give up just for one night's sleep disturbance.

Insomnia. Deal with it.

Clomipramine might diminish your sex drive. Deal with it. Clomipramine might prevent you from achieving orgasms. Deal with it. If you have really "TriedEveryMedication", why the heck are you being so picayune about side effects, many of which mitigate or disappear altogether?

I couldn't sleep for almost two weeks when I first began treatment with Parnate and desipramine - which produced a robust response (Six months beginning in June of 1987). Two weeks. Had I decided to quit taking those two drugs after my first day of insomnia, I would never have achieved remission back then. The only reason treatment was discontinued is because a delusional mania emerged after six months of a stable remission. After I finally found another doctor willing to treat me with the exact same combination of drugs, I never again responded to it.

That's another lesson to be had. It applies to "pulsing" antidepressants or adjuncts - taking the same or similar drug treatments multiple times: "Antidepressant discontinuation-induced treatment refractoriness". If you are chronically TRD, you are probably a *lifer* of a successful treatment.

Nardil gave me persistent (partial) insomnia, dizziness, and fainting, especially at the beginning of treatment. It made me sit on the toilet for 30-45 minutes just to achieve micturition (urination). It was scary. I didn't want to go to the hospital to be catheterized. It was worth the 45 minutes. I took bethanechol (Urecholine) to be mitigate this side effect. I believe it is a pro-cholinergic. I had no intention of stopping treatment.


> does this get better? or should i dose in the morning?

It might not make any difference when you take it, but you can take it all at once in the morning to see what happens. It is certainly worth a try before remediating the insomnia with medication.


- Scott

I didn't have any insomnia at all with clomipramine (Anafranil). It did diminish my sex drive. The side effects were a hybrid of TCA and SSRI Otherwise, it felt I


Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

 

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