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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Jackster on August 29, 2001, at 5:56:43
Just want to compare notes on side effects experienced and any good results.
Jackie
Posted by SalArmy4me on August 29, 2001, at 15:41:24
In reply to Anyone on Anafranil (clomipramine)?, posted by Jackster on August 29, 2001, at 5:56:43
I was on it for three months earlier this year at 250 mg per day. The only side-effect I had consistently was sexual dysfunction. It did not alleviate my depression.
PARKER, GORDON. 'New' and 'old' antidepressants: all equal in the eyes of the lore?*. British Journal of Psychiatry. 179:95-96, August 2001"
"The Danish University Antidepressant Group (DUAG) was the first to challenge the comparable efficacy Zeitgeist, conducting separate double-blind studies of the TCA clomipramine and two SSRIs, citalopram (DUAG, 1986) and paroxetine (DUAG, 1990), with the TCA being more effective than the SSRIs in the overall samples... Thus, while the DUAG data indicate that endogenous (melancholic) patients were twice as likely to respond to clomipramine than to an SSRI, non-endogenous patients also showed an even greater likelihood (i.e. 5-7 times) of responding to the TCA."
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Posted by JohnL on August 29, 2001, at 15:44:59
In reply to Anyone on Anafranil (clomipramine)?, posted by Jackster on August 29, 2001, at 5:56:43
> Just want to compare notes on side effects experienced and any good results.
>
> JackieHi Jackie,
I am not currently on Adafranil, but I did try it for about two weeks. The side effects for me were excessive sweating, difficult and frequent urination, dry mouth, and darn impotence. I might have been able to deal with the other side effects, but the sexual dysfunction was absolutely not acceptable to me, so I had to dump it. I always believed there was something out there that would help me a lot without giving me sexual problems. It was a long haul, but I was right.Other than the typical side effects that can be expected with tricyclics, such as the urination thing or the dry mouth thing, Anafranil has been documented as being both PRO sexual as well as ANTI sexual. Some women have incredible sexual experiences on Anafranil, while others instead lose the ability to enjoy sex. It can go either way, and mileage obviously varies quite a bit. I hope it is working out well for you.
I think back in the old days Anafranil had a very good track record. Nothing has changed, except that these days most doctors tend to avoid the tricyclics in favor of SSRIs instead, mainly due to more tolerable side effects. But Anafranil has a long history of being a very good antidepressant. As with all meds however, mileage does vary.
John
Posted by JahL on August 29, 2001, at 17:17:09
In reply to Anyone on Anafranil (clomipramine)?, posted by Jackster on August 29, 2001, at 5:56:43
> Just want to compare notes on side effects experienced and any good results.
>
> JackieI was on 300mg/day a while back. Did nothing for my depression but then nor does anything else.
Side-effects were typical of TCAs; *sweating* (known as 'the sweating AD' amongst UK pdocs), urinary hesitancy, orthostatic hypotension & slightly blurred vision. Until I added Lithium Clomip. was surprisingly tolerable.
One thing you may want to watch out for is the fact that it has something of a reputation as a weight-gainer. I certainly developed a sweet tooth.
G' luck,
J.
Posted by Cam W. on August 29, 2001, at 17:29:27
In reply to Anyone on Anafranil (clomipramine)?, posted by Jackster on August 29, 2001, at 5:56:43
Jackie - As Jah said above, Anafranil™ (clomipramine) is a tricyclic antidepressant (TCA), so may get some of the side effects he mentions. The TCAs can be placed on a spectrum, with the poles being serotonin reuptake inhibition SRI) at on end, and norepinephrine reuptake inhibition (NRI) at the other. A TCA like maprotiline (Ludionil™) and desipramine (Norpramin™) are at the NRI end of the spectrum, while Anafranil is at the SRI end of the spectrum.
So, Anafranil can be considered the TCA-equivalent of an SSRI (very little NRI in comparison to it's SRI action). For years Anafranil was the gold standard for OCD and, to a certain extent, panic disorders.
I hope that this is of some help. - Cam
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Posted by DN on August 30, 2001, at 15:02:25
In reply to Re: Anyone on Anafranil (clomipramine)? » Jackster, posted by Cam W. on August 29, 2001, at 17:29:27
> I've tried most of the ssri's and effexor for obsession, GAD, social phobia with little success. I know mileage varies, but does anyone think that anafranil, given my other trials is worth a shot. Just a little background as a child I had rituals. They have faded. Just wondering if the root of my problems is still OCD. Any thoughts would be appreciated.
DN
Posted by sunnely on August 31, 2001, at 18:44:22
In reply to Anyone on Anafranil (clomipramine)?, posted by Jackster on August 29, 2001, at 5:56:43
> Just want to compare notes on side effects experienced and any good results.
>
> JackieAside from the side effects mentioned in the previous posts, it is clinically advisable to obtain a heart tracing (usually called EKG or ECG) before clomipramine (Anafranil) is started, and then periodically thereafter for routine monitoring.
Like other tricyclic antidepressants (TCAs), Anafranil has been reported to induce heart dysfunction including prolonged QTc (EKG) leading to "torsades," AV block, and cardiac arrest. Clomipramine (the parent compound) is a potent serotonin reuptake inhibitor. However, the drug is demethylated in humans, and the resultant metabolite (desmethylclomipramine) is a potent norepinephrine reuptake inhibitor. Clomipramine is metabolized to desmethylclomipramine by at least 2 cytochrome enzymes, CYP1A2 and CYP3A4.
As a precautionary measure, someone who is on Anafranil should avoid taking other drugs known to prolong QTc. Some of the drugs reported to prolong QTc include the antibiotics belonging to the class of quinolones; antipsychotics such as thioridazine (Mellaril), mesoridazine (Serentil), pimozide (Orap), and ziprasidone (Geodon). Needless to say, if at all possible, avoid drinking grapefruit juice while on Anafranil. For more info on drugs and prolonged QTC/torsades, go to the following site:
Posted by Andre Allard on August 31, 2001, at 23:04:25
In reply to Anyone on Anafranil (clomipramine)?, posted by Jackster on August 29, 2001, at 5:56:43
Even though I felt my obsessions and depression improve over the week I was on clomipramine, I could not tolerate more than 75mg of the dirty drug.
Good luck!
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