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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by jms600 on October 30, 2008, at 17:47:30
Hi everyone,
I know this topic has been touched upon in a couple of the previous posts - especially posts from yxibow and ricker (sorry, don't mean to repeat responses), but how dose Clomipramine compare to SSRIs for anxiety based disorders??
Is Clomipramine any better at treating anxiety (Generalised Anxiety Disorder, panic disorder, social phobia etc) than the SSRIs?? Or are the SSRIs (Seroxat/Cipralex/Lustral etc) more effective than Clomipramine??
Also, is 'poop out' common with Clomipramine?
I've become tolerant to Benzodiazepines so they aren't really a long term option for me!
Thanks!
Posted by ricker on October 30, 2008, at 20:17:54
In reply to Clomipramine v SSRIs for anxiety disorders..., posted by jms600 on October 30, 2008, at 17:47:30
If you are not suffering with depression, I would suggest paxil for GAD, anxiety, social phobia. Keep in mind everyone responds differently so ultimately, it may be a matter of trial and error.
IMO, paxil is not great at treating severe depression, but it sure helped me with my anxiety.I'm not a fan of benzo's as a first line treatment for anxiety due to the constant up and down ride, not to mention the depressive effects?
I have been on clonazepam for 20 years so I don't mean to sound hypocritical as I find there is somewhat of a mood stabilizing effect when taken with a A/D. I don't take the clonazepam prn, it's 0.5mg 2x day, I think of it as my multivitamin!Also, prolonged anxiety may manifest itself into depression, kinda sneaks up on you gradually. It's not something you may notice daily, sometimes it's others that may comment on your behavior?
As far as clomipramine, I found it to be good for depression and as mentioned earlier, I was on it for 9 years so "poop-out" was not an issue. SSRI's are well documented for their "poop-out", but that may not be the case for you if depression is not an issue? Something else to keep in mind, the internet is a good source of information, but that's all it is, anonymous suggestions. Some people have a wealth of knowledge, very well schooled on pharmacology and what not, but they are unable to find the "magic bullet" themselves?
Best of luck with your treatment.
Posted by yxibow on October 31, 2008, at 2:09:56
In reply to Re: Clomipramine v SSRIs for anxiety disorders... » jms600, posted by ricker on October 30, 2008, at 20:17:54
> If you are not suffering with depression, I would suggest paxil for GAD, anxiety, social phobia. Keep in mind everyone responds differently so ultimately, it may be a matter of trial and error.
> IMO, paxil is not great at treating severe depression, but it sure helped me with my anxiety.
The only problem with Paxil is getting off of it and remembering to take it, it has withdrawal issues. Well there's two issues, some people gain a bit of weight on it too. But it does help a subset of people with anxiety, yes, I'd agree.
> I'm not a fan of benzo's as a first line treatment for anxiety due to the constant up and down ride, not to mention the depressive effects?Not everyone gets depressed on benzodiazepines -- and a constant up and down ride is more perpetrated by not being on a constant level or using two or three of them at different times and rates -- not every benzodiazepine is 100% the same.
> I have been on clonazepam for 20 years so I don't mean to sound hypocritical as I find there is somewhat of a mood stabilizing effect when taken with a A/D. I don't take the clonazepam prn, it's 0.5mg 2x day, I think of it as my multivitamin!
Hmm.. a curious way of putting it, but that's only about 20mg of Valium.
>
> Also, prolonged anxiety may manifest itself into depression, kinda sneaks up on you gradually. It's not something you may notice daily, sometimes it's others that may comment on your behavior?
>
> As far as clomipramine, I found it to be good for depression and as mentioned earlier, I was on it for 9 years so "poop-out" was not an issue. SSRI's are well documented for their "poop-out", but that may not be the case for you if depression is not an issue? Something else to keep in mind, the internet is a good source of information, but that's all it is, anonymous suggestions.I would agree too -- my comments and I think the comments of a lot of people on here are personal experiences -- case studies is what you would call it if you wanted to be dry. I mean if you heard a dozen or two people saying the same thing about a medication, there might be a grain of truth to it.
Some people have a wealth of knowledge, very well schooled on pharmacology and what not, but they are unable to find the "magic bullet" themselves?
Quite true -- and there rarely ever is a "magic bullet" for any condition.
Clomipramine like any TCA can also cause halo effects and the like due to anticholinergic activity, but apparently Paxil does too, that would vary by the person.
-- Jay
Posted by Maxime on October 31, 2008, at 8:13:03
In reply to Clomipramine v SSRIs for anxiety disorders..., posted by jms600 on October 30, 2008, at 17:47:30
Since clomipramine has more side effects than most SSRIs, maybe trying an SSRI first might be the way to go. Paxil is supposed to be good for anxiety, but I went manic on it. Everyone is different when it comes to meds. I have a lot of anxiety on top of my depression and Cymbalta helps both ... but then again that's just me.
Lexapro might be a good SSRI to try for anxiety as it is usually quite sedating. Or Luvox for the same reason.
Good luck with whatever you decide to try.
Posted by Medline on October 31, 2008, at 10:30:24
In reply to Re: Clomipramine v SSRIs for anxiety disorders..., posted by Maxime on October 31, 2008, at 8:13:03
Clomipramine is a dirty drug with a lot of side effects. For your Anxiety consider a SSRI like Lexapro or an SNRI like Effexor XR, you can combine these drugs with Lyrica wich has shown in studies to be effective for GAD and Social Phobia. I think it's even approved for GAD in Europe, but I'm not sure.
Posted by Phillipa on October 31, 2008, at 16:51:12
In reply to Re: Clomipramine v SSRIs for anxiety disorders..., posted by Medline on October 31, 2008, at 10:30:24
luvox and paxil only two at low doses can tolerate. But also need low dose benzos for me that is. I was only on 10mg of paxil and just bit off a little of the pill for about a week or so and was okay. Only withdrawal was so mild brain zaps. Good luck with whatever you decide to try. Phillipa
Posted by jms600 on November 2, 2008, at 11:17:21
In reply to Clomipramine v SSRIs for anxiety disorders..., posted by jms600 on October 30, 2008, at 17:47:30
Tried Seroxat/Paxil a few years back. On it's own it helped a bit, but when I took it with Stelazine it seemed to really do wonders! I spoke to my doctor about withdrawing it as I thought I was better, however, when I lowered the dose my anxiety came flooding back. My doctor told me to go back on the previous dose but it just didn't seem to help the second time around.
I suffered really badly with the drug's side effects and also found it almost impossible to come off (when I came off it for the second time), even though I gradually withdrew the drug slowly. It's a horrible drug and I wouldn't want to go back on it ever!
I've also tried Cipralex/Lexapro - worked for a few months and then I experienced the dreaded 'poop out'!
This is the end of the thread.
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