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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Justherself54 on April 20, 2010, at 19:39:14
Saw my pdoc yesterday. We're upping the dosage to 100 mg. starting tonight, then I'll have blood work done in two weeks. So far the side effects are bearable, and I've noticed a wee smidge of motivation surfacing. Enough to at least get some housework done, and I can now leave the house. My back pain has not returned.
He told me I could restart my modafinil to help with the sedation, but I forgot to ask him if I could use seroquel, as I've noticed my sleep is much worse since starting the clomipramine. I currently take one and a half 7.5 zopiclone and .05 clonazapam at bed and it's just not doing the same job it was before.
Can I take seroquel with my current combo?
Posted by Phillipa on April 21, 2010, at 0:47:27
In reply to Clomipramine, posted by Justherself54 on April 20, 2010, at 19:39:14
I just wanted to say I'm thrilled for you that it's working how wonderful!!!!! Love Phillipa
Posted by SLS on April 21, 2010, at 6:42:35
In reply to Clomipramine, posted by Justherself54 on April 20, 2010, at 19:39:14
> Saw my pdoc yesterday. We're upping the dosage to 100 mg. starting tonight, then I'll have blood work done in two weeks. So far the side effects are bearable, and I've noticed a wee smidge of motivation surfacing. Enough to at least get some housework done, and I can now leave the house.
> My back pain has not returned.
How cool is that?!
Great news.
Seroquel has a metabolite that inhibits the reuptake of NE in the same way clomipramine does. However, I don't know if at low dosages this effect would be potent enough to be concerned about. I once took a combination of Seroquel (> 100mg) and imipramine. The addition of Seroquel made me irritable and perhaps dysphoric. No other AP affected me that way.
- Scott
Posted by Justherself54 on April 21, 2010, at 11:11:07
In reply to Re: Clomipramine » Justherself54, posted by SLS on April 21, 2010, at 6:42:35
Thanks Scott..
I assumed I had been taking 75 mg for close to a week, before ramping up to the 100 mg., until I looked closely at the bottle which said they were 50 mg tablets, same as I was taking before. On the instructions, it said to take one and one half. However, no one at the pharmacy explained that I would have to split a pill (frankly, I think they should have split the proper number). I guess lesson learned, never assume anything.
I'm tempted just to bypass the ramping to 75 mg. and just go straight to the 100 mg.
My question is, will I increase my chance of side effects by doing this, instead of going slower with the 75 mg.? This is the first TCA I've been able to tolerate, so I want to give it the best trial I can.
Thanks for your support!
Posted by SLS on April 21, 2010, at 11:41:14
In reply to Re: Clomipramine » SLS, posted by Justherself54 on April 21, 2010, at 11:11:07
> I'm tempted just to bypass the ramping to 75 mg. and just go straight to the 100 mg.
I found clomipramine to produce more side effects than imipramine at the same dosage. My impression is that the two drugs are not milligram equivalent. I would treat clomipramine as being more potent than imipramine, and having a lower therapeutic dosage window. For this reason, I think it would be better if you were to take 75mg for several days before going to 100mg.
Do you have an idea as to what your doctor plans to set as a target dose of clomipramine?
> This is the first TCA I've been able to tolerate,
That's interesting. Most people have a more difficult time tolerating clomipramine. What was it about the other TCAs that you found to be intolerable?
- Scott
Posted by Justherself54 on April 21, 2010, at 12:37:33
In reply to Re: Clomipramine » Justherself54, posted by SLS on April 21, 2010, at 11:41:14
Hi Scott.
From what I understand from my pdoc is the range for depression treatment is between 100 and 200 mg. I was to have a blood test two weeks after increasing it to 100 mg. to test the levels. We both thought I was on 75 mg and was tolerating it quite well, although my depressive symptoms are still pretty bad, but I know now I'm still at 50 mg.
The other 3 TCA's I've tried were amitriptaline, nortriptaline, and one other (the name escapes me right now). All caused such severe sedation to the point where I was sleeping during the day for more than 10 hours, and was not hearing the telephone ring, nor my dog barking. When I was awake I felt like I was hungover.
I have three small grandchildren and I was afraid I wouldn't respond during that kind of sleep if something happened when they were staying with me.
I have to say I was not thrilled to try another TCA, due to my previous experiences with them, however, this is so different, it gives me hope that I can get some relief from the depression.
Right now all I'm experiencing as side effects are dry mouth, loss of appetite (OK by me as I'm overweight) and more difficulty sleeping and a bit of sedation during the day, but not enough to even have a nap on.
That's why I'm wondering if I could tolerate the increase to 100 instead of doing the 75 mg increase, just to try to quickly reach a more theraputic range for my depressive symptoms, but I also want to be cautious not to invite a host of unwelcome side effects by doing it too quickly.
Thanks so much for your response.
Posted by bulldog2 on April 21, 2010, at 15:40:16
In reply to Re: Clomipramine » SLS, posted by Justherself54 on April 21, 2010, at 12:37:33
> Hi Scott.
>
> From what I understand from my pdoc is the range for depression treatment is between 100 and 200 mg. I was to have a blood test two weeks after increasing it to 100 mg. to test the levels. We both thought I was on 75 mg and was tolerating it quite well, although my depressive symptoms are still pretty bad, but I know now I'm still at 50 mg.
>
> The other 3 TCA's I've tried were amitriptaline, nortriptaline, and one other (the name escapes me right now). All caused such severe sedation to the point where I was sleeping during the day for more than 10 hours, and was not hearing the telephone ring, nor my dog barking. When I was awake I felt like I was hungover.
>
> I have three small grandchildren and I was afraid I wouldn't respond during that kind of sleep if something happened when they were staying with me.
>
> I have to say I was not thrilled to try another TCA, due to my previous experiences with them, however, this is so different, it gives me hope that I can get some relief from the depression.
>
> Right now all I'm experiencing as side effects are dry mouth, loss of appetite (OK by me as I'm overweight) and more difficulty sleeping and a bit of sedation during the day, but not enough to even have a nap on.
>
> That's why I'm wondering if I could tolerate the increase to 100 instead of doing the 75 mg increase, just to try to quickly reach a more theraputic range for my depressive symptoms, but I also want to be cautious not to invite a host of unwelcome side effects by doing it too quickly.
>
> Thanks so much for your response.
>I would do the 75 just to make the transition smoother. You'll get to 100 quick enough. So this is a tca that requires a certain blood level to be effective?
I'm up to 50 mg and I didn't get any sciatica relief. A little disappointed. I thought 50 mg was the lowest dose for a therapeutic response but I guess I was wrong.
Posted by SLS on April 21, 2010, at 15:51:25
In reply to Re: Clomipramine » SLS, posted by Justherself54 on April 21, 2010, at 12:37:33
> From what I understand from my pdoc is the range for depression treatment is between 100 and 200 mg.
That sounds right to me. I believe the PDR lists the maximum dosage of clomipramine as being 250mg, so you have some room to work with.
It is hard to guess at what your reaction would be to a 100% increase in dosage. You may tolerate it well or you may trigger side effects that would not have emerged had you used an intermediate dosage. I can certainly understand your impatience at wanting to relieve yourself of a tortuous depression.
Perhaps you can open the capsules and pour out half the contents so as to take 75mg for a few days to see how you tolerate it.
I will be interested to see how you do with clomipramine. I hope it is your magic pill. With the exception of the MAOIs, clomipramine is regarded by many to be the most efficacious antidepressant.
- Scott
Posted by floatingbridge on April 24, 2010, at 17:24:03
In reply to Clomipramine, posted by Justherself54 on April 20, 2010, at 19:39:14
I'm very happy to hear about your remission of back pain. That's a relief!
This is the end of the thread.
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