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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by linkadge on July 10, 2005, at 15:24:13
In reply to Re: Going back on Anafranil (Clomipramine) :-/, posted by med_empowered on July 10, 2005, at 14:29:57
I don't think you need to import parnate. I was on it 2 years ago and got it from shoppers drug mart.
Was it discontinued in canada ??
Linkadge
Posted by ed_uk on July 10, 2005, at 16:21:23
In reply to Going back on Anafranil (Clomipramine) :-/, posted by rod on July 10, 2005, at 12:20:58
Hi Roli!
>I am lonely.
:-(
>So its really hard to get to know people, because they (most of the time) have the impression I dont like them...
Smile :-D
> I reviewed my "tried drug sheet" and apart from Amitriptyline and Nortriptyline (which pooped out quite much :-( ) Clomipramine was the 3rd "best"
So amitriptyline pooped out? What dose were you on?
>Seroquel?
Seroquel seems to work as an AD for some, perhaps more so than Zyprexa.
>MAOIs?
Can you get the pharmacy to import an MAOI with the permission of the Department of Health. I have a friend in Poland who does just that.
>I have some Anafranil left. I will introduce it without a pdoc....
I think it's a good idea to try Anafranil, but you'll have to come off the nortriptyline first.
Kind regards
~Ed
PS. I know you're not old :-P
Posted by rod on July 10, 2005, at 17:55:22
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » rod, posted by ed_uk on July 10, 2005, at 16:21:23
>I don't think you need to import parnate. I was on it 2 years ago and got it from shoppers drug mart.
>Was it discontinued in canada ??
>Linkadge
Wellllll I dont live in Canada....
But Canada is cool! :-P
> >So its really hard to get to know people, because they (most of the time) have the impression I dont like them...
>
> Smile :-Dhmmm haha. I dont find this funny....
If it would be that easy.
> > I reviewed my "tried drug sheet" and apart from Amitriptyline and Nortriptyline (which pooped out quite much :-( ) Clomipramine was the 3rd "best"
>
> So amitriptyline pooped out? What dose were you on?
>150mg. And it does not seem to work anymore.
> >Seroquel?
>
> Seroquel seems to work as an AD for some, perhaps more so than Zyprexa.Yes, but I could read that some persons find it "numbing" and like a knock out. Zyprexa was achemical knock out for me..
> >MAOIs?
>
> Can you get the pharmacy to import an MAOI with the permission of the Department of Health. I have a friend in Poland who does just that.Yes it is possible. no problem. But I would have to pay for this extra..
> >I have some Anafranil left. I will introduce it without a pdoc....
>
> I think it's a good idea to try Anafranil, but you'll have to come off the nortriptyline first.hmmmm will think about that.
> PS. I know you're not old :-P
But I FEEL old ! like 70.. :-O
Posted by SLS on July 11, 2005, at 7:34:56
In reply to Going back on Anafranil (Clomipramine) :-/, posted by rod on July 10, 2005, at 12:20:58
Hi Roland.
That's a heck of a list of drugs you have tried.
> I feel friendly, in a good mood, but my face shows something else....
Absolutely true! People respond differently to me when I am feeling improved. I have a brigher and friendlier countenance that appears to affect people differently - even if only passing by them on the street or in a supermarket. It is frustrating. It's hard enough to meet people as it is without having to break through a body-language barrier.
> There are no real options left anymore. I reviewed my "tried drug sheet" and apart from Amitriptyline and Nortriptyline (which pooped out quite much :-( ) Clomipramine was the 3rd "best"
I don't see imipramine. I don't see Effexor. I don't see lithium. I don't see thyroid. I don't see Tegretol or Trileptal. Of course, I don't see all the combinations you have tried.
Is metyrapone available in your country?
---------------------Pol J Pharmacol. 2004 Nov-Dec;56(6):849-55. Related Articles, Links
Effect of metyrapone supplementation on imipramine therapy in patients with treatment-resistant unipolar depression.-----------------------
Arch Gen Psychiatry. 2004 Dec;61(12):1235-44. Related Articles, Links
Metyrapone as additive treatment in major depression: a double-blind and placebo-controlled trial.------------------------
How did you respond to crappy moclobemide?* What drugs did you have a partial or brief response to?
You still have friends here. If you smile at me, I will smile back at you.:-)
- Scott
Posted by ed_uk on July 11, 2005, at 13:23:17
In reply to Re: Going back on Anafranil (Clomipramine) :-/, posted by rod on July 10, 2005, at 17:55:22
Hi,
>hmmm haha. I dont find this funny....
If it would be that easy.OK, now you've upset me. I wasn't being serious.
~Ed
Posted by rod on July 11, 2005, at 13:59:10
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » rod, posted by ed_uk on July 11, 2005, at 13:23:17
> >hmmm haha. I dont find this funny....
> If it would be that easy.
>
> OK, now you've upset me. I wasn't being serious.
>
> ~Edmm Sorry Ed. I know this wasnt serious. But thats what I hear all the time... over and over again... and I aint find this funny anymore... understand me. I didnt want to offen anyone
Roland
*mereachesedabouquetofflowers* :-) ?
Posted by ed_uk on July 11, 2005, at 14:44:17
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » ed_uk, posted by rod on July 11, 2005, at 13:59:10
Hi Roli!
>But thats what I hear all the time... over and over again... and I aint find this funny anymore... understand me.
Sorry :-) It was a dumb thing to say, I apologise.
>*mereachesedabouquetofflowers* :-) ?
Aww thank you! It took me a while to read that :-P
Kind regards
~Ed
Posted by ed_uk on July 11, 2005, at 14:49:21
In reply to Re: Going back on Anafranil (Clomipramine) :-/, posted by rod on July 10, 2005, at 17:55:22
Hi again!
>Yes, but I could read that some persons find it "numbing" and like a knock out.
True :-( But I've known people to find Zyprexa a 'knock out' and Seroquel antidepressant.
>150mg (amitriptyline). And it does not seem to work anymore.
If the side effects were tolerable at 150mg, you could increase the dose a bit. Blood level and ECG monitoring might be a good idea. Cliffstone took 300mg amitriptyline!
>>I think it's a good idea to try Anafranil, but you'll have to come off the nortriptyline first.
>hmmmm will think about that.
I think it might be useful to gradually decrease your nortriptyline dose while you increase the clomipramine.
Btw, have you had your nortriptyline blood level measured? Perhaps it would help you to optimise the dose.
Kind regards,
~Ed
Posted by rod on July 11, 2005, at 17:35:58
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » rod, posted by SLS on July 11, 2005, at 7:34:56
Hi Scott
> > There are no real options left anymore. I reviewed my "tried drug sheet" and apart from Amitriptyline and Nortriptyline (which pooped out quite much :-( ) Clomipramine was the 3rd "best"
>
> I don't see imipramine. I don't see Effexor. I don't see lithium. I don't see thyroid. I don't see Tegretol or Trileptal. Of course, I don't see all the combinations you have tried.ok. I forgot:
Effexor
T3 augmentation of Nortriptyline
Fish OilAnd I have taken most of the drugs in various combinations. Well, do you want me to write all combinations too? Well if its important for you I will try to do it. So, Should I?
I have not tried: (which isnt available)
Imipramine (not available anymore)
Trimipramine (na)
Desipramine (na)
Protriptyline (na)
Lofepramine (na)
Parnate (na)
Nardil (na)
available, untried stuff:all other AEDs except Lamictal, Neurontin and Lyrica
Tegretol (maybe also worth a try. I have read it reduces negative symptoms in shiz. or was it trileptal? hmm I guess both do quite the same. right?)
Trileptal
Topamax
Valproic acid stuff
+other AEDs availableLithium (ok. I could give it a try)
Opipramol
Dibenzepine (thats the name of the drug itself. not the class)
FluvoxamineSeroquel
Geodon
Haldol ;-O just a joke...Duloxetine (not yet available. And I dont expect much from it..)
Agomelatine (hopefully will be avail. soon. worth a shot)And the CRF Antagonist (these are the drugs that will do the trick IMO)
maybe in 5 years?>
> Is metyrapone available in your country?
>I cant see its available, unfortunatly
>
>
> How did you respond to crappy moclobemide?Was crap. It wasnt as bad as your reaction to it (hmm some things very well stay in my memory), but made me worse. Especially when I combined it with Adrafinil later. After a short significant improvement, it made me much worse.
> * What drugs did you have a partial or brief response to?
well most of the drugs had some good sides
Some worked for a short time. some for a few days. some made me worse.Had partial response to the SSRIs (Prozac, Celexa, Lexapro, (Effexor), (Anafranil)) Which just meant they had some good effects, but most of them where worse. especially cognition. There were episodes of improvement but in the end they often made me worse. No anticholinergic drugs produce such a "stupor" as the serotonergic drugs do to me. Actually I would have to write an essay about every drug to describe the effect in detail. Its hard to gerenralise.
Anafranil had the lowest impact on cognition, numbness and sexual dysfunction. Thats why I reconsider it.Amitrip (had best response to this drug ever. Was almost in clinical remission. But my supersmart doc wanted to put me on Prozac. I ended up taking Zyprexa, Prozac and Ami. I got extremely worse over time. since then, ami alone makes me worse. I guess it did some harm. And Prozac can greatly increase blood levels of Ami)
Nortrip
Lamictal (cognitive side effects. Felt like being on an SSRI)
Methylphenidat (but only in combo with DHEA, without, I crash after a short time)
Abilify (SSRI like effect)
Mirapex (stupor and apathy on the long term)
Clonazepam
lyrica
Neurontin
Amisulpride
DHEA / 7-Keto DHEA mood brightening and anti stress. But I seem to develop tolerance to it. Once a pdoc told me that DHEA is very well known to poop out for psychiatric purposes. I guess your body can compensate the artificial intake over time.
well, thats all, I think
Scott, since you are on Parnate, do you find it having an impact on your "core symptoms"? Does it make you a bit more talkative? How is cognition. How is "shyness"? Does it make you anxious, nervous or inhibited?Right now, I havent chenged anything yet. I somehow think about driving to Slovakia or the other eastern european countries to get some PARNATE!? if available.
bye and thanks
PS: if something is unclear just ask. I am a it confused today...
Posted by rod on July 11, 2005, at 17:43:56
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » rod, posted by ed_uk on July 11, 2005, at 14:49:21
> If the side effects were tolerable at 150mg, you could increase the dose a bit. Blood level and ECG monitoring might be a good idea. Cliffstone took 300mg amitriptyline!
>Unfortunately it just doesnt work anymore and actuall makes me somewhat worse. (since I combined it with Zyprexa and Prozac)
> Btw, have you had your nortriptyline blood level measured?NO because incurance doesnt cover any blood level measurments for ADs..
I am really fed up... with the people who are responsible for this and the licensing of drugs. NO parnate, Nardil in a country with one of the highest suicide rates in the world! As far as I know Finnland, Hungary and Astria chance the first 3 places each year....
Why? beeeep please be civil..
Posted by Declan on July 11, 2005, at 21:20:02
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » SLS, posted by rod on July 11, 2005, at 17:35:58
Hi Roland
I find Parnate makes me more decisive and is somewhat euphoric, though it doesn't stop me feeling sad. While it doen't make me feel friendly, I do find social situations easier to handle, ie I feel less overwhelmed.
Declan
Posted by rod on July 12, 2005, at 10:31:00
In reply to Re: Going back on Anafranil (Clomipramine) :-/, posted by Declan on July 11, 2005, at 21:20:02
Hi Declan
> I find Parnate makes me more decisive and is somewhat euphoric, though it doesn't stop me feeling sad.
So, would you say it makes you more optimistic? more slef esteem?
thanks
bye
Roland
Posted by SLS on July 12, 2005, at 10:53:06
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » SLS, posted by rod on July 11, 2005, at 17:35:58
Hi Roland.
Where are you living right now? I know metyrapone is available the UK. If you want to experiment with cortisol / HPA stuff, you might want to try taking ketoconazole to see if it helps at all - even if only for a short time.
Our illnesses seem to present very similarly. Maybe I'll just let you figure it out for the both of us and have you tell me what to do. :-)
I am amazed at the rate at which you have lost access to the older medications. It is scary. I hope it doesn't happen in the US. It will be very interesting to see how you react to agomelatine. If you respond well to it, I'll have to see what I can do to get it. I once tried taking melatonin. I'm pretty sure it made me feel moderately worse. I didn't take it for too many days. The deterioration in my condition was too obvious.
> And I have taken most of the drugs in various combinations. Well, do you want me to write all combinations too?
I doubt that would be necessary. I'll just make believe you've done most of the same things that I have.
Anafranil + lithium sounds interesting. If I understand you correctly, you have not yet tried lithium?
For me: Parnate + desipramine (had best response to these drugs ever. Was almost in clinical remission). But my supersmart doc wanted to put me on Prozac.
Sound familiar? I never responded to this same combination again.
> Scott, since you are on Parnate, do you find it having an impact on your "core symptoms"?
No. It gives me more mental energy to work with, but that's about it. Part of that includes more energy to talk, but not an increase in sociability. Adding nortriptyline helps a bit in that aspect. I found Nardil to be better for mood-brightening and socialability, but it leaves me with very little once it poops out.
> Right now, I havent chenged anything yet. I somehow think about driving to Slovakia or the other eastern european countries to get some PARNATE!? if available.
You can work with Parnate more easily. You can go higher in dosage with reduced side effects. You can add things like nortriptyline, bupropion, and amphetamines to it.
If you have never tried Parnate or Nardil, you really should consider making it your next move. Just be prepared to deal with insomnia. Insomnia is a difficult side effect to deal with, but should be dealt with agressively and not be allowed to determine the course of treatment. I found that insomnia with MAOIs was a good sign for me that I would respond to it.
How did Lyrica affect you? What were you taking along with it?
- Scott
Posted by ed_uk on July 12, 2005, at 13:54:30
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » ed_uk, posted by rod on July 11, 2005, at 17:43:56
Hi Roli,
Are you still interested in trying a few more anticholinergics? I think you had a good response to biperiden, or some other anticholinergic.... Perhaps you should try orphenadrine, procyclidine, benztropine and trihexyphenidyl.
>NO parnate, Nardil in a country with one of the highest suicide rates in the world!
I expect that Parnate is probably going to be discontinued in the UK fairly soon, it's so rarely prescribed. Nardil will almost certainly remain available, at least in the near future. Desipramine has already been discontinued in the UK, I expect that nortriptyline will follow soon - it's rarely prescribed :-( I find it worrying.
Kind regards
~Ed
PS. I agree with Scott that clomipramine + lithium is a good idea. A nice low dose of Li might do the trick.
Posted by rod on July 12, 2005, at 20:37:15
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » rod, posted by SLS on July 12, 2005, at 10:53:06
Hi Scott
> Where are you living right now?
Austria (but no mountians where I live :-) )
> Our illnesses seem to present very similarly. Maybe I'll just let you figure it out for the both of us and have you tell me what to do. :-)
hehe I try my best... :-)
> It will be very interesting to see how you react to agomelatine. If you respond well to it, I'll have to see what I can do to get it. I once tried taking melatonin. I'm pretty sure it made me feel moderately worse. I didn't take it for too many days. The deterioration in my condition was too obvious.
hmmm I have a light box, which should work by decreasing melatonin secretion during the day. right? But I dont benefit from a light box actually. It even makes me somewhat worse.. anyway.
> Anafranil + lithium sounds interesting. If I understand you correctly, you have not yet tried lithium?
No. no lithium yet
But I am not sure if this would be a good idea. And you get worse from it as far as I know!? but I could give it a try on a very low dose and see how it is....> > Scott, since you are on Parnate, do you find it having an impact on your "core symptoms"?
>
> No. It gives me more mental energy to work with, but that's about it. Part of that includes more energy to talk, but not an increase in sociability. Adding nortriptyline helps a bit in that aspect. I found Nardil to be better for mood-brightening and socialability, but it leaves me with very little once it poops out.hmm then I dont know if its worth the money and efforts to get it. But lets see, maybe I can "go on vacation" to a country which has it and acidentally get depressed there and urgently have to see a doc get some parnate :-P which my insurance may cover, since they do cover drug and doc costs when you are on vacation in a foreign country..
> How did Lyrica affect you? What were you taking along with it?Lyrica is actually one of the few things that do hit the core of my disease. It helps with concentration, brightens mood a bit and makes me more resistant to stress...
might sound "strange" but it feels like a weak antidote for this crappy feeling in my head.. its almost as if I can feel on the surface of my brain, there is something wrong...bye and thanks
Roland
Posted by ed_uk on July 13, 2005, at 13:43:07
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » SLS, posted by rod on July 12, 2005, at 20:37:15
Hi Roli :-)
Are you still interested in trying a few more anticholinergics? I think you had a good response to biperiden, or some other anticholinergic.... Perhaps you should try orphenadrine, procyclidine, benztropine and trihexyphenidyl.
~Ed
Posted by rod on July 14, 2005, at 3:46:18
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » rod, posted by ed_uk on July 13, 2005, at 13:43:07
Hi Ed, my friend =)
> Are you still interested in trying a few more anticholinergics? I think you had a good response to biperiden, or some other anticholinergic.... Perhaps you should try orphenadrine, procyclidine, benztropine and trihexyphenidyl.Yes, Procyclidine had some good effect. But its anxiogenic after some days. And I am really not sure if they are a long term solution. I guess not. But sure, I still have these drugs on my list of possible candidates...
bye
Roland
Posted by Declan on July 14, 2005, at 5:26:38
In reply to Re: Going back on Anafranil (Clomipramine) :-/ » Declan, posted by rod on July 12, 2005, at 10:31:00
Hi Roland
It would certainly fire me up if I took more of it, more optimistic yeah, self-esteem I dunno. But as I need to sleep, and I sleep poorly anyway, I'm just taking 10mg/d, which makes my sleep only slightly worse. And it was what my truly nice doctor, in his wisdom, Rxd. It is quite dopaminergic which suits me, I like it. But I wondered today, as one does, how much sadness is appropriate in this world? Perhaps it's subtherapeutic, or maybe the therapeutic window is narrow.
Declan
Posted by rod on December 2, 2005, at 8:42:03
In reply to Going back on Anafranil (Clomipramine) :-/, posted by rod on July 10, 2005, at 12:20:58
hi everybody.
So, now I am back on Anafranil. Taking if for some weeks now, and have to say it really helps. (unlike the SSRIs, for me)
And I am starting to realize my social anxiety (its actually more like a fear) is (was) a *much* (!) bigger probem than I thought it is. Well, I guess some doctors a right after all, but unfortunately they put me on the wrong (for me) drugs (SSRIs) for that purpose... No, never tried nardil and probably never will..
Its almost a bit "magic" to feel some "walls" coming down, the bars of my cage I was in seem to dissipate. A few days ago I went out and it was almost weired, because unknown people just started talking to me. ! just smalltalk.. but hey! I just dont look so "angry" anymore in social situations. My social anxiety is much more like a social fear. I dont get a red face, increased heart rate or other "adrenergic" symptoms. I just feel "unwell", want to hide, in a deep hole, where noone can see me... And "putting" (I couldnt influence this ofcourse) on this face is (I guess) an uncounscious mechanism to keep people away from me. away, so no one will talk to me. .. a mechanism to "protect" me.. but an unsuccessful one in the end.
Well, I increased to ~110mg, but in combination with my ohter drugs was too much, and my weight almost exploded... So now I am back on 75mg. And thats ok also.. and a girl I know noted that my "little" belly suits me fine :-) (because I also look better when non depressed and non smoking) ... yes I am still overweight, but it seems ok. I will slowly start to exercise and eat less cookies and everything will turn out fine...
thats my little message..
bye
IM Weasle :P
Posted by ed_uk on December 3, 2005, at 12:26:27
In reply to Re: Being back on Anafranil (Clomipramine), posted by rod on December 2, 2005, at 8:42:03
Hi Roli
I'm overweight too, although not very much :-)
>Its almost a bit "magic" to feel some "walls" coming down....
Hey that's fantastic! Are you feeling quite comfortable in social situations now?
MFG :D
Ed
Posted by rod on December 4, 2005, at 11:44:57
In reply to Re: Being back on Anafranil (Clomipramine) » rod, posted by ed_uk on December 3, 2005, at 12:26:27
> Hi Roli
>
> I'm overweight too, although not very much :-)Hi Ed,
I started at 70kg (154 pounds) before nortriptyline and meanwhile I have almost 100kg (220 pounds).. so thats a gain of ~ 60 pounds ... but mainly because of increased appetite..
> >Its almost a bit "magic" to feel some "walls" coming down....
>
> Hey that's fantastic! Are you feeling quite comfortable in social situations now?Yes, much more comfortable than in ages.. not really Pro-social, but it seems to be the only drug which does this to me... neither Klonopin or other things alike have such an effect on me.
I am sure it will even get better, because once a doc said hes sure it will take up to 6 months for me to fully respond. Didnt believe then, but I guess he is right..... :-)> MFG :D
>
> EdSincerely
Roli
Posted by rod on December 31, 2005, at 12:24:49
In reply to Re: Being back on Anafranil (Clomipramine) » ed_uk, posted by rod on December 4, 2005, at 11:44:57
Hi
Just wanted to say, I am on 150mg since some days. The increased appetite, sugar cravings are almost gone. And I also stopped Depakote, because I was so bad before christmas. I just dont need it at the moment. But still take all the other stuff..
I wish you all a "remissive" new year. ;-)
bye
~r
Posted by ed_uk on December 31, 2005, at 12:37:53
In reply to Re: Being back on Anafranil (Clomipramine), posted by rod on December 31, 2005, at 12:24:49
Hi Roli
How is Anafranil affecting you at 150mg? 150mg clomipramine is renowned for its efficacy as an antidepressant, at least it was - when TCAs were more popular.
Ed
Posted by rod on December 31, 2005, at 12:44:12
In reply to Re: Being back on Anafranil (Clomipramine) » rod, posted by ed_uk on December 31, 2005, at 12:37:53
> Hi Roli
>
> How is Anafranil affecting you at 150mg? 150mg clomipramine is renowned for its efficacy as an antidepressant, at least it was - when TCAs were more popular.
>
> EdHi Ed,
It just gives me more relief. works better. and sugar cravings are gone :)
bye
Posted by AMY II on February 29, 2008, at 14:02:34
In reply to Going back on Anafranil (Clomipramine) :-/, posted by rod on July 10, 2005, at 12:20:58
You say you lost weight taking Clomipramine??? I am afraid to take it because I tend to weight gain on SSRI's and my PDOC says clomipramine is known for weight gain.
This is the end of the thread.
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