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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by bulldog2 on June 5, 2010, at 17:29:27
Saw my p-doc on Tuesday and ne reviewed my blood tests. Somewhat high on prolactin and low normal on testosterone.
We were both concerned about the results. I mentioned a dopamine agonist or a stimulant to combat the high prolactin and he didn't like those ideas. He wants me to wean off and try marplan in a month.
He didn't really give any reasons why he disliked my ideas. Any thoughts about this as I liked the med?
Posted by sigismund on June 5, 2010, at 19:55:14
In reply to Coming Off Of Clomipramine, posted by bulldog2 on June 5, 2010, at 17:29:27
Would it be unusual for someone your age to have a low normal testosterone result?
Depends on the reference range?
The prolactin might result from the clomiprimine?
I'd be pretty reserved about this change, because there isn't a better than even chance that marplan will do it for you.
Posted by floatingbridge on June 6, 2010, at 1:05:08
In reply to Re: Coming Off Of Clomipramine » bulldog2, posted by sigismund on June 5, 2010, at 19:55:14
Sigi has good questions. You seem adept at changing meds, but I wonder if marplan would limit your options. And you're still feeling good?
Posted by sigismund on June 6, 2010, at 2:15:09
In reply to Re: Coming Off Of Clomipramine, posted by floatingbridge on June 6, 2010, at 1:05:08
I'm prejudiced in favour of Marplan, of course.
But you like clomiprimine, and you might not like Marplan.
Posted by sigismund on June 6, 2010, at 2:18:43
In reply to Re: Coming Off Of Clomipramine, posted by sigismund on June 6, 2010, at 2:15:09
You are able to compare your testosterone (total, free) and prolactin prior to and after clomiprimine?
At our age you might expect them to be through the floor and the roof.
Posted by bulldog2 on June 6, 2010, at 10:16:53
In reply to Re: Coming Off Of Clomipramine, posted by sigismund on June 6, 2010, at 2:18:43
> You are able to compare your testosterone (total, free) and prolactin prior to and after clomiprimine?
>
> At our age you might expect them to be through the floor and the roof.Yes this same p-doc ran this test on me about 10 years ago. The testosterone was 390 and the prolactin was in the upper 1/3 level of normal.
I guess my issue was why not try out a dopamine agonist or a stim to see wether we could get better lab numbers. Also might be a good augment.
Now if he insists on taking me off which at this point he appears to be doing I have no problems with an maoi. I would try the king of maois which I think is nardil but I've heard of the horrible weight gain issues which is bad for me so I guess marplan is a good choice. I've tried parnate at 60 mg with only moderate success. Not as good as the clomipramine.
Posted by SLS on June 6, 2010, at 11:44:35
In reply to Re: Coming Off Of Clomipramine » sigismund, posted by bulldog2 on June 6, 2010, at 10:16:53
> I guess my issue was why not try out a dopamine agonist or a stim to see wether we could get better lab numbers.
You seem to be quite fixated on lab numbers. I know that our situations are different, but if the worst clomipramine were to do to me is to produce marginal alterations in prolactin and testosterone levels, I would gladly trade those side effects for remission from depression. Your numbers aren't off by that much. However, I doubt that you will be content to continue with clomipramine without first knowing how Marplan affects you. It's a difficult decision to make.
- Scott
Posted by Phillipa on June 6, 2010, at 12:35:06
In reply to Re: Coming Off Of Clomipramine » bulldog2, posted by SLS on June 6, 2010, at 11:44:35
Scott still thinking of the three day blip as I know it means something. It's like pushing on the accelorator of a car getting some gas and it then doesn't get through? As for Labs same with thyroid it's how you feel not the numbers. Too bad docs don't see that they are into numbers. Phillipa
Posted by Brainbeard on June 6, 2010, at 16:04:32
In reply to Coming Off Of Clomipramine, posted by bulldog2 on June 5, 2010, at 17:29:27
I'm neurotically concerned about prolactin levels myself. But it doesn't really make much sense. High prolactin levels induced by clomipramine will rarely cause serious trouble. Yeah, when you start lactating, OK, that would be quite disconcerting. Or if you'd start looking like Pamela Anderson. But otherwise? I'd try and give the med a longer chance and see if you're still troubled by it after, say, two or three months. The med may work well enough by that time to make you consider it a minor issue.
We have a comedian here in Holland, Mike Boddé, who has been on clomipramine for more than a decade. And he's very happy with the drug. It pulled him out of a wrecking depression. The med's made him kind of fat. He accepts that. And it looks very natural on him. There always is a trade-off. Coffee makes your teeth turn yellow or brown. Still, most people like to drink it.
Posted by bulldog2 on June 6, 2010, at 16:16:30
In reply to Re: Coming Off Of Clomipramine » bulldog2, posted by SLS on June 6, 2010, at 11:44:35
> > I guess my issue was why not try out a dopamine agonist or a stim to see wether we could get better lab numbers.
>
> You seem to be quite fixated on lab numbers. I know that our situations are different, but if the worst clomipramine were to do to me is to produce marginal alterations in prolactin and testosterone levels, I would gladly trade those side effects for remission from depression. Your numbers aren't off by that much. However, I doubt that you will be content to continue with clomipramine without first knowing how Marplan affects you. It's a difficult decision to make.
>
>
> - ScottIt was actually the reverse situation here. I began suffering a certain side effect that can be caused by high prolactin. I told my p-doc and he ordered the tests. The only thing that would really help would be a dopamine agonist to lower prolactin.
This is the end of the thread.
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