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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by g_g_g_unit on September 25, 2010, at 5:40:28
My legs won't stop jerking. I spent most of the day in bed because I was so exhausted from not sleeping last night. My GP's away for two weeks and I'm scared of my psychiatrist and don't know who talk to. I hate this - all of it. Who knew so much could go wrong.
Posted by Maxime on September 25, 2010, at 6:02:26
In reply to miserable, posted by g_g_g_unit on September 25, 2010, at 5:40:28
> My legs won't stop jerking. I spent most of the day in bed because I was so exhausted from not sleeping last night. My GP's away for two weeks and I'm scared of my psychiatrist and don't know who talk to. I hate this - all of it. Who knew so much could go wrong.
That doesn't sound good at all. Why are you scared of your pdoc? That's not good. Do you think you should go off the medication until you see your GP? Two weeks is long time to suffer. Also, you don't want the side effect to be permanent. The more I think about the more I think that yes, you should stop the med.
I wish there was something I could do.
Posted by g_g_g_unit on September 25, 2010, at 6:29:19
In reply to Re: miserable » g_g_g_unit, posted by Maxime on September 25, 2010, at 6:02:26
Thanks Maxime. I've only met with my psychiatrist twice. She's the medical director of a hospital and rather stately, if you know what I mean. She's nice, but I just find her and her position a little intimidating.
Anyway, my apologies, I've just been feeling sorry for myself lately, but to think - another pointless complication, another failed trial, another withdrawal. These last two years have just been a haze.
>
> That doesn't sound good at all. Why are you scared of your pdoc? That's not good. Do you think you should go off the medication until you see your GP? Two weeks is long time to suffer. Also, you don't want the side effect to be permanent. The more I think about the more I think that yes, you should stop the med.
>
> I wish there was something I could do.
Posted by Maxime on September 25, 2010, at 7:10:37
In reply to Re: miserable » Maxime, posted by g_g_g_unit on September 25, 2010, at 6:29:19
> Thanks Maxime. I've only met with my psychiatrist twice. She's the medical director of a hospital and rather stately, if you know what I mean. She's nice, but I just find her and her position a little intimidating.
>
> Anyway, my apologies, I've just been feeling sorry for myself lately, but to think - another pointless complication, another failed trial, another withdrawal. These last two years have just been a haze.
>
> >Your post and thoughts are not pointless. So erase that from your vocabulary. Do you think that cogentin would help? Maybe you could go to a walk in clinic and ask for some ... just enough until your GP returns.
Yes, your pdoc does sound scary. Any chance you can see another one?
I am really sorry that you are going through this.
> > That doesn't sound good at all. Why are you scared of your pdoc? That's not good. Do you think you should go off the medication until you see your GP? Two weeks is long time to suffer. Also, you don't want the side effect to be permanent. The more I think about the more I think that yes, you should stop the med.
> >
> > I wish there was something I could do.
>
>
Posted by g_g_g_unit on September 25, 2010, at 10:00:10
In reply to Re: miserable » g_g_g_unit, posted by Maxime on September 25, 2010, at 7:10:37
Thanks for your concern Maxime, you're too sweet. I ended up speaking to a pharmacist. He recommended I see a doctor as soon as possible, because what I'm describing (weird jerking movements in my hips, legs and feet) sounds like it might be dystonia, so my dad's taking me to his GP tomorrow. Maybe I'll look at getting a new p-doc . . it's kinda sad that I can't even call her when I feel like this. Like I say, it's not that's she's explicitly cruel or anything, just a little intimidating.
>
> Your post and thoughts are not pointless. So erase that from your vocabulary. Do you think that cogentin would help? Maybe you could go to a walk in clinic and ask for some ... just enough until your GP returns.
>
> Yes, your pdoc does sound scary. Any chance you can see another one?
>
> I am really sorry that you are going through this.
>
>
> > > That doesn't sound good at all. Why are you scared of your pdoc? That's not good. Do you think you should go off the medication until you see your GP? Two weeks is long time to suffer. Also, you don't want the side effect to be permanent. The more I think about the more I think that yes, you should stop the med.
> > >
> > > I wish there was something I could do.
> >
> >
>
>
Posted by Phillipa on September 25, 2010, at 12:13:46
In reply to Re: miserable » Maxime, posted by g_g_g_unit on September 25, 2010, at 10:00:10
Sounds like a good idea to see you doc tomorrow. I find pharmacists my best source of information on meds. Good Luck Phillipa
Posted by Jeroen on September 26, 2010, at 8:54:53
In reply to miserable, posted by g_g_g_unit on September 25, 2010, at 5:40:28
yep, tardive dyskinesia from anti psychotic medication, they didnt warn me for this either
its just an evil force that tried to undermine our healing process
Posted by ed_uk2010 on September 28, 2010, at 17:43:55
In reply to Re: miserable » Maxime, posted by g_g_g_unit on September 25, 2010, at 10:00:10
Hi GGG,
If your medication is making you feel so miserable, something is wrong. How about 25mg in the morning and 50mg at night? - a dose reduction plus splitting the dose. Many people take quite low doses of clomipramine because it can be very potent.
Posted by g_g_g_unit on September 28, 2010, at 20:17:14
In reply to Re: miserable, posted by ed_uk2010 on September 28, 2010, at 17:43:55
> Hi GGG,
>
> If your medication is making you feel so miserable, something is wrong. How about 25mg in the morning and 50mg at night? - a dose reduction plus splitting the dose. Many people take quite low doses of clomipramine because it can be very potent.Hey ed - I ended up speaking to my psychiatrist yesterday. Thankfully, she cut right through my excessively polite ramblings and said that the sleep loss was unacceptable, and advised I bring my dose back to 75mg immediately. She said that if I still had movement problems in two days, to then reduce the dose to 50mg.
Her reasoning was that I may have titrated too quickly, but since learning that clomipramine is a D2 antagonist, doesn't that mean that the movement problems are not going to be transient?
Posted by ed_uk2010 on September 29, 2010, at 14:52:36
In reply to Re: miserable » ed_uk2010, posted by g_g_g_unit on September 28, 2010, at 20:17:14
>I bring my dose back to 75mg immediately. She said that if I still had movement problems in two days, to then reduce the dose to 50mg.
That sounds very reasonable.
>Her reasoning was that I may have titrated too quickly, but since learning that clomipramine is a D2 antagonist, doesn't that mean that the movement problems are not going to be transient?
I believe that it's a very weak D2 antagonist but I doubt that that's responsible for your current symptoms. Muscle twiching and exaggerated reflexes in the legs are typical of potent serotonergic drugs. I think it's a sign that the dose is excessive. Metabolism of clomipramine is extremely variable and dosage requirements vary substantially from person to person. Don't worry about taking any particular 'target dose', just find the dose which reduces your symptoms without causing unacceptable side effects.
Posted by g_g_g_unit on September 29, 2010, at 23:37:22
In reply to Re: miserable » g_g_g_unit, posted by ed_uk2010 on September 29, 2010, at 14:52:36
> I believe that it's a very weak D2 antagonist but I doubt that that's responsible for your current symptoms. Muscle twiching and exaggerated reflexes in the legs are typical of potent serotonergic drugs. I think it's a sign that the dose is excessive. Metabolism of clomipramine is extremely variable and dosage requirements vary substantially from person to person. Don't worry about taking any particular 'target dose', just find the dose which reduces your symptoms without causing unacceptable side effects.
>Ah okay. I had been told that it's a moderate D2 antagonist.
Strangely, I'm finding that the drug has vastly different properties at different doses. At 100mg, I was disorientated, foggy, and prone to slurring my speech, whereas reducing the dose to 25-75mg seems to bring on a potent NRI effect that is not entirely dissimilar to my Ritalin experiments. I get bad muscle tension, a feeling of being strangely immersed in my environment (to the point of occasional dissociation), and a kind of weird scrambling of my working memory, despite feeling more alert overall. I may be talking out of my butt, but does that sound like too much noradrenaline in the frontal cortex?
I also wish I knew why this lower dose was still wrecking my sleep. I never awaken fully enough to know whether it's the muscle twitching, but I have this feeling of watching myself sleep the whole time. I've tried 75mg all at night, and 50mg in the night + 25mg in the morning, but it makes no difference. Are there some people who take it all in the morning?
Thanks again for your continued support and advice! :)
Posted by ed_uk2010 on September 30, 2010, at 14:37:36
In reply to Re: miserable » ed_uk2010, posted by g_g_g_unit on September 29, 2010, at 23:37:22
>I had been told that it's a moderate D2 antagonist.
I think it's weak compared with its major effects eg. SRI, NRI.
>I may be talking out of my butt, but does that sound like too much noradrenaline in the frontal cortex?
I have no idea.
>I also wish I knew why this lower dose was still wrecking my sleep.
Clomipramine isn't necessarily sedating, although it can be for some people, especially at first.
>Are there some people who take it all in the morning?
I imagine so. You could try it. Since it doesn't make you drowsy, that could be better.
>Thanks again for your continued support and advice! :)
You're welcome.
>
Posted by g_g_g_unit on October 2, 2010, at 8:34:22
In reply to Re: miserable » g_g_g_unit, posted by ed_uk2010 on September 30, 2010, at 14:37:36
One last question, if you don't mind: how long should I give side-effects to pass + a therapeutic effect to appear before completely giving up hope?
So far the movements have lessened at 75mg, which I'm thankful for, but the cognitive dysfunction is pretty bad (possibly the worst I've experienced on an AD).
Posted by ed_uk2010 on October 2, 2010, at 15:23:00
In reply to Re: miserable » ed_uk2010, posted by g_g_g_unit on October 2, 2010, at 8:34:22
>One last question, if you don't mind: how long should I give side-effects to pass + a therapeutic effect to appear before completely giving up hope?
It's a bit difficult to say because I think you've been on an excessive dose (for you). There is evidence that clomipramine can be effective at 10mg three times a day, for example.
This is the end of the thread.
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