Cutting back dosage of anafranil?

[Jakemje]

Spoke with my pdoc today, and she believes I was doing better on a low dose of this med with a beta blocker, than I am on 75mg. I have only been at 75mg for a week, and she said just drop it down to 50mg tonight.

I know anafranil has a long half life, but is that a huge drop? Or has not being on it for long the reason for the big drop.

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Where at Ian on This?

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Where are you at Ian on this rather?

[panic_down_under]

Spoke with my pdoc today, and she believes I was doing better on a low dose of this med with a beta blocker, than I am on 75mg. I have only been at 75mg for a week, and she said just drop it down to 50mg tonight.

Given that the usual adult clomipramine therapeutic range is 100-250mg this seems wrong to me. How can she know how well you would do on 75mg after only a week? It takes about that long just for clomipramine plasma levels to stabilize after a dose adjustment. Was taking this med her idea, or yours?

I know anafranil has a long half life, but is that a huge drop? Or has not being on it for long the reason for the big drop.

I doubt you will experience any withdrawal from dropping back the dose after only a week at 75mg.

[Jakemje]

It was hers. I took 25mg for 10 days and felt good. When I went up to 50mg, a little more anxious along with a 110 bpm resting heart rate. Stayed on that a week and then to 75mg. After about 3 days, my anxiety went through the roof. Actually had to get someone to drive me home today since my eyes were so blurry.

Now, from what I have been reading, "they" (some of the medical digests that I can find) they recommend a low dose of clomipramine 10-25mg. Even a lot of the people on this site are only on 25-50mg. But I do see where in the pamphlet on the med, that it's suggested to get up to 100-150mg, as tolerated, and can go up to 250-300mg.

So I don't know. It doesn't make sense to me either that do many take a low dose, but yet it says to take a high dose.

But, if these are just side effects, I can't take them. I've seen no good from it, and the med is now keeping me from being able to drive

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ww. ncbi.nlm.nih.gov/pubmed/9533169

[panic_down_under]

Stayed on that a week and then to 75mg. After about 3 days, my anxiety went through the roof.

That is a common initial side-effect of most antidepressants caused by the initial increase in serotonin activity. The brain usually responds within a week or two by reducing serotonin synthesis and expression and anxiety levels drop back to baseline until the med kicks-in, but may spike again for a while after dose increases.

Ask your psychiatrist to prescribe a small dose of diazepam for a couple of weeks to get you through this, or the beta-blocker if it was discontinued.

Now, from what I have been reading, "they" (some of the medical digests that I can find) they recommend a low dose of clomipramine 10-25mg.

TCAs are prescribed at low doses for many things other than treating anxiety and depression including blocking nerve pain, migraines, insomnia, IBS, neuralgia, premature ejaculation, nicotine withdrawal, tinnitus, bed wetting, etc, etc. But for anxiety/depression you'll need more than 10-25mg.

Even a lot of the people on this site are only on 25-50mg.

Well they shouldn't be for anxiety/depression, imho.

www.ncbi.nlm.nih.gov/pubmed/9533169

This is male bovine manure on several levels, but the main one is no single dose of any antidepressant will lower anxiety, although the placebo effect may. It simply isn't the way antidepressants work, but back in 1998 they didn't know about hippocampal neurogenesis.

[Heretic]

I existed quite peacefully on 25mg daily for a long time... Now I must take 2x25, because I tried to drop Anafranil and take only Coaxil - which did not work in the end.