View Full Version : Imipramine or Clomipramine
My doctor wants me to try imipramine, but everything I read points to clomipramine being superior. I suffer mainly from extreme anxiety (psych thinks I have anxious depression) and some depression. Not really any OCD, although when my anxiety is high, I have OCD thoughts. I don't want to start imipramine, only to wish I started clomipramine. The side effects of imipramine seem to be worse than clomipramine. Any help would be appreciated (hopefully you could help me PDU)? Other meds include Mirt 30mg, Olanzapine 2.5mg and Nortriptyline 125mg. I would be changing from Nortriptyline as I am still getting anxiety and depression while on it. TIA.
panic_down_under
26-07-17, 13:21
I don't want to start imipramine, only to wish I started clomipramine. The side effects of imipramine seem to be worse than clomipramine.
Clomipramine is the most potent non MAOI antidepressant available. It is a pity it became so strongly linked to OCD that many doctors now think this is all it's good for. It works just as well for the other anxiety disorders and depression and is about as effective for treatment-resistant (refractory) depression as the MAOIs.
BTW-clomipramine is a more potent 5-HT2a receptor antagonist than mirtazapine, which supposedly is responsible for the mirtazapine therapeutic response (it almost certainly isn't), so there would seem to be no point in continuing to take it if you're on clomipramine except perhaps as a antihistamine sedative, but this was even more the case with nortriptyline too.
The typical TCA anticholinergic side-effects such as dry-mouth and constipation may be a little more severe than with imipramine, but about the same as with nortriptyline.
Thanks for your response once again PDU. You're awesome. I have read a few studies where they have compared the two. One of them states: 'With respect to all major outcome parameters ie full panic attacks, total number of anxiety attacks (full plus mild), and anxiety between attacks, the effect of clomipramine was clearly and significantly superior to that of imipramine'. I will need to discuss with psych further and will take the study with me.
panic_down_under
27-07-17, 06:36
I have read a few studies where they have compared the two. One of them states: 'With respect to all major outcome parameters ie full panic attacks, total number of anxiety attacks (full plus mild), and anxiety between attacks, the effect of clomipramine was clearly and significantly superior to that of imipramine'. I will need to discuss with psych further and will take the study with me.
If panic attacks were your main problem I'd be suggesting imipramine as it was the 'gold standard' med for panic disorder until the SSRIs became available and worked well for me. But for mixed anxiety and depression clomipramine is likely to be the better bet.
Mermaid, I have an agitated depression diagnosis and it's a very complex condition to treat. I remember that my psych from many years back (now a published author and renowned in the psych world) put me on moclobemide but this drug is probably not used much now.
Thanks PDU and Pulisa. I think it is a combination of anxiety and depression. I think the clomipramine would be better. I guess I will speak to the psych and see what she recommends with all the information I have gathered. I just don't want to push for the clomipramine and for it to come back and bite me on the bum. I just hope I can get through any added anxiety and depression I might experience when I am swapping over.
Hi PDU, I was wondering if you could tell me what the difference (if any) is between, Nortriptyline, Imipramine and Clomipramine. Also when swapping over, is there likely to be a lot of side effects, given they are from the same class of meds. Also if Nortriptyline didn't work, is it likely that swapping to Imipramine won't do much good either? My main complaints are high anxiety and depression. Thanks PDU.x
panic_down_under
31-07-17, 03:01
what the difference (if any) is between, Nortriptyline, Imipramine and Clomipramine.
Nortriptyline is a straight noradrenaline/norepinephrine reuptake inhibitor. It has little impact on serotonin. Imipramine is a fairly potent serotonin and mild noradrenaline reuptake inhibitor, and clomipramine is both a very potent serotonin and noradrenaline reuptake inhibitor.
Also when swapping over, is there likely to be a lot of side effects, given they are from the same class of meds.
Perhaps as you're going from a med with very little serotonin activity to a very potent serotonin reuptake inhibitor. However, the TCAs tend to produce less severe side-effects at the beginning than SSRIs/SNRIs, although, as with everything about antidepressants, there are no guarantees.
TCAs are not a uniform group of meds which all do basically the same thing as is the case with SSRIs. Their effects differ greatly in how they work.
Also if Nortriptyline didn't work, is it likely that swapping to Imipramine won't do much good either? My main complaints are high anxiety and depression.
Not necessarily as they do different things.
Thanks again Ian for your invaluable information. I am seeing the psych tomorrow and will discuss the Imipramine and Clomipramine with her...I am pretty sure she will stick to her guns though. I have asked about the clomipramine twice before, the first time she said it was for OCD and the second time she said it is too sedating.
panic_down_under
31-07-17, 12:56
the first time she said it was for OCD and the second time she said it is too sedating.
Wrong on both counts. Sedation is mostly produced by antihistamine potency and clomipramine is a weaker histamine H1 antagonist than nortriptyline, though imipramine is a little weaker again. a1-andrenergic and 5-HT2a receptor antagonism also plays a part and in that regard again there isn't that much difference between clomipramine and nortriptyline, so if sedation wasn't an issue with nortriptyline then it shouldn't be with clomipramine.
Anyway, if she is so concerned about sedation why are you on mirtazapine and olanzapine which are both very sedating?
Hi PDU
I have seen the psych this morning and she has agreed to changing to Clomipramine. The schedule she has given me is as follows: I am currently on 125mg of Nort.
Sunday
Nortriptyline 3 tabs (75mg)
Tuesday
Nortriptyline 1 tab (25mg)
Wednesday
Clomipramine 1 tab (25mg)
Thursday
Clomipramine 2 tabs (50mg)
Sunday
Clomipramine 3 tabs (75mg)
I have asked if I could spend a week at each level with the Clomipramine, so 25mg one week, 50mg week two etc.
Do you think slowing down the increase in Clomipramine is necessary or do you think because I am taking the Nortriptyline it would be better to ramp it up over a week.
I hate medication changes and my anxiety is already high just thinking about it. Sorry for all the questions. Thank you again for all the information you have shared with me. I know I should be asking the psych some of these questions, but the psych is a bit of a scatterbrain, she asked me what medications I'm on when I go in, and then says 'oh, I have so many patients I can't remember what everyone is on'. So I would probably trust your judgement more than hers. The only reason I am staying with her is because she is linked to the hospital where I was admitted at the end of last year.
Thanks PDU.
panic_down_under
01-08-17, 01:50
I have asked if I could spend a week at each level with the Clomipramine, so 25mg one week, 50mg week two etc.
Do you think slowing down the increase in Clomipramine is necessary or do you think because I am taking the Nortriptyline it would be better to ramp it up over a week.
While I would have suggested a different approach, I prefer your psychiatrist's faster switching method to limit any withdrawal symptoms than your slower pace, however, they may not be that severe anyway as the TCAs are usually easier to quit than the SSRIs and SNRIs.
I know I should be asking the psych some of these questions, but the psych is a bit of a scatterbrain, she asked me what medications I'm on when I go in, and then says 'oh, I have so many patients I can't remember what everyone is on'.
This is what patients' records are for, to be quickly read between patients!! Sigh!! One of the things I've observed about doctoring generally, and psychiatry in particular is critical thinking skills don't seem to be a basic requirement. :sad:
Hi PDU! Just curious as to how you would do the swap over as you mentioned you would have gone for a different approach. I have read somewhere to reduce Nort down to 25mg and then start the Clom and I have also read a study where patients were taking 150mg Clom and 50mg of Nort (which I will not be doing), but obviously they can be taken together, as I think I will still have the Nort in my systems when I start the Clom. Thanks PDU. You are a 'fountain of knowledge'.
panic_down_under
03-08-17, 07:25
Hi PDU! Just curious as to how you would do the swap over as you mentioned you would have gone for a different approach.
I think cross-tapering is a better strategy. But your doctor should be the arbiter.
Not doing too well with my taper so far. Only dropped one tablet last night instead of 2 (started on 125, so only dropped down to 100). Probably just my mind playing tricks on me, but I am actually worried that I will lose my mind by dropping this med so quickly. Doesn't it put your brain into all kinds of chaos. Have psych appoint tomorrow to see what she thinks. I want to do it quickly, but I'm really scared of what may happen. So far today have just felt a little off, but nothing major.
Have only been on med about 6 months all together, with 3 of them being at 125mg, before that 100mg.
panic_down_under
07-08-17, 07:34
Not doing too well with my taper so far. Only dropped one tablet last night instead of 2 (started on 125, so only dropped down to 100). Probably just my mind playing tricks on me,
Almost certainly. Nortriptyline has an average half-life of 25 hours, range 16-90 hours, so withdrawal symptoms don't usually begin immediately.
but I am actually worried that I will lose my mind by dropping this med so quickly. Doesn't it put your brain into all kinds of chaos.
Withdrawal symptoms are usually physical, not psychological. Plus TCAs tend to produce less severe symptoms than the SSRIs and SNRIs.
Thought I would keep updating, incase someone is in a similar situation to me at some stage. My taper has had an extra day added to it. So is now:
Tuesday
Nort 1 tablet
Wedn
Nort 1 tablet
Thursday
Clom 1 tablet
Friday
Clom 1 tablet
Saturday
Clom 2 tablets
Sunday
Clom 2 tablets
Monday
Clom 2 tablets
Tuesday
Clom 2 tablets
Wednesday
Clom 3 tablets
Had another psych appointment today, where we nutted out a plan for the week ahead. Plus we put a safety plan into place in case it all goes to shit. She has written up admission papers, so if it does go to shit over the weekend I can go into hospital. Anxiety seems a little higher today. I take Clonazepam at 8.00am and 2.00pm and could really feel the anxiety ramping up before the 2.00pm dose. Also have I think a tension headache of some sort. Feeling a little yuck. Will be glad when work is over. Will try and keep updating for others that are starting on Clomipramine.
Hi Mermaid and PDU,
I have been prescribed Nortriptyline (10MG) as an add on to my celexa. I currently taken that in conjunction with my daily clonazepam (which I want to get off of). Is it normal for psychiatrists to add on this medicine for anxiety while taking an SSRI. Now i'm anxious to start a new medication. I'm afraid it's going to cause increased anxiety. Any thoughts on this drug combination?
Hi Ethansmom
I have read about Nortriptyline being an add on to other meds. I was taking Nortriptyline while I was tapering off sertraline, so you can definately take it with other meds. I don't remember any added anxiety when I started the Nort. My anxiety did improve, but not enough to get off the clonazepam, which is why I am now changing to Clomi. I am hoping that it will do enough for my anxiety and depression so that I can get off the Clonazepam. I was taking 125mg of Nort so was on a much bigger dose. I would think that you would hardly notice the Nort at 10mg and would doubt you would have any anxiety. Nort did raise my heart rate. I use to sit at about 50 or 60 resting, whereas now my resting is around 80. I do think this relates to the dose though so again you probably woudn't notice anything. I did get postural hypertension at the start, so just take is slow to start with. This did end up going after a week or so and again was at a higher dose. I was started on it while I was in hospital (so I increased quite quickly from memory). Try not to be scared, it is only a small dose. I have tapered down to 25mg and took my last tablet of them last night. Tonight I take my first dose of Clomi 25mg, so know that it is scary, but we have to do it to try and get better. If you have any questions about it, feel free to ask.
Scaredbear
09-08-17, 22:17
Hello,
I just wanted to give you my experience with clomipramine. I was started on this by a psychiatrist when I was 15 due to sudden onset of severe panic disorder - not OCD. I have been on it (on various doses between 50mg and 150mg) ever since - I am now 27. Although I still have bad phases of severe anxiety (and some obsessive thoughts regarding death) generally, I would say this drug saved my life.
My mum also started experiencing panic attacks a few years back and has been on a low dose of clomipramine which has helped her.
It's quite a rare drug these days apparently but I can really say it has helped me, as much as I believe any med would. I haven't suffered any serious bouts of depression since before being prescribed it either.
Only major side effects are bad dry mouth and drowsiness but the dry mouth goes away and the drowsiness is manageable!
THanks for your quick response regarding the nortriptyline. I'm always afraid of side effects and my doctor knows this. I was told to take it before bed. My main goal too is to get off clonazepam. I take 2MG a day. So now i'm going to be taking 3 drugs... I hate that! Clonazapam is what really helps me, but only to a certain point. I'm going to take my first dose of nortrip on Friday evening to see how I react. I'm already catastrophizing some horrific outcome---so much anxiety!
Were you taking your nortrip after the clonazepam at night? Just curious what your schedule was like?
Hi! I'm the same with worrying about side effects, but at the end of the day, the docs know what they are doing. My schedule was:
8am .5mg Clonazepam
2pm .5mg Clonazepam
Before Bed (so around 9ish). 1mg Clonazepam, 125mg Nortriptyline, 1.5mg Olanzapine, 30mg Mirtazapine. (It was about 10 tablets all together and I swallowed them all together).
I have never had any bad side effects doing this and if my kids woke up during the night, I was able to get up to them without any problems.
Please try not to worry about it, it is such a tiny dose. I don't even think you would have side effects on that dose, but if you do it would be more like, dry mouth and constipation.
If you need to chat, I'm here :-)
---------- Post added at 09:50 ---------- Previous post was at 09:42 ----------
Hello,
I just wanted to give you my experience with clomipramine. I was started on this by a psychiatrist when I was 15 due to sudden onset of severe panic disorder - not OCD. I have been on it (on various doses between 50mg and 150mg) ever since - I am now 27. Although I still have bad phases of severe anxiety (and some obsessive thoughts regarding death) generally, I would say this drug saved my life.
My mum also started experiencing panic attacks a few years back and has been on a low dose of clomipramine which has helped her.
It's quite a rare drug these days apparently but I can really say it has helped me, as much as I believe any med would. I haven't suffered any serious bouts of depression since before being prescribed it either.
Only major side effects are bad dry mouth and drowsiness but the dry mouth goes away and the drowsiness is manageable!
Hi Scaredbear! Thank you for giving us your experience on Clomipramine. It can be quite a stuggle sometimes on here to find someone who has experience with these medications. With regards to the drowsiness are you still able to drive, work etc. I am starting tonight on 25mg. My main concern is an increase in anxiety, as my levels are already pretty high, even though the last few days haven't been too bad because I have been able to have a relatively good sleep. I'm on other sedating medication (olanzapine, mirtazapine and klonopin, so I am hoping once the Clomipramine kicks in, I can start to reduce some of these meds. Thanks again for your input. Tracy
I left a message for my psy this morning, I thought she nortryptalyine was the generic for Elavil. Now i'm wonder if she meant to prescribe Amatryptyline?? So frustrating, now i'm questioning if she even wrote down the right prescription.
Scaredbear
10-08-17, 21:35
Hi Scaredbear! Thank you for giving us your experience on Clomipramine. It can be quite a stuggle sometimes on here to find someone who has experience with these medications. With regards to the drowsiness are you still able to drive, work etc. I am starting tonight on 25mg. My main concern is an increase in anxiety, as my levels are already pretty high, even though the last few days haven't been too bad because I have been able to have a relatively good sleep. I'm on other sedating medication (olanzapine, mirtazapine and klonopin, so I am hoping once the Clomipramine kicks in, I can start to reduce some of these meds. Thanks again for your input. Tracy[/QUOTE]
Hello! Yes I can still drive and hold down a full time job on 150mg. I was slightly less drowsy when on a lower dose - 80mg for about 2 years at uni and I managed to have a complete university experience including working late nights till 3am in a bar and getting up for a 9am lecture. To be completely honest, I think with the drowsiness you just learn to manage it. It's something you get used to. I have been feeling tired for years but I would rather have that and less anxiety than the other way round!
I'm not saying it's a wonder drug I still have bad anxiety spells that can last months HOWEVER when I was started on clomipramine I couldn't leave the house whereas now I live a normal life. In my experience, doctors aren't that familiar with clomipramine as SSRI's are more commonly prescribed and clomipramine is a tricyclic. It is therefore quite difficult to find people with experience of it. If I can help in any way I will!
Hi Scaredbare! That is great that it hasn't impacted on your life in a negative way. I still have kids to run around to school etc, so am glad I can still drive etc. I took my first dose last night, I was a little apprehensive, but it turned out okay. I woke early at 3.30am, but I think I managed to dose back off, even though it sometimes feels like you just lay there awake. I had an early start for work so was up and out of the house by 5.00am. Not feeling too bad so far (I had imagined much worse). I woke up drenched in sweat (it is winter here at the moment though, so I was pretty rugged up. I could feel my anxiety a little more than usual and just feel a bit meh. I am at work and it feels like the time is dragging on and on. Haven't really felt like eating anything and have been drinking lots of water and tea with ginger in it to keep any nausea away. I don't even know if I have nausea. I feel sleepy and yawning. Haven't noticed any change in heart rate or anything else really. Will update later. Well off to bed after my first day. Nothing really to update on. Felt a bit off most of the day, but it wasn't bad, was tired late afternoon so had a lay down. Not sure if I slept. Will report tomorrow. Uneventful day today.
Yesterday wasn't too bad. I had a very bad headache, like I had been hit in the head with an ice pick kind of a headache. I think this is probably a mixture of withdrawal from the Nort and starting the Clomipramine. I ventured out to do some groceries, but stayed at home so I could lay down when I felt like it because of the headache. I couldn't sleep though and was up a lot longer last night than I usually am. I have done three nights at 25mg and am thinking of increasing to 50mg tonight as we have a public holiday tomorrow. After that I think I might sit at 50 for a bit longer. I am tolerating it okay so far. Headaches and anxiety have been manageable. Back to work on Tuesday.
Headaches definately been the worst. Today, same thing. Fell asleep this morning. Headache still there when I woke up. I'm sure yesterday it was behind my right eye and today behind my left.
Hi mermaid,
Is it normal to feel drowsy on 10 mg of nortriptyline? Its day 2 and I feel drowsy even though I take of at night. I also take celexa and clonazapam.
Hi! To be honest I can't really remember and if it did it passes. I would say give it a week and you will probably find it goes. It just takes a bit of time to get into your system. How have you been feeling otherwise. I did a quick taper off Nort (within a week) and on to Clomipramine and I'm finding it quite difficult. I think I should have taken a bit longer to come down in the Nort. I just want to sleep all day and I'm back at work tomorrow.
Other than feeling very drowsy the next day, I do feel a bit better. My doctor said Nort starts working very quickly. I'm only on 10MG. I'm also concerned about weight gain as a side effect (as I've already gained 20 pounds from Prozac that has only budged about 5 pounds or so.) I'm been working out everyday and going to therapy weekly. I have it tonight and am so excited to talk with the therapist. I just hope this gives me the boost to calm down. I do notice my pulse is a bit higher- but returns to normal when I am totally calm (at night). I wonder if I will have an issue with that. I know you mentioned your pulse was higher. I have Obsessive thoughts and wear a fit bit everyday, so i'm constantly checking. Maybe I should just put down the fit bit!!! It's feeding my anxiety. Or maybe only look at it twice a day instead of every 10 minutes:ohmy:
Hi! I think with a lot of meds they say you put on weight. I think if you exercise and eat healthy you will be okay. I have a fit bit too. I check my pulse a lot too, but I don't get worried about it. My psych once told me that they wouldn't be worried until my resting pulse was up around 130bpm. It has never even got close. If you obsess and worry over it though, maybe be better to turn the heart rate monitor off. I am pretty sure you can do this in the settings. That's good that you are having therapy. I really enjoyed the Acceptance and Commitment Therapy, but not the CBT so much. I felt I got a lot more information about how to deal with the thoughts with the ACT. I went up to 50mg on Clomipramine last night. Not feeling too bad today, but at work, so can't nap if I feel drowsy. I'm not overly drowsy. I've noticed that my eyes seem a bit blurrier today, other than that pretty much the same. I have notice the intrusive thoughts that I usually only have when my anxiety is high have come back, but I think it is the withdrawal from the Nort and starting the Clomip that has caused that. The psych said to stay on this dose for a week, so next Monday I will go up to 75mg and then sit there for a few weeks and then evaluate how the anxiety etc is. I read that it takes 8 days for Nort to be eliminated from the body. I took my last dose on Wednesday, so this Thursday the 17th it should be out of my body. I was pretty rough over the weekend, so I am hoping that is the only withdrawal I will have from it. Has PDU left? Sorry for rambling. Just doing a bit of an update at the same time. Still having the intrusive thoughts, I'm trying to ignore them, but they are very annoying at the moment. Hope they start to fade soon. If my mind is busy I forget about them. Had been feeling kind of flat over the last couple of days, but just baked a cake when I got home from work, so things are hopefully improving. I always bake when I'm feeling good, so hopefully I'm on the up
I was wondering about PDU as well? I hope he's okay!! I hope this new medicine works for you. I'm on day 5 of Nortryptyline and I've noticed an increased in energy and happiness, but still have intrusive thoughts that I have to find throughout the day. I'm better when i'm at work that when i'm sitting idle doing nothing. My therapists believes in CBT and I find that it does help me see how irrational I can be. I hope this is the right med. I go for a med review next week.
I was wondering about PDU as well? I hope he's okay!! I hope this new medicine works for you. I'm on day 5 of Nortryptyline and I've noticed an increased in energy and happiness, but still have intrusive thoughts that I have to find throughout the day. I'm better when i'm at work that when i'm sitting idle doing nothing. My therapists believes in CBT and I find that it does help me see how irrational I can be. I hope this is the right med. I go for a med review next week.
Hi! I am really glad that you feel like you are having some success with the Nortriptyline. I felt that it worked, but it didn't work enough. I was still having problems with anxiety and depression. I was taking it with Sertraline initially but have now stopped that. I haven't been feeling to bad, I think I am still going through a few rough bumps. I stopped the Nort 8 days ago and it takes that long for it to fully get out of your system, so I'm thinking these bumps are due to coming off that and starting on the Clomipramine. The Clomipramine hasn't been too bad with start up, as I was experiencing most of the side effects on the Nort anyway...blurry eyes (which is due to your eyes being dry) and constipation being the main ones. I have eye drops, but I rarely use them and take Metamucil once a day for the constipation, which seems to help. Please keep in touch and let me know how you get on with everything and I will do the same. Talk soon...Tracy x
I'm hopeful that our medications are going to work...... we need them to :)
I have days where I feel better and then other days where I don't feel as great. It's been one full week on 10MG of the nort. So far, I do have the eye blurriness. I'm going to try to keep eye drops in my purse. I wear contacts so and that the end of the day they are super blurry!
Keep me posted.
Hi! Fingers crossed the meds work. I have been on 50mg for one week and tonight I go up to 75mg. Like you, I have good days and not so good days. I wouldn't say they not so good days are unbearable, they just not as good as the good days. I find if I am distracted, I am much better. I had a little panic driving the kids to school today. I felt a bit dizzy I think and then I always think I'm going to pass out. My daughter said 'It's okay Mum, you have to face your fears'. Bless her. I have been okay for the rest of the day. I'm not really sure what dose is supposed to be good for panic and anxiety, I think around 100mg. I will stay at 75mg at least for a week I guess and then see how I go from them. It takes 3 weeks to reach a steady state so I don't know if that means it takes that long to work or not. 75mg is the theraputic dose though. I think the Nort works as an add on to boost up the other med you take, so hopefully over the coming weeks you see improvements. I will let you know how I get on tomorrow after increasing the dose. xx
7:00am: Took my first dose of 75mg last night. Had to be up early for work. Woke with my heart racing 95bpm, when I got up it went up to 105bpm which worried me a little. I tried not to worry about it as I know that Clomipramine can cause tachycardia. The psych has told me before that they wouldn't be worried until it was up around 130bpm while resting. At work now and it is 62bpm. Feeling okay so far, same as every other day before I increased the dosage.
Thanks for the update and I pray that things get better for you and all of us on here!
I'm wondering if you could tell me whether the nortriptyline caused increased hunger? I hope this goes away!!! I can't afford to put on any more weight. I see the psy today, so i'll see what she says.
Hi! It's hard to say regarding weight. I take three medications that list 'weight gain' as a side effect (clomipramine, olanzapine and mirtazapine). I have started dieting and exercising. I lost a few kilograms, but then just plateaued. I haven't been exercising since starting the clomipramine. If you eat healthy and exercise, that is the best you can do. Most medications seem to list weight gain as a side effect, so changing from one to another, doesn't really seem to matter. It is better to just try and work with it I guess.
Update: Day 2 on 75mg Clomipramine. Increased anxiety and heart racing 95bpm again on waking. Feeling anxious today, but know it's from the medication and hopefully means it is doing something. Heart rate drops after I get up in the morning back to about 70bpm.
Hi Mermaid,
Same issue here. Day 13 of 10MG of nortryptyline. Feeling more anxious as well. Is this normal? I know the SSRI's do that to me, but my doctor wants me to increase the nort to 20MG this Friday. Is that a wise decision??? Ugh, i'm so riddled with anxiety. today was my son's first day of school and it was a bit emotional for me. My heart rate has been in the 90's all day, so decided to take a Xanax and to put the fit bit away!
Hi Ethansmom. I guess you should discuss with your psych to see if you should go up or not. I know it's hard to even contemplate doing it when your anxiety is already high.
Update: I didn't have any racing heart rate today. Anxiety level is through the roof. Hopefully it calms down soon. I just keep telling myself that it's the medication making changes in my brain that is making me feel like this and hopefully it means it's going to work eventually to decrease my anxiety.
That's a good way of thinking about it--- it's making positive changes in the brain-- so hopefully that's a good sign?? I just want to conquer this thing.
Took first 100mg dose last night 29th August. Still waking early (around 4am and laying there awake until it is time to get up for work (usually around 5.30-6.00am). Really struggling with the anxiety still during the day. I want to try and stick it out because I don't want to change meds AGAIN, but it is very difficult to put up with it. Plus I don't know if I am going to be stuck like this or once the body gets use to it, it will start to decrease. Feeling a bit off today also. Heart rate is up over the 100s if I get up to do anything, but sitting or laying down, resting heart rate is around 70.
Hi Mermaid,
It's so hard to know if we should stick with the med, or if it's just not the right fit for us. I have a feeling the Celexa i'm taking is not doing much for me, and so the doctor added Nortryptyline. I'm feeling anxious today (much less than yesterday), but i'm wondering if I need to just drop/ or change the Celexa. The psychiatrist didn't want to change too many variables so she though it would be easiest to add nort to see if would help alleviate my terrible anxiety. I'm going to double the dose of nort on Friday, that way I can deal with the extra anxiety over the weekend. I wonder if I should just start now and deal with it with Xanax if I need too. Thoughts??
Hi! I agree with the psych and not changing too many things at one time, because then you don't know what is causing what. It is your choice if you want to increase, as you said you do have backup Xanax there if your anxiety spikes. I am going back to see my psych today as things have gone down hill very quickly anxiety wise when I increased to 100mg. I just can't tolerate it, plus it shoots my heart rate up. I am going to ask her if it is worth continuing or if I should try something else or go back to the Nort. She said because I am having increase heart rate on 100mg there is very little room for increase past that, so I may have needed to change anyway. I will see what she says in any case. Kind of wishing I had just stuck with the Nort now. I have booked a holiday two weeks away and with the way I am feeling now, I would not be able to go. Keep in touch and I will let you know how I get on this afternoon. Tracy xx
Hi Mermaid,
How did things go today? I have noticed an increase in heart rate too, but then it goes back to normal. Like right now it's at 67 which is good. You are right about not changing too many variables at once. I was thinking about raising the dose this weekend and then seeing how that goes. Otherwise, I may ask to switch over from Celexa to Lexepro. Lexepro is supposed to be better for anxiety (and is the sister drug), however I remember trying that years ago. I only stuck it out for 7 weeks. I may try that again and see how it goes :( It's too bad that clonazepam is the only thing helping me. I wonder if I'll be on that for the rest of my life. One day at a time, I suppose. Not sure how i'm going to know when to wean off that, but we'll see.
Hi Ethansmom! Just back from the psych. She has taken me off Clomipramine and put me back on Nortriptyline. She felt this was the best way forward as the Clomipramine has really ramped up my anxiety, plus I was having the fast heartrate she said I probably wouldn't get passed 100mg. One morning I woke up and my heartrate was 160bpm. It was starting to add to my anxiety as well as I was worried that I was going to have a heart attack. Not that fast heart rate can cause that (I think it is only if it stays high continuously), but I am also over weight and have had high cholesterol. So tonight I start back on the Nortriptyline. It may not have been perfect last time, but I was at least functioning. Since Monday I have felt terrible with anxiety and really agitated. So if this doesn't work, I will be back in hospital so they can monitor how I am going. I really don't want to go back to hospital, so fingers crossed that this works. Keep in touch and let me know how you are getting on. xx
Ok. I'm so glad you switched back. Sometimes we have to listen to what our bodies are telling us! I know we have anxiety, but we have to advocate for ourselves at the same time. Tomorrow makes 3 weeks for me on the 10 mg of Nort. I am going to go up to 20 this weekend and see how I feel. Right now I'm still anxious but more back to my baseline anxiety so maybe it's time to go up. If you can do it, so can I. I just need to take that leap of faith. I'll keep you posted
Take care
Sara
Hi Sara! I stopped the Clomipramine cold turkey on Wednesday night, took 25mg Nort on Thursday and 75mg Nort last night. I am to stay on that dose until I see her again on Monday. I am on 2mg Clonazepam in the morning, 1mg at midday and 2mg at night. That is such a huge dose, but believe it or not, I am still getting anxiety in between doses. Usually towards the end of each 6 hour period. I am petrified of taking so much, but because she is ramping up the Nort so quickly and my depression is so bad (like agitated/anxious depression) I guess is the best way to describe it, she has told me to trust her and let's get this done quickly (in one week) and then come back to just the 2mg of Clonazepam. I could either go into hospital and do it or stay at home and do it. I chose to stay at home and do it. It is Saturday today and I see her again on Monday. Shitting myself, but I don't know what else to do except trust her. Before I saw her on Thursday I was a mess and couldn't see any way to solve this problem with my anxiety being so bad. So I have trust her...I still feel nervous about it though. Hope you are going okay and the increase hasn't been too bad. Let you know how you are getting on? Tracy
Update: Took the 2mg last night and the 2mg this morning and have decided that it is too much. I slept 10 hours last night, then woke up for two hours and slept for another two hours. My Mum said that I looked drugged, so I didn't take any at midday and am feeling much more with it. Am starting to feel more anxious now, but will try and hang out till about 8.00pm and take my night time dose. Think I might just take 1mg at bed time and see how I feel. That's what I usually would have taken anyway.
THanks for the update. I'm day 7 into the nort. I was feeling better until yesterday(I got into a car accident), but thankfully am okay. I'm not sure if it's the increase in nortriptyine making me anxious, or the car accident (or both)
Sara
I've been prescribed Clomipramine and don't take it. Apparently one of the side effects is big weight gain. I've always gained weight on SSRIs which is a big problem as I have an eating disorder as well as anxiety and OCD. The doctor must think I'm crazy if they think I'm going to take this, I'd rather suffer what I'm going through now which is hell but I'm done with meds I hate the feeling on them.
Hi All
I am currently having a bad period of anxious depression and have been upping clomipramine from 30mg(the dose I have been on for 5 years) to 70mg and I can't say I feel any better, just as anxious/depressed but have been messaging PDU for some advice on dosing. Anyway I have gone to 100mg tonight and gonna try to give it a shot until my next GP appt on 26th April, so at least I will have given it a go and then if I am better or worse I can report back to Doc. Wanting to ask if anyone in this thread is still on a TCA and if so how are they getting on with it. I need some moral support. I can't tolerate SSRI's, so really hoping this increase helps. I am not really sure if I have had any side effects from the increase yet as it is hard to tell what is me and what is anxiety. Heart rate is speedy but it was anyway with anxiety just before Christmas, so again hard to say if it is the clom. x
Hi All
I am currently having a bad period of anxious depression and have been upping clomipramine from 30mg(the dose I have been on for 5 years) to 70mg and I can't say I feel any better, just as anxious/depressed but have been messaging PDU for some advice on dosing. Anyway I have gone to 100mg tonight and gonna try to give it a shot until my next GP appt on 26th April, so at least I will have given it a go and then if I am better or worse I can report back to Doc. Wanting to ask if anyone in this thread is still on a TCA and if so how are they getting on with it. I need some moral support. I can't tolerate SSRI's, so really hoping this increase helps. I am not really sure if I have had any side effects from the increase yet as it is hard to tell what is me and what is anxiety. Heart rate is speedy but it was anyway with anxiety just before Christmas, so again hard to say if it is the clom. x
Hi! I am on Nortriptyline and have been since 2016. I take 150mg which is the highest dose you can take of that medication. I think I remember having faster heart rate when I first started, but that seems to have settled. The main side effects I get are dry mouth and constipation. I was initially on 125mg and when I went up to 150mg my anxiety improved. If you have any other questions, please contact me. Tracy
Thanks, I am a week into 100mg of clomipramine and I feel horrendous - anxiety is off the scale and I am so down.
I am to start Clomipramine for intrusive thoughts switching from 75 mgs of amitriptyline to 50 of Clomipramine are the side effects bearable I have a prescription of Xanax if the anxiety gets bad what dose did you start at
Are you still on Clomipramine
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