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[Migdonam]

I've been reading the following articles: 

https://psychotropic...nti-depressant/

https://psychotropical.info/tca-intro/

https://psychotropic...nfo/snri-intro/

 

Seems to be a pretty potent drug: SNRI, antagonist of the alpha1-adrenergic receptor, the histamine H1 receptor, the serotonin 5-HT2A, 5-HT2C receptors, the dopamine D1, D2, and D3 receptors, and the muscarinic acetylcholine receptors. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system; so that speaks for itself.

 

The reviews on drugs.com and other sites also are quite positive.

 

The following ranking is interesting: http://slatestarcode...d-perversities/

 

These numbers are based on aggregated patient ratings. Top 4 drugs:

# Nardil 1.25

# Parnate 1.23

# Chlomipramine 1.22

# Emsam/selegeline 1.07

 

=> Clomipramine roughly on pair with MAOI, followed by Nefazodone (R.I.P) and Imipramine. Imipramine is also a potent SNRI, but lacks the strong 5HT-antagonism compared to Clomipramine. I suppose that's the pharmacological difference which makes Clomipramine superior... ?

 

Clomipramine exhibits some antagonism of dopamine D1, D2 and D3 receptors... can one expect some clinical & therapeutic benefits from this?

 

Clomipramine acts as a functional (potent!) inhibitor of acid sphingomyelinase (FIASMA): http://en.wikipedia.org/wiki/FIASMA

Some interesting graphs regarding antidepressant FIASMAs: http://d-nb.info/1011278227/34

 

Who here has been on Clomipramine and what were your experiences with it?

 

Edited by Migdonam, 07 March 2018 - 09:16 PM.

[Catwoman]

It's been a few months....you might not be that interested in clomipramine users?
I think you posted this on other forums as well, but I'll share my experience with clomi here as well.

I started taking it about 4 weeks ago. I've increased to 50 mg, so that's still a low dose. My pdoc wants me to go up to 75 or maybe 100 mg and stay there for a while.

In the past I've taken SSRI's (which helped me achieve complete remission) but they did poop out on me. I struggled the last two years with supplements, drug holiday and later on again with anti-depressants (Zoloft and Luvox), but nothing really got me back on track. My body probably adapted to the method of action and doesn't respond to serotonin inhibition anymore. 

I can clearly feel the noradrenergic side effects: sweating, dry mouth now and then, more appetite, waking up early (but no trouble falling asleep), urinating takes longer (only happens when I go to the toilet after waking in the middle of the night)

Serotonergic: muscle twitches, restless ankles when waking up in the morning, lower libido

I can't see if clomipramine is working for me; my doctor and I decided to go slow and 4 weeks is too short anyway. Although clomi is an SNRI (and not so different from SSRI's as it works on serotonin) my pdoc wanted to follow the OCD-treatment guidelines.
Since I'm in the OCD-spectrum going on clomipramine makes sense....but I really have my doubts.

Edited by Catwoman, 14 August 2018 - 10:31 AM.