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Clomipramine and Trazodone-scared, please help

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I've been checking out my med interactions and of course there are a lot of them because I take a lot of drugs. However, what's got me particularly anxious is the information on taking clomipramine AND trazodone. Both are tricyclics. The words "life-threatening" and "death" are used a lot in this combo. Also, zofran with these drugs gets the, "you're gonna die" stamp.


Now, I am on 50.mg. clomipramine and 100mg. trazodone which are not high doses. Does anyone have any words of advice? I do see my pdoc on the 28th, but I'd like to still be alive by then. The serotonin syndrome part isn't what scares me the most, as I have been on this combo for awhile with no symptoms fitting that description. The interaction checker is mentioning something about the QTc interval. I don't know what that means.


Anyway, I am freaking out right now, and would love if someone with some knowledge could give me some more information. Of course, I've googled the shit out of this, and didn't find much except the interaction checker. My science background is not strong, so please tell me whether I need to do something fast or if it's okay. I know you're not doctors; but I value your opinions.


Thank you.


P.S. I did leave a msg. for the nurses at the clinic I go to. They suck, so they probably won't call back and my pdoc is not in the office and does not check her messages when she's not, so you all are kind of my source of information. I was not concerned earlier in this treatment, because I didn't care if I lived or died. I care now.

Edited by malachite
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The QT interval, or QTc, is a measurement of the time that the heart takes to de- and re-polarize during a contraction (it's called that because it is measured as the distance between the Q and T waves in an ECG).  Some medications, particularly psychotropics, can slow down the repolarization of the heart muscle (the heart basically runs on electricity) and cause the length to increase.  This can make the heart more vulnerable to developing an arrhythmia called Torsades.


That being said, this is a common issue in psychiatry - MANY psychotropics cause long QT - so psychiatrists are extremely aware of it.  If your psychiatrist has prescribed these medications together, I would bet money I don't have that your doctor is aware of the potential for long QT (and it's only a potential, not an actuality).


When the QT issue becomes more of a problem is if you overdose.


Torsades is a scary thought, but very very very rare in healthy people with a normal heart taking medication at the prescribed dose.


If you are very worried, you can always ask your doctor to do an ECG to make sure your QTc is normal at your next visit.  But the likelihood is low enough that most psychiatrists don't even check the QTc routinely for people who are on medication.


Interaction checkers always pull up the most fatal, scary sounding stuff.  If you are on more than a couple of meds, odds are good that some of them somewhere will interact and that something freaky will come up.  It's why doctors prescribe drugs and computers don't.


Of course I am not a doctor and this is not medical advice - hopefully your doctor will call you back on Monday.  But if you are taking your medication as prescribed, you can probably assume that your doctor feels it is safe (this isn't always the case, but the QT issue is very common in psychiatry).


If you want a more professional opinion, you can call your pharmacy - pharmacists know a lot about medication interactions too and they probably have more opening hours than your doctor's office.

Edited by tryp
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Thank you both so much. I don't know why I didn't think of calling my pharmacy sooner. I did just call, and the pharmacist said that he wasn't coming up with anything regarding the QTc interval issue. He did say I am at low risk for serotonin syndrome, but if I've been on them for awhile with none of those symptoms, it is highly unlikely to happen. I am taking a deep breath and chilling out. Thank you, tasty, jt and tryp.


I also had an EKG just yesterday at the ER after my Imitrex scare. It was normaI. I do have Tachycardia, but no other cardiac issues.

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