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Clomipramine | The "Gold Standard" when it comes to Depression and OCD?

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2 hours ago, echolocation said:

hi everyone, figured i'd just resurrect this thread instead of making a new one since there's all sorts of good info in here.

i'm going to be starting clomipramine soon. my OCD-ness is up in the air, but i have OCPD, intrusive thoughts, and a chronically low mood, so pdoc figures it's worth a shot. i was on effexor 225 mg and risperidone 0.75 mg for ages, and it worked great until risperidone made me lactate. :^( we dropped that and tried abilify for a bit under the theory that i seemed to respond well to effexor + low-dose AAP. abilify gave me pretty bad cognitive side effects (terrible memory) right off the bat and i had to discontinue because my work performance was beginning to suffer because of it. i was on 2 mg for a couple months.

effexor, currently at 262.5 mg, is going down to 150, and i'm starting clomipramine at 25 mg this week, once i manage to get my script to the pharmacy. not on an AAP at all currently.

my main question is, did any of you find clomipramine sedating at all? i don't seem to do well on activating drugs.

anyone who's tried this and hasn't chimed in on this thread already, please share your experiences! my hopes are still up, but it seems like many of you had a mediocre experience on this.

@Catwoman if you're still around, and still on clom, how have you been doing?


I didn't find it sedating.  The opposite actually. That and Luvox gave me awful insomnia. It's sedating for most though. I just get paradoxical effects from meds. 

However it WAS effective for the OCD. Went from severe to moderate. I was able to let things go, really early on too. 


Good luck! It's been life changing for some other people I know. 

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At risk of talking about my dog again, his vet told us it could cause hypothyroid (which dogs tend to).  No idea if that happens to people too, but you could always monitor for.

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jarn, never apologize for talking about your dogs! noted. i'll look into it. thank you!

@Persona_Is_Life thank you for sharing! that makes me hopeful. my obsessive stuff is not severe, but it's beginning to turn into a contamination-type thing, which i'm concerned about. i'm struggling with using the washroom at work because i'm afraid of getting someone else's piss on my hands, somehow. it's rather stressful. plus the usual sexual intrusive thoughts about people i know, which got a lot worse on abilify. hopefully it all settles down soon.

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Paroxetine: a selective serotonin reuptake inhibitor showing better tolerance, but weaker antidepressant effect than clomipramine in a controlled multicenter study. Danish University Antidepressant Group. [April 1990]

Citalopram: Clinical effect profile in comparison with clomipramine. A controlled multicenter study [August 1986, Danish University Antidepressant Group | Psychopharmacology, Springer-Verlag]

It may be an old set, but the quality of the study is high, it's overall well designed, and the study's creators are "independent".

It is ridiculous that they are afraid of prescribing efficient drugs which had been the well-established Gold-Standard for millions of psychiatric patients during the 60s, 70s and 80s... and even to this day those old drugs have bigger effect sizes than "modern" antidepressants. I don't mind that they prescribe SSRIs as first line treatment, but that never-ending focus on SSRIs and ongoing SSRI-roulette is a pain in the butt. This is cause for despair.

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