Clomipramine AND an SSRI together?

[JJ17]

Just wondering if anyone has taken this or has knowledge on how it actually works. The only thing I’m confused of is: 

Is its metabolite truly that potent on noradrenaline? Some places online call it almost an SNRI (yet still a TCA) since it has strong NE reuptake action. One doctor online claimed it’s SERT and NE action was equal but I don’t know if that’s true. 

Also: if taking an SSRI then well that SSRI works to reuptake SERT via whatever methods it does. Now does the TCA clomipramine also reuptake SERT in basically the exact same way as SSRIS (possibly even competing with it?) do or does it do it in a different way being a TCA? 

As wasn’t sure if it worked differently enough on SERT than SSRIS do so that it has a “synergy effect” VS just double stacking two of the same SERT inhibitors. 

I also read that doses as low as 10mg occupy around 80% SERT. Which is equal to the therapeutic or starting dose of most SSRIS. Wikipedia claims it can reach 100% occupancy at higher and chronic dosages, but the source it links is confusing. So I wonder if at 50-100mg dosages how much SERT it occupies. As I cannot seem to find any number or chart showing it’s occupancy level. 

Also I take Zoloft 200mg daily which from the research I have looked up is getting around 85% SERT occupancy, maybe 90% as the chart is hard to read. Only Paxil tops Zoloft for SERT occupancy for SSRIS in the studies I’ve seen. Which Paxil seems around 90% + or so at max dose.  So if Zoloft is already occupying that much SERT, and you where to add on 50mg of clomipramine, I wonder which would have more SERT occupancy (Zoloft 200mg or clomipramine 50mg) and if they would compete with each other for the same SERT sites or what not. 

 

Basically I’m trying to get my sertonin levels up high. I already take l-tryophan daily with my SSRI as I know SSRIS don’t actually create sertonin. Also my doctor agrees with the low sertonin theory which is why he is okay with me taking the max dosages for SSRIS, possibly even a combo if one works. So yes, I am doing it under a doctors care but looking to learn some info first. 

[cakepop]

[deleted]

Edited April 7, 2019 by cakepop

[trophy]

AFAIK what you've written is correct. Clomipramine is a very powerful SRI and its metabolite is a powerful NRI. It works by the same mechanism as SSRIs which is by binding to and occupying Seratonin uptake receptors, preventing Serotonin itself from binding.

https://psychotropical.info/clomipramine-potent-snri-anti-depressant/