IhaveOCD: clomipramine

[IHAVEOCD]

I am taking clomipramine 25 mg and Prozac 40mg from last three years. I want to quit clomipramine because of weight gain issues. Is it possible to try and see if I am able to quit otherwise start taking it again. Do I have to take higher does if I start again? What can I do to avoid insomnia while not on clomipramine as I have heard it comes when u try to withdraw? Should I take something for better sleep?

[Gridley]

Hello, IHAVEOCD, and welcome to SA.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• Any drugs prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

Reinstatement of a drug you are tapering is possible if withdrawal symptoms are unbearable.  It isn't a guarantee of diminished symptoms but it's the best tactic available.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  Please read the first few posts of this topic on  reinstatement.:

About reinstating and stabilizing to reduce withdrawal symptoms.

   

Because reinstatement doesn't always work, it's best to taper slowly enough so that reinstatement isn't necessary.  At Surviving Antidepressants, it is recommended that a person taper

by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.
  
To get you started, and familiarized with the protocols followed by SA, I am linking a few topics so that you have a better understanding of what is recommended here. 

 

Before you begin tapering what you need to know

What is Withdrawal Syndrome?
Why taper by 10% of my dosage?

 

I know the weight gain is of concern to you, but we would advise that you taper the Prozac before the Clomipramine.  Prozac is an activating drug, also known as an accelerator, while tricyclics like Clomipramine are more sedating drugs, also known as brakes.  Thus, Clomipramine will act as a buffer and help you through the taper and withdrawal from Prozac.  

Taking multiple psych drugs? Which drug to taper first?

 

I faced a similar situation to yours two years ago, before I discovered SA.  I was on Lexapro (activating SSRI) and Imipramine ( sedating tricyclic).  I wanted to get off the tricyclic and, not

knowing the brake-accelerator factor, began to taper it.  All went well for around six months when I started experiencing extreme anxiety, which I'd never before experienced, as well as insomnia.  Without the buffer of the tricyclic, the activating effects of the Lexapro were pronounced and awful.  I reinstated part of my dosage of Imipramine but it took me four months to stabilize and I am currently holding.  Around this time I discovered  SA, which advised me to taper the activating Lexapro, which I did.  Now, a year later, I am doing well though probably would be doing better if I had stayed on the Imipramine until I'd gotten off the Lexapro.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us.