TiredGuy: 6 Years on Clomipramine and Worse

[TiredGuy]

Hi all, 

 

I’m coming to this side after experiencing years of what I believe to be protracted benzo and adderall withdrawal. I couldn’t cope with being completely med-free so I decided to try an anti depressant called clomipramine. After 6 years of being on this drug, a new horrible depression started to creep in. At first it was mild and I blamed it on work. Eventually it would be so bad that I felt like a demon was watching me and planting deep hopeless thoughts and despair inside my mind. Shortly before this, I had tried Keto, one session of LENS neurofeedback, and my beloved Dog has passed away. At first I wondered what had worsened this creepy weird depression, but over time it stuck with me and now I believe it to be some kind of symptom of being on this antidepressant for too long. I had experienced this type of thing before…on the benzo I ended up with more anxiety in the long run, and on the adderall long term I found I could concentrate less and less and always feel tired. 
 

ive been tapering off clomipramine for about a year and went from 112mg to 60mg. The “Hell” feeling as I call it is pretty bad now and I still fear it’s not the med causing it and that I’m under some sort of spiritual warfare…

 

I’m going to keep tapering and hope to recover once im completely off. If anyone has any thoughts or tips it would be greatly appreciated. This really sucks!

[getofflex]

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  I'm sorry that you are experiencing this dark and creepy depression.  It must be scary for you.  You have come to the right place.  Depression like this can indeed by brought on by the stress to the nervous system caused by withdrawal from the drug.

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some information about how these drugs actually work.  This explains why it is important to taper off very slowly and cautiously.

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

 Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

What is Withdrawal Syndrome?

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the taper becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Clomipramine

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. This is extremely important. 

 

Considerations About Stability Stop Jumping Around

 

Keep it Simple, Slow, and Stable

 

 

When we recover, there may be times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

 

Windows and Waves Pattern of Stabilization

 

Here are some techniques to cope with symptoms: 

 

Acknowledge, Accept, Float

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Dark intrusive thoughts are part of WD, which it sounds like you may be experiencing.  I, too, have experienced this during withdrawal.  It is the result of a nervous system that is out of balance and in disequilibrium from the withdrawal. Read this thread to hear experiences of other members with this sort of thing: 

 

Deep Despair, Dread, Doom, Horror

 

The good news is, depression and dark thoughts brought on by withdrawal should eventually go away.  

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

 

Omega 3 Fish Oil

 

I will need more details about your taper from clomipramine before I can suggest a course of action.  This will be in your drug signature if you follow the instructions above.  In the meantime, take heart.  Everyone here has been or is going through similar experiences.  The keys to recovery are time and patience.  The good news is, you will eventually recover, if you take proper care of yourself.  Hang in there.  

 

Edited August 24, 2021 by getofflex

[TiredGuy]

Hi Getofflex,

 

thank you for all the valuable information I really appreciate it. One of my major fears is the fact that these symptoms started before I even began tapering and on a dose I was stable on for at least a year or so. Wondering if because I was on it for so long it started causing new symptoms. 

[Altostrata]

Welcome, @TiredGuy

 

Had you ever accidentally skipped a dose of clomipramine, or taken it off-schedule?

 

What times o'clock do you take your drugs, with their dosages? How do you feel before and after each dose?

[TiredGuy]

Hi @Altostrata,

 

I take it consistently every night before bed. It’s got a long half-life so I don’t think I need to worry too much about what time I take it.

[Altostrata]

No, you do have to take even clomipramine on a consistent schedule. When it mysteriously stopped working, it may have been because you took it inconsistently and got withdrawal symptoms nobody recognized.

 

17 hours ago, Altostrata said:

What times o'clock do you take your drugs, with their dosages? How do you feel before and after each dose?

 

[TiredGuy]

Hi @Altostrata, 

 

that’s an interesting point. I’ve pretty much taken it every night before bed. I did try cutting dose a few times and then ended up going back up. I also feel that trying the keto diet might have made the med stop working too since my body is used to carbs. I guess the only way to find out now is to just keep tapering and be off this sh*t. Is it okay to cut dosage every 2-3 weeks instead of once per month? It’s the scariest feeling ever that doesn’t feel like the medication, just feels like I must be possessed for the sins I’ve committed.

[getofflex]

19 minutes ago, TiredGuy said:

I did try cutting dose a few times and then ended up going back up.

This can also cause you to have WD symptoms.  Please read 

 

Considerations About Stability Stop Jumping Around

 

Keep it Simple, Slow, and Stable

 

19 minutes ago, TiredGuy said:

Is it okay to cut dosage every 2-3 weeks instead of once per month?

We do not suggest that.  In fact, if I were you, I would stay on my current dose for a while, as in several months, to allow my nervous system a chance to stabilize and heal.  Take the exact same dose, at the same time of day each day.  Don't miss doses.  

 

It would help if you could give more details in your drug signature about your clomipramine taper over the past couple of years, such as the time of each and every dose change.  For example, mid March 2020, end of June 2021, etc.  If you remember specific days that's great.  

 

 

 

Edited August 25, 2021 by getofflex

[Altostrata]

Keto isn't for everyone, and it may be best to phase into it gradually if you want to try it.

 

If you've gotten withdrawal symptoms before, that's a red flag not to cut corners regarding tapering if you want to reduce clomipramine again.

 

Please review  Why Taper by 10% of my Dosage  

 

Tips for Tapering Clomipramine 

 

[TiredGuy]

@getofflex @Altostrata I had been on a stable dose for at least a year and these feelings were still happening. If anything the med is now causing the symptoms and it’s not because of withdrawal. I’m feeling pretty desperate to be off it if now.

[getofflex]

I can understand why you would feel this way.

On 8/23/2021 at 11:40 PM, TiredGuy said:

ive been tapering off clomipramine for about a year and went from 112mg to 60mg.

 

49 minutes ago, TiredGuy said:

I did try cutting dose a few times and then ended up going back up

10 minutes ago, TiredGuy said:

I had been on a stable dose for at least a year

 

The statements above contradict each other.  To advise you, it would help if you could give us more specifics on the times you changed the dose of your drug in the past year, as previously requested.  Thank you.  

[TiredGuy]

@getofflex

 

So sorry for the confusion. I started Clomipramine 6 years ago and landed on 75mg initially. 2 years into this med I increased to 100mg. Within the next two years I tried cutting my dose back a bit but always gave up and went back to my 100mg dose. All was fine after those attempts. Then two years ago I started having depression from my days off from work and I didn’t know why. I also got a new job and couldn’t hear to feel this way so we upped my dose to 125mg and it was too stimulating so I went down to 112.5mg (splitting capsule in half). So after a year or so of being on this dose, the depression and creepy hell feeling came back even though I was on the same dose for a year. The most worrisome part is that these new symptoms started while I was on my full dose of the medication and not because of withdrawal. 
 

the only theory I have is the Tardive dysphoria thing that states when you’re on a med long term, it becomes pro-depressant rather than anti-depressant. The other scary part is that the feeling doesn’t seem like it’s from the med and it just seems like maybe I am possessed or crazy. Hopefully that’s the anxiety talking but idk.

[Altostrata]

18 hours ago, TiredGuy said:

So after a year or so of being on this dose, the depression and creepy hell feeling came back even though I was on the same dose for a year. The most worrisome part is that these new symptoms started while I was on my full dose of the medication and not because of withdrawal. 

 

Your history of going on and off drugs may contribute to your nervous system being vulnerable to negative symptoms, and sensitive to inconsistent dosing, as mentioned before. Overstimulation from a psychiatric drug also is stressful for your nervous system.

 

We still advise starting with a 10% taper per month, calculated on the last dose level, to see how that works for you. With your history, you may need an even more gradual schedule to go off clomipramine comfortably.

[TiredGuy]

@Altostrata

 

any thoughts about adding another med like remeron if things get really bad?

[getofflex]

We are a forum for helping people taper off of psychiatric drugs. Therefore I can’t give you any advice about going on any drug. Only a doctor can do that.

 

It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

 

Edited August 26, 2021 by getofflex

[Altostrata]

On 8/23/2021 at 9:40 PM, TiredGuy said:

ive been tapering off clomipramine for about a year and went from 112mg to 60mg. The “Hell” feeling as I call it is pretty bad now and I still fear it’s not the med causing it and that I’m under some sort of spiritual warfare…

 

What was your tapering method? How did your symptom pattern change while you were tapering clomipramine? When was the last time you made a reduction?

How has your symptom pattern changed since you made that reduction?

 

Is the "Hell" feeling better or worse after you take clomipramine every night? Is it better or worse at any particular times of day?

[TiredGuy]

@getofflex okay I will update my signature when u get a chance to sit at the computer.

 

@Altostrata my tapering method is to reduce by 5mg every month. I have a pharmacy that custom makes the 5mg doses. When I first started tapering I actually felt better and the hell feeling went away. Not sure if it was coincidence or placebo. Then I noticed a month later it seems to come back and when I would taper again, it would go away. Once I got to a much lower dose, it doesn’t seem to matter or feel different when I make a cut in dose. 
 

the hell feeling is the very worst on the weekends when I’m off work and trying to rest and then goes into Monday and Tuesday when the work week begins. I feel my best and this symptom is the most mild on Thursdays and fridays when the weekend is around the corner. I guess it’s a forced distraction that prevents the ruminating. The obvious advice is to do more on my time off to force myself not to think about it but I really miss having the downtime to relax and just enjoy myself. I feel exhausted because I’m either working or battling these symptoms.

[Altostrata]

21 hours ago, TiredGuy said:

The obvious advice is to do more on my time off to force myself not to think about it but I really miss having the downtime to relax and just enjoy myself.

 

Can you think of any ways to both stop worrying about tapering and relax and enjoy yourself?

 

The "Hell" feeling sounds like something you might work on with a psychotherapist.

[getofflex]

23 hours ago, TiredGuy said:

@Altostrata my tapering method is to reduce by 5mg every month

Please remember that SA suggests an exponential taper, and this is a linear taper.  Please read my links above "Why Taper by 10% of my Dose", and "Tips for Tapering Clomipramine".  

[Altostrata]

fyi @getofflex as Tiredguy is taking 60mg clomipramine, a monthly reduction of 5mg is well within our 10% guideline and probably is sufficiently gradual until his clomipramine dosage is below 50mg, when he will have to decide on a smaller monthly decrement.

 

On 8/26/2021 at 3:19 PM, TiredGuy said:

Then I noticed a month later it seems to come back and when I would taper again, it would go away. Once I got to a much lower dose, it doesn’t seem to matter or feel different when I make a cut in dose. 

 

From Wikipedia: Clomipramine has a half-life of "Clomipramine is metabolized in the liver mainly by CYP2D6. It has a terminal half-life of 32 hours, and its N-desmethyl metabolite, desmethylclomipramine, has a terminal half-life of approximately 69 hours." 

 

Quote

clomipramine is more potent as an SRI than any selective serotonin reuptake inhibitors (SSRIs), it is more potent than paroxetine, which is the strongest SSRI.

 

Due to the long-acting metabolite, a decrease in clomipramine will take full effect in about 14 days. It may take another 10 days or so for your nervous system to "notice" the decrease and produce those "Hell" symptoms, which are withdrawal symptoms from an extraordinarily powerful antidepressant. Even though the amount of decrease is small, a month is still not quite enough time for your receptors to adapt to the lower dose.

 

You might do better with smaller decreases, 2.5mg for example until you are down to 25mg clomipramine (then, you might want to change to 1mg decreases until you get to 10mg). Depending on how you feel, you might be able to make these smaller decreases every 3 weeks instead of 4 weeks.

[getofflex]

On 8/26/2021 at 5:19 PM, TiredGuy said:

I feel exhausted because I’m either working or battling these symptoms.

I know that withdrawal from psych drugs really sucks.  It is unfair that we have to go through this, because of ignorance on the part of the medical profession, in most cases.  However, I have found that if I can accept my symptoms, instead of trying to fight them, I actually feel better.  There are things we can do to help the symptoms, up to a point.  But sometimes, they just ain't going anywhere.  When that happens, practicing acceptance can give you peace, and save your energy from trying to fight them.  Here is a link on radical acceptance that talks about this.  See if it helps. 

 

https://www.dbtselfhelp.com/html/radical_acceptance_text.html

[TiredGuy]

On 8/27/2021 at 4:09 PM, Altostrata said:

From Wikipedia: Clomipramine has a half-life of "Clomipramine is metabolized in the liver mainly by CYP2D6. It has a terminal half-life of 32 hours, and its N-desmethyl metabolite, desmethylclomipramine, has a terminal half-life of approximately 69 hours." 

 

 

Due to the long-acting metabolite, a decrease in clomipramine will take full effect in about 14 days. It may take another 10 days or so for your nervous system to "notice" the decrease and produce those "Hell" symptoms, which are withdrawal symptoms from an extraordinarily powerful antidepressant. Even though the amount of decrease is small, a month is still not quite enough time for your receptors to adapt to the lower dose.

 

You might do better with smaller decreases, 2.5mg for example until you are down to 25mg clomipramine (then, you might want to change to 1mg decreases until you get to 10mg). Depending on how you feel, you might be able to make these smaller decreases every 3 weeks instead of 4 weeks.

@Altostrata This is REALLY interesting because I thought it was about 3-4 days to start feeling the withdrawal. Should I wait a couple months and just try to stabilize for now? That might be a good way to find out what's coming from the withdrawal and what isn't. 

 

[getofflex]

This sounds like a very good plan. I’ve had nothing but good things come from holding.

[Altostrata]

Clomipramine has a much longer half-life than the more common SSRI and SNRI antidepressants, all with a half-life of about 24 hours (except for fluoxetine). Except for fluoxetine, dosage changes in the SSRIs and SSNIs probably will take full effect in 3-4 days.

[TiredGuy]

Hi all, I’m back. 
 

was doing so much better these past few months and barely had these symptoms anymore. Not sure what brought it back recently but I’m just really looking forward to being off Clomipramine completely. Is protracted or PAWS common for tricyclic anti depressants? Really hope that once I get off, I’ll be feeling much better shortly after.

[ChessieCat]

  

Q:  Is there anything that you might have done/might have happened recently which was stressful?

 

Examples:  sickness, antibiotics, Covid vaccination, drinking alcohol or caffeine, change of job, financial stress, relationship stress, physical overexertion.  Some members have found that even good occurrences can cause stress, like going on a holiday or having a celebration or having visitors etc.

 

Please see this topic:

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

Also see:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

and

  

On 12/27/2015 at 6:37 AM, Altostrata said:

Basically- you have a building where the MAJOR steel structures are [...] to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were [...] to rebuild the tower - WHILE people were coming and going and [...] to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while [...] is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made. 

 

[Altostrata]

On 5/19/2022 at 12:07 AM, TiredGuy said:

Hi all, I’m back. 
 

was doing so much better these past few months and barely had these symptoms anymore. Not sure what brought it back recently but I’m just really looking forward to being off Clomipramine completely. Is protracted or PAWS common for tricyclic anti depressants? Really hope that once I get off, I’ll be feeling much better shortly after.

 

Good to hear. What are you taking now, at what times o'clock and dosages? 

 

Protracted withdrawal is less likely if you taper gradually.

[TiredGuy]

On 5/18/2022 at 4:51 PM, ChessieCat said:

  

Q:  Is there anything that you might have done/might have happened recently which was stressful?

 

Examples:  sickness, antibiotics, Covid vaccination, drinking alcohol or caffeine, change of job, financial stress, relationship stress, physical overexertion.  Some members have found that even good occurrences can cause stress, like going on a holiday or having a celebration or having visitors etc.

 

Please see this topic:

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

Also see:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

and

  

 

Hey thank you very much for your post. Feeling a bit better and hopefully I stay that way. Can’t think of much in terms of changes that would trigger me. Had a big work thing that I had been dreading so maybe I felt worse the closer the date came. Luckily the work thing is over now and went fairly well.

[TiredGuy]

On 5/20/2022 at 12:23 PM, Altostrata said:

 

Good to hear. What are you taking now, at what times o'clock and dosages? 

 

Protracted withdrawal is less likely if you taper gradually.

Hi there! Im at 42.5mg from being at 45mg for 3 months or so. I take it every night around 10pm

[Altostrata]

You've come a long way. Please let us know how you're doing.

[TiredGuy]

Having a rough time again. I’m down to 40 from 42.5mg which I think I decreased 2-3 weeks or so ago. I know I’m supposed to taper as slow as possible but I REALLY want to be off this crap for good. Is it too big of a jump to reduce by 5mg/month for the next 8 months? My highest dose was 125mg so I’ve come a long way. I believe I’ve been tapering for around a year and a half.

[Altostrata]

If you're having a rough time already from tapering too fast, making a big jump probably will make it worse. We don't have any way to fix this. It's up to you if you want to experience withdrawal syndrome.

Why taper by 10% of my dosage?

 

Tips for tapering off clomipramine (Anafranil)

 

Ordinarily, if someone gets withdrawal symptoms during a taper, we advise them to hold on that dosage for a while to let their nervous system settle down, then taper more gradually. If you had a hard time going from 42.5mg to 40mg, which is less than a 6% reduction, you probably should plan on perhaps a 3% reduction per step. You'd have to see whether you develop a withdrawal symptom pattern after a 3% reduction to see how often you can do this.