What are your thoughts on Clomipramine?

[Sascha100]

Hey guys,
Im made a post a few days ago where I said that Ive been taking Paxil (40mg), Zoloft (300mg) and Luvox (250mg) over the last 10 years. Never had issues coming off them but was stupid and tapered ridiciously fast. I suffer from extremely severe OCD and depression and need medication. Luvox helped me immensely but now Im scared of the possibility of PSSD. What are your thoughts on Clomipramine? Do you think it has a lower incidence of causing PSSD? Clomipramine would be the only reasonable alternative to SSRIs for my very very severe OCD. Thank you

[arahant]

Hey guys,
Im made a post a few days ago where I said that Ive been taking Paxil (40mg), Zoloft (300mg) and Luvox (250mg) over the last 10 years. Never had issues coming off them but was stupid and tapered ridiciously fast. I suffer from extremely severe OCD and depression and need medication. Luvox helped me immensely but now Im scared of the possibility of PSSD. What are your thoughts on Clomipramine? Do you think it has a lower incidence of causing PSSD? Clomipramine would be the only reasonable alternative to SSRIs for my very very severe OCD. Thank you

Clomipramine is considered the "gold standard" for OCD treatment.
My father takes clomipramine and his severe OCD improved a lot.

If you are also obsessed about potential problems of a medication, and having very very severe OCD can make your worries even worse.
There is a treatment that does not involve drugs and it is used as a last resort in people who did not even respond to medications in maximum doses.
Some people with severe OCD cannot have a functioning life with full doses of medication, or without any medication.

"Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder"
https://www.ncbi.nlm.nih.gov/pmc/articl ... po=2.77778

In medicine, interventions must be understood and explained to patients in terms of "risk-benefit" relative to prognosis without treatment.
This is the foundation of informed consent.

[Sascha100]

Thank you for your reply, arahant. Still, I don't know if Clomipramine has a chance of developing PSSD, if the chance is lower or even higher..

[arahant]

Thank you for your reply, arahant. Still, I don't know if Clomipramine has a chance of developing PSSD, if the chance is lower or even higher..

You have been taking insane doses of SSRis over 10 years; I guess you said on another post that had no significant problems with sexual dysfunction and etc.

I am kinda impressed that you had taken 300mg of Sertraline before and had no PSSD complaint. This drug was like a shotgun hit on my body, and I took it up to 150 mg.

It looks like its perceived benefits on easing your OCD is higher than any other side effect.

There's no yes/no question for clomipramine-PSSD on you, and I know that for an OCD sufferer, dealing with uncertainty is a hell of a nightmare and can trigger lots of anxiety and thought rumination and obsessions.

I have also seen people complaining about the exact PSSD after a single pill, but more, I have seen two cases of people claiming the same symptoms, but they've never taken a single drug.

You may have been worried about PSSD for apparent reasons because you are posting here.

If your OCD is severe, Gamma Knife Surgery for OCD involves no drugs, and it is targeted.

Clomipramine is a powerful drug that can reduce the overthinking by scary low levels compared to the baseline; I say that because I witnessed my father before and after taking it.

I just wonder the likelihood of you taking clomipramine for not enough time to handle OCD, It is a real risk of keep ruminating it's sexual side effects after quitting it and calling your new obsession as PSSD.

[Sascha100]

Thank you once more for your reply. I have heard that Clomipramine does have an incredibly strong effect. Last question: Do you think Im more likely to get PSSD if I would restarted Luvox or start Clomipramine because Ive already gone haywire on SSRi or less likely because my body seemed to respond very well to SSRIs in the past?

[Thomas]

PSSD is very rare.
But it could be psychologically induced by the fear of PSSD. So, if you fear it and have other options than SSRIs, these options may be safer.

[arahant]

Thank you once more for your reply. I have heard that Clomipramine does have an incredibly strong effect. Last question: Do you think Im more likely to get PSSD if I would restarted Luvox or start Clomipramine because Ive already gone haywire on SSRi or less likely because my body seemed to respond very well to SSRIs in the past?

As I said before, there's no yes/no answer for your question. If you are worried about these drugs, even if you have taken SSRi in insanely high doses without any issues. Not having any issues in the past would be an answer.

During my PSSD recovery, some of my baseline obsessions prior Sertraline started to increase.

I started NAC two weeks ago and I started to notice improvements. The common dosage is from 2400 mg/day to 3000mg/day


Reference:

N-Acetyl Cysteine in the Treatment of Obsessive Compulsive and Related Disorders: A Systematic Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4423164/

NAC appears to be extremely well tolerated, with minimal adverse effects reported. Mild gastrointestinal effects appear to be the most common symptom-flatulence (which ceased after two weeks of NAC supplementation),

Other clinical trials have demonstrated no adverse effects, and NAC has shown to be very well tolerated in doses up to 8,000 mg/day in other areas of research.39,71,83) This suggests there may be scope for a higher dose of NAC to be investigated in OCD and OCRD patients who appear resistant to doses of 3,000 mg/day used in the discussed research.

You have taken serotonin increasing drugs with crazy high doses with some improvements, maybe trying modulate excess glutamate would be another useful trial.


Best of luck

[cosmo]

Clomipramine (Anafranil) worked great for my anxiety and depression but is what gave me PSSD

[Numbtomind 2]

Clomipramine gave me full blown pssd and anhendoina in early 2018. I took it after trying 6 different SSRIs with no sexual issues. Then I try this new drug for my ocd and instantly turn asexual.

I'm here to say two things. 1. It was the only drug to completely take away my constant ruminations and thoughts.2 If you don't care about your sex life and think living without ocd is more important,go ahead and try it. Keep in mind clomipramine is a older drug and therefore could have more side effects.

TDLR; I took a small dose of 25mg , and it completely took away every single thought and memory I had. I live with a empty mind now, that's why I don't feel sexual anymore. The benifit is, I live without ocd and anxiety now but my sex life is permanently damaged indefinitely.