# Clomipramine??



## jfromaz (Mar 23, 2009)

QUOTE; _Simeon D, Stein DJ, Hollander E
Treatment of depersonalization disorder with clomipramine.
Biol Psychiatry. 1998 Aug 15;44(4):302-3.
BACKGROUND: Although there is a dire paucity of data on the pharmacologic treatment of depersonalization disorder, there have been a few reports in the literature suggesting that selective serotonin reuptake inhibitors may be of therapeutic benefit. In this study, we undertook to evaluate the efficacy of the potent serotonin reuptake inhibitor clomipramine in treating depersonalization. METHODS: Eight subjects with DSM-III-R depersonalization disorder were entered into a double-blind crossover trial consisting of 8 weeks desipramine and 8 weeks clomipramine. Due to the very small size of the trial findings are presented descriptively. RESULTS: Of 7 subjects who entered the clomipramine trial, two showed significant improvement in depersonalization. Three subjects dropped out early, unable to tolerate adverse effects. Of 6 subjects who entered the desipramine trial, I showed significant improvement in depersonalization. One clomipramine responder was subsequently followed in open maintenance treatment with clomipramine for 4 years, and her depersonalization symptoms remained in almost complete remission, with relapses upon each attempt to taper off or switch medication. CONCLUSIONS: *Clomipramine may be a promising pharmacologic treatment for primary depersonalization disorder and warrants further investigation.* [Abstract]_

your thoughts?


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## jfromaz (Mar 23, 2009)

From wikipedia;

Clomipramine (Brand name Anafranil) is a psychoactive/psychiatric drug used as an antidepressant and anxiolytic agent. It is a member of the tricyclic antidepressant (TCA) chemical class. It was developed in the 1960s by the Swiss drug manufacturer Geigy (now known as Novartis) and has been in clinical use worldwide ever since.

Indications

Major depression
Obsessive compulsive disorder (OCD)[2]
Panic disorder with or without agoraphobia
Narcolepsy
Premature ejaculation
*Depersonalization disorder*
Chronic pain with or without organic disease, particular headache of the tension type
Enuresis (involuntary nightly urinating in sleep) in children and adolescents
Off label uses: sometimes antidepressants of this type have been found helpful in reducing relapses in cocaine addicts and to help repair cocaine-caused neurotransmitter imbalances and early brain damage. Further studies are needed for clomipramine in this regard. Also has been used in dogs with severe anxiety disorders (separation anxiety, etc.), OCD, or cognitive dysfunction syndrome with some success.
It may take 2 to 3 weeks before the full effects of this medication are noticed in most indications and two months or more in OCD.
Along with SSRIs, clomipramine is a frequently prescribed drug for the treatment of OCD. As is typical with the older tricyclic antidepressants (the tertiary amines), it has more side effects than SSRIs, so some authorities regard it as a second-line treatment to be used if treatment with SSRIs fails. However, disregarding side effects, it may be slightly more effective in combating the symptoms of OCD. It is not commonly used for treating depression, and usually another tricyclic (or drug from a different class) would be used. Clomipramine and the SSRIs (specifically Paroxetine) have also been used to treat premature ejaculation.


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## jfromaz (Mar 23, 2009)

Interestingly enough, some paradoxical reports on the drug (anafranil) according to "askapatient"

One person with DP/DR said _



I took Anafranil for Depersonalization and General Anxiety Disorder. For the first 7 days I felt absolutely Nothing. It's as if I was swallowing candy. But then on day 8 I started to feel very anxious a few hours after I took it. Also couldn't sleep very well. This medication usually makes people tired. But it had the opposite effect on me. It didn't make me any more tired than usual. It actually made it harder to get to sleep. Then on Day 9 I had a full blown panic attack after I took it. I thought I was going to have to call 911. My anxiety went through the roof and I thought I was going to have a heart attack. I was scared!!! The next day my left ear started ringing and I felt as if I was getting a sore throat. This stuff started doing some weird things to me, so I decided to stop taking it before the side effects got even worse. Medication can effect everyone differently. This just isn't the right one for me. Use at your own risk!

Click to expand...

_Another said;


> Completely removed anxiety symptoms, OCD under control and easy to snap out of when I'm stressed. *Complete remission of Depersonalization.*


Not very conclusive, 1 of 2 people found anafranil an effective treatment for dp/dr based on that website.. http://www.askapatient.com/viewrating.a ... =anafranil

though it might be worthy of looking into


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## Absentis (Jul 10, 2007)

I tried clomipramine once... it made me more anxious and gave me insomnia. I wouldn't stop anyone from trying it, but I know I won't ever take it again.


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## Sketch2000 (Nov 10, 2008)

Good point. Everyone reacts differently to meds that work in the brain.
I pointed out the success of this drug in Dr. Simeone's book to my Pdoc, he was willing to try it except I will have to get off my current antidepressant (Luvox CR), and I'm not sure I want to go thru hell again.

Chris


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## Absentis (Jul 10, 2007)

Sketch2000 said:


> I pointed out the success of this drug in Dr. Simeone's book to my Pdoc


There were seven people in that study. Seven! And three of them dropped out due to adverse effects. And you know how many of them actually improved? TWO!! That's minuscule for a drug study, since testing a drug for a certain indication usually involves _thousands_ of people at a _minimum_. It is ludicrous to base treatment on that study alone because it is very easy to get a "statistically significant difference" with a very small sample size. It is due to the math, and not the drug, that the study was considered a success. It'd be nice to think that researchers couldn't manipulate data to support the conclusion they desire... Oh well.

If clomipramine was studied for depersonalization disorder with a larger sample size, I'd bet that the results would be negative.


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