Clomipramine/can it make thoughts worse at first?

[Donnahoney1]

Hi is anyone on clomipramine I started 18 days ago at 10mg haven't had any side effects that I'm aware of so seem to be tolerating it quite well, but my thoughts seem to be a lot worse on and off the last 2 weeks and I wondered if this was due to starting a new medication or is it making my ocd worse? Worried as iv tried quite a few ssris before this one and none have ever helped my anxiety! 

[Ashley]

Hi Donna,

Medication tolerances will vary from person to person. Some people report it helps anxiety, some report it makes it worse.   I have read some people where they have said that meds do make their thoughts seem worse for a short period, so that's not unique.

But long-term it may be worth knowing that medication won't make OCD go away, the medication will generally (for most people) just help a person cope with the thoughts/anxiety created by OCD better.  The therapy is what will help you respond with non anxiety responses to the intrusive thoughts.  Are you getting any therapy Donna?

 

 

[Donnahoney1]

I have had cbt many times over the past few years and recovered at one point. However my anxiety worsened over the years and I found myself plagued once again by ocd and it just changes theme, Now I have obsessive thoughts that I either have to google for answers or seek reassurance over the most ridiculous things! I know that sometimes it takes longer for medication to help ocd 4-6 weeks? 18 days is probably too short a time to tell at this point. I am scared to ask to be referred for cbt again as iv had it 5 times in the past.

[Ashley]

1 hour ago, Donnahoney1 said:

I know that sometimes it takes longer for medication to help ocd 4-6 weeks? 18 days is probably too short a time to tell at this point. I am scared to ask to be referred for cbt again as iv had it 5 times in the past.

The thing is Donna, there is no guarantee meds will work at all, be it 18 days or 6 weeks.  Hopefully in time you will find they do start to help, but I think we have to be realistic and give you the heads up that they may not help.

Please don't be scared to ask for help. Think of it this way, the failure for therapy to work in the past is their fault not yours! It's their failing!   If it helps, I have done that too, I have asked for more help and in fact have an assessment tomorrow. 

I did give you the name of an expert in your area the other week, why don't you ask your GP to refer you to her?  (it could take weeks and weeks to see her, so sooner you ask the better)?  Good luck

[Donnahoney1]

Iv asked my GP to refer me but they won't they said I have to refer myself which I did to whom you suggested but unfortunately they don't take self referrals, it's ridiculous the way the NHS works!  All I can have is standard cbt again which didn't really help the last few times. I'm a bit worried now that il always be stuck like this as it's just a repetitive cycle being referred for cbt all the time. I haven't a clue where to seek proper help with someone who is clued up on ocd. Mental health services just aren't up to scratch!

[Ashley]

That's right, the service in question is secondary tier so would need to be GP referral. If you have already had IAPT therapy (which I think you said you have) then the next step up is secondary care.

I would contact the GP again and tell them the Dr in question requires local GP referral and does not take self-referral. Be a little insistent if you feel able to be, and see what the GP says. If the GP refuses, ask them to confirm why.

[Donnahoney1]

Thank you I am going to ask my GP because I really want help to overcome this. I just wish I could stop googling my thoughts, I get a question I my head and have to find the answer but it just makes it worse because when you google stuff you get lots of different answers so you can never be certain anyways so it's a waste of time! Just wish my brain would realise that! So annoying

[Ashley]

You rightly sort of answered your own question there Donna.... the more we Google the less certain we become anyway.  When that happens, when you get the urge to Google can you try refocussing, 'call a friend', go for a run or whatever..... and see if you still have the urge to Google 10, 20 minutes later when you come off the phone?

[Donnahoney1]

It's true isn't it? It just doesn't answer your questions because you find that you get loads of different opinions and information so you can never be completely satisfied. I'm going to try a little bit harder to ignore the urge to google or ask reassurance because it becomes a cycle, after you've done the compulsion it just leads to more obsessions and then then the compulsion again. You'd think it would be easy enough to stop considering those are the only compulsions I have. 

[seekingERPnorthwest]

On 31/07/2017 at 21:45, Donnahoney1 said:

Hi is anyone on clomipramine

Hi Donna, just to say that yes, I'm taking it, on 150mg at the moment and the psychiatrist has told my GP I can increase by 25mg each month - I think up to 250mg.  The side effects for me are dry mouth, constipation, twitching / jerking.  Sometimes a sort of burning feeling when I take them.   In the beginning the side effects also included feeling like a zombie and this pulsating tinnitus when trying to get to sleep.  I also find that a side effect of antidepressants can be that it's harder to cry - which is a bad thing if you find crying to be a cathartic release. Previously I tried 2 SSRIs (citalopram and paroxetine), an SNRI (venlafaxine) and another tricyclic (dosulepin). 

[PhilM]

I agree that using search engines can lead to uncertainty but to some extent (if we use them "sensibly") we can at least find out more about specific medications from genuine medical websites.

I'm personally not a big fan of medication for OCD as over the last 20+ years I have tried lots - including many anti-depressants and (totally inappropriately in my opinion) anti-psychotic medication - with no discernible results or effect on my OCD.

I think we have to be realistic as Ashley suggests about prescription medication. Some may be helped (which of course pleases me) whilst others such as myself have seen no benefits.

10mg is a very low dose - I was on 300mg of Clomipramine a day in 1997 and it had no impact on my OCD but believe me the side effects were horrendous.

[Donnahoney1]

I haven't had many side effects off clomipramine in fact it seems to be the only one that has lowered my anxiety after trying several ssris over the years! So it must be doing something. I had a dry mouth and tiredness but they have gone now and I'm only on the 4th week on them. I think changing the way our brains respond to thoughts is the best way to go now iv realised medication can only do so much. But it's so hard when you just get bombarded with thoughts and feel you need an answer all the time. It feels like it will never go away until you give in to the compulsion, feels like it's burning a hole in your head!