Anyone take clomipramine (or other tricyclics) support needed

[tralalaaaaaa]

I have been on clomipramine for a number of years after having problems with seroxat / paroxetine.
(Each time I tried to come off I went rapidly downhill - severe anxiety and panic attacks.)
I had been down to 25mg for 8 years and very well (despite some very difficult and upsetting family illness plus a stressful job and financial issues.)
At the start of 2020 I started to split the dose to make it approx 17/18mg and all fine for next two years.
3 weeks ago I suddenly had a panic attack and all has come crashing down despite me doing all my usual
Self help things. Severe anxiety / can't stop crying / feeling desperate / insomnia.
I can't believe that 3 weeks ago I was fine.
Anyway I've gone back up to the 25mg but last time this happened 14 years ago I had to go back up to 75mg and it took a good 6 months to improve.

Just wondered if anyone has any advice. (Including increasing dose again on tricyclics. I do tend to have lots of side effects at first. Dropped down to 50mg quite quickly last time and stayed on that for quite a long time before eventually going down to 25mg.

Sorry so long.

Bump

I think possibly that there are very few people on tricyclics now.
It's nearly a week now since I went back up to 25mg but things very difficult.
Doing everything I can in terms of breathing exercises / cbt etc.

I've not taken tricyclics so can't offer any personal insights on that front, but I've been on MAOIs and know that feeling of being on a less-usual medication and not having ready access to a community of people with experiences to draw on.

I hope someone with some relevant experience with these meds posts soon, or alternatively I found that Reddit, Facebook groups, and a couple of American mental health forums are more likely to have medication-specific subforums where you might find more people with experience with these drugs. Are you under a psychiatrist? If not, can I suggest that if you don't already have a GP who's experienced with using these drugs for mental health purposes, you seek out the oldest (i.e. literally most advanced in years) GP at your practice, assuming they're decent with mental health stuff, as on balance they're likely to have had more experience of using these medications in a mental health context.

You could also post again here but more about the specific symptoms you're having and perhaps their relation to taking antidepressants more generally, as I believe some people do experience similar on SSRI/SNRI drugs, and even if there are major pharmacological differences that make the drug-related parts hard to compare, you can get a bit of support for the panic attacks, anxiety, insomnia, etc.

I'm sorry if this hasn't been helpful — I didn't want to leave you completely unanswered.

Thank you for the really kind reply @JarByTheDoor
All good suggestions

Good luck — I guess you're currently in that horrible stage where the meds haven't started tackling your MH symptoms yet, but you're dealing with the initiation effects from increasing dose on top of the mental health symptoms, and everything just feels shit squared?

Ye that's exactly where I am and terrified that I won't be able to get better again.

Ah yeah I'm familiar with that feeling too, it's foul isn't it? Even if this medication has always eventually worked before, or you've always found some way to feeling better (which you have, because as you said three weeks ago things were going well), there's a niggling worry that this time will be the time it doesn't work, this is it, this is me forever now…

You say you've got some CBT techniques you use — are you able to apply those to the thoughts about not getting better?

Yes that's exactly it.
And the anxiety is 24/7 and very 'physical.'
Trying really hard with the cbt etc

If it's a really physical kind of anxiety, the racing heart and sweaty palms type, would the GP maybe be able to prescribe you some beta blockers if they're medically appropriate for you, just to get you through this phase while you're waiting for the clomipramine increase to take effect?

@JarByTheDoor I could ask about that when I'm able to see the gp

I hope you don't have to wait too long.

I'm someone on tricyclics!

In fact I'm on a SNRI and amitryptaline, which was initially prescribed for neuropathic pain, but my psychiatrist is so pleased with how I'm doing on both together that I'm to stay on it even if my pain improves.

I have very longstanding complex chronic depression and anxiety and know I'll never be medication free, so I try not to worry too much about it. The side effects are minimal after 10 years and I'm much much better mentally than I have ever been.

Thank you for replying @weegiemum I'm so glad you are doing well.
I'm terrified at the moment that the clomipramine won't kick in again as feel so awful. Not sure why happened out of blue but guess that doesn't really matter.