Anafranil: Old School Anti-Obsessional... Any experience?

[Kobayashi]

So my GP has just advised me to stop following the advice of my PDoc as things haven't been going well with the Lexapro and Risperidone he's prescribed.

She (my GP) wants me to continue with the Lexapro and add 25mg of Anafranil at night - give things a week or so and if I tolerate it well I'm to come off the lexapro slowly and increase the Anafranil.

I read mixed reviews of this stuff. Some people LOVE it, others find the side effects too harsh. My Pharmacist told me that its old-school, and is making a come-back as its very effective if you can get through the side effects.

I have pure - O - no compulsions.

Anyone have any experience?

Nicko

 

[Daniel E.]

BTW, as you may know, it's FDA approved for OCD.

 

[Retired]

My Pharmacist told me that its old-school, and is making a come-back

Every physician has a protocol for dealing with various diagnoses based on training and clinical experience.

Sometimes this will include medications that may not be the most recently introduced to market, but are meds with which the physician has extensive experience and uses them to determine a particular patient's response.

Medicine is as much art as it is science, and every physician has his/her preferred treatment strategy.

We should not be unduly influenced b the hype created by the pharmaceutical industry in consumer ads on TV, that seem to promote the idea that if the latest medication is not used, then there is little hope for successful treatment.

While new medications are important and necessary improvements in therapy, we should not consider the latest meds as being a status symbol such as needing to drive the latest model car.

If your physician has found success in working with Anafranil, then feel comfortable in giving it a try, and report your progress in detail so your doctor can evaluate your progress.

It's the only way you and your doctor can make the best choices for your treatment options.

 

[David Baxter PhD]

A good example is the anti-hypertensives (blood pressure medications). Like most people these days, I was started on the new breed of these medications but struggled with various side-effects and by trial and error found one that wasn't too bad, other than occasional problems with postural hypotension and lightheadedness or dizziness.

Then, in 2007, it appeared that I was having allergic reactions to numerous things and possibly one of those was the anti-hypdertensive I was taking. Given that, by then, I'd tried nearly every type of modern drug for the issue, my doctor put me on a low dose of an older medication (the so-called "water pill"). Not only does that low dose control the blood pressure very well, but I have no side-effects at all. An added bonus is that I went from $80 - $100 per month on the newer medications to a cost of about $16 for a 3 month supply of the current medication.

 

[Andy]

Isn't this like Paxil? Or similar to it?

If it is, then I can tell you my expereince was nil. It did nothing for me. My frined used it for awhile and she was really glad to have been put on it.

If it's not like paxil, then just ignore this, lol I just thought I would tell you a litle story!

 

[Daniel E.]

Isn't this like Paxil? Or similar to it?

Anafranil is a tricyclic antidepressant, not a SSRI like Paxil.

 

[Andy]

Yes, I just looked it up, thank-you. Sounded familiar. So there you go a nice little story about paxil.:blush:

Back to Anafranil...

 

[David Baxter PhD]

So there you go a nice little story about paxil.:blush:

You can never have too many Paxil stories.

 

[Andy]

That's what i was thinking. :think:

 

[Kobayashi]

Thanks for the responses guys. I'll give it a shot and report my progress.:2thumbs:

Cheers!

KOB

 

[Kobayashi]

So I've been on this stuff for a few days - 25mg. (I decided to wait until the holidays were over before I started). I'm still taking 25mg of Cipralex in the am and have stopped the .25mg of risperidone.

Things so far are ok. Don't really notice any significant difference. Bit of dry mouth.

The biggest thing is that I'm not sleeping well. I fall asleep fine, but seem to wake up every hour or so in this kind of twilight sleep state. Apparently, (according to my wife), I'm having lots of interesting conversations in my sleep too! I thought this stuff was supposed to be sedating? Strange. Anyway - I'll report back as things progress.

Cheers!

 

[Melon Collie]

From my personal experience only, I wish to add that if you have ever had suicidal thoughts you should consider something else instead of anafranil.

 

[Kobayashi]

How long after you started anafranil did you experience a problem with this?

 

[David Baxter PhD]

From my personal experience only, I wish to add that if you have ever had suicidal thoughts you should consider something else instead of anafranil.

How long after you started anafranil did you experience a problem with this?

I also wonder why you make that statement, Melon Collie, and why you believe the anafranil was at fault.

Some similar concerns were expressed about SSRIs a few years ago but the evidence is rather convincing that it is not the medications per se that are the cause of suicidal thinking but rather a combination of the depression the medications are used to treat and limited or inaccurate information given to patients about how the medications work (i.e., poorly informed expectations about the medications).

 

[Kobayashi]

Here's my take on it:

When I first became ill with OCD - I didn't even know what was wrong with me. I did have thoughts of self-harm, although looking back, they really weren't suicidal thoughts. (I didn't have a plan, I had no desire to actually do anything like hurt myself) - It was just the OCD rearing its ugly head and making me think that I wanted to do the unthinkable - I was afterall stressed to the max. I still get these thoughts, but I know that they are just obsessions and they aren't real.

The first med they put me on was Citalopram - an SSRI. I had some intense start-up issues with this med, that actually increased the volume and frequency of my OCD thoughts. It was awful. I don't know why SSRI's etc can do this to some people. When they switched me to Cipralex, I experienced the same thing - and yes some of the thoughts I had could be construed as "suicidal" - But I know now that they were just thought processes gone awry as my brain was adapting to the new med. My Doc told me this and that I had to "push through" the thoughts. (A prescription of ativan also helped to get me through the start up side effects). My Doc only gave me 20 of them and I didn't need to use them all.

Just my 2 cents.

 

[David Baxter PhD]

There is also some evidence that an apparent increase in suicidal thinking may come early in treatment with antidepressant medication as a result of an increase in psychological and physical energy. Thus, it's not a direct side-effect of the medication but rather the individual reacting to part of what the medication is supposed to do.

In other words, physicians and therapists certainly need to monitor depressed patients when they first start taking medications, but indeed all depressed patients should be monitored for suicidal ideation whether they are taking medication or not. What this really underscores is the critical importance of close monitoring early in treatment and followup evaluations within a week or two of initiating treatment with antidepressants.

 

[Melon Collie]

Sorry. I felt as soon as I posted that I should either change my wording or elaborate on my post. My intention is to help prevent anyone else going through what I did.

In addition to the dry mouth that you experienced I also felt a strange sensation of being unable to cry when I was sad. I think Anafranil is an excellent medication and I hope it works well for you.

I don't think that it's to blame and I don't think it causes suicidal thinking but I do think it is dangerous in the hands of a person that is intent on self-harm.

Another option to switching, if you feel like taking more that you are supposed to, is give the meds to your wife and she gives you a daily dose. My husband had mine under lock and key for about a year before they switched me over to prozac.

 

[Kobayashi]

Good points. I think it all depends on the individual and their unique circumstances with these meds. I was just browsing another Psych forum and saw several posts form people who attribute anafranil to actually saving their lives when they were in the depths of depression and more specifically from the torments of OCD.

These forums are great for getting a "broad spectrum" view on the overall advantages and disadvantages of medications. I try to take what people say with a grain of salt before jumping to the conclusion that I'll get the same side effects or all of a sudden end up with some nasty condition called "Hot Dog Fingers". Its a tough thing to do though as we are all looking for answers.

 

[Kobayashi]

So I'm almost a week into taking 25mg of anafranil. Past few days have been rough. Increased anxiety and increased OCD (pure-O). I'm still on the 25mg of cipralex too. Just not feeling myself. Had to pop .5 mg of ativan last night. haven't used that for a while. I'm hoping that this is just start up side effects - similar to what I went through when starting cipralex. Definitely not feeling any better yet - that's for sure. I'm going to give this a few more days - not sure at what point I pull the plug if its not giving me the desired results.

Any feedback is appreciated.

 

[Melon Collie]

I wish I could remember my start up side effects, if I had any. But it's been twenty years since I went off of it and I just can't remember. Sorry, I'm no help.

I was also prescribed Zoloft and now Prozac. Maybe one of these may be worth trying if you have to stop the Anafranil?