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New meds - new info! (attn:Hibee if you're available!)

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Posted 3/31/2012 9:36 AM (GMT 0)
Hi everyone -

I'm supposed to start taking my new anti-depressant this weekend.  My psychiatrist put me on a VERY low dose of Anafranil (10mg) due to problems I had adjusting to Zoloft in the past.  My pharmacy had an issue with the script saying they don't make Anafranil in that dosage and that they would have to contact my doctor.  The next night they called and said the script was ready to pick up.  My husband picked it up for me so I didn't talk with the pharmacy or my doctor during this time.  When I got the script I realized it was for Clomipramine 25 mg (generic Anafranil) - 25 mg!!!  That's 2 1/2 times what my doctor told me he wanted me on.  I looked it up when the pharmacy first told me there was a problem and the generic starts at 25 mg.  I did think I saw something that said name-brand Anafranil started at 10 mg but I can't find that now.  I also have trouble swallowing pills and these are much larger than I would have thought and are gelcaps so I probably can't crush/chew them.  I am kind of freaking out about all of this - especially because it's the weekend and I don't have a number for my doc other than the office number.  I don't want to start taking a dose 1 1/2 times what we discussed without first talking to my doctor.  Any advice or comments to help calm me down until I can get ahold of my doc?  Thanks.

Post Edited (AnxiousMomma) : 4/17/2012 3:20:16 PM (GMT-6)

Posted 3/31/2012 11:23 AM (GMT 0)
I personally would be hesitant to take a dose so far above what my doc prescribed too. In Australia we have a medical advice line that's open 24/7. Is there something like that where you are? can you call the pharmacy and talk to the pharmacist (the person who actually handles the medications rather than the person just behind the counter )? if you can't and you haven't actually started the meds yet maybe it can wait till Monday and you can get on to your doc?
Hope you can get things sorted soon :)
Posted 3/31/2012 2:04 PM (GMT 0)
Good advice by belladonna!

I would personally wait. Considering your initial reaction from the last time, you may be a little sensitive to medication, and I would want my doctor's go ahead on this.

Hang in there through the weekend if you choose to wait...we will be here to help and support you. This is rough I know, the anticipation and worry, then the waiting and confusion...I can imagine you are starting to feel frustrated!

Keep posting,

S.C.
Posted 3/31/2012 11:58 PM (GMT 0)
AnxiousMomma,

I have a question....Are the pills scored in the middle? Like can you cut them in half? Reason being is that I am supposed to be taking 150 mgs of Zoloft (only take 125 though) and they gave me a script for 45 100 mg. pills for the month, i'm supposed to cut the extra 15 in half, and take one and a half pills.

I would definately wait and talk to your doc first before taking any, but this may be why they gave you the 25 mgs. To cut them in half, that would be 12.5 mgs.

Just a thought.....Fox

*UPDATE* I just looked it up for you and this is what I found......

Anafranil®, (clomipramine hydrochloride capsules USP), is an antiobsessional drug that belongs to the class (dibenzazepine) of pharmacologic agents known as tricyclic antidepressants. Anafranil (clomipramine hcl) is available as capsules of 25, 50, and 75 mg for oral administration.  So that should pretty much answer your question. He probably wants you to cut them in half.

Post Edited (Fox7) : 4/4/2012 9:34:22 PM (GMT-6)

Posted 4/1/2012 2:06 PM (GMT 0)
Good Morning,

I am sorry to read about your mix up with the medications - I have run into this same problem over the years - what my Dr. ordered was not available and so it is a back and forth before the medications is ordered. 

I think Fox has a good point - 1/2 of the 25 mg would = 12.5mg  which is as close to 10 as you can get.  Call your Dr. tomorrow and get intructions on what he wants you to do.  Meanwhile let go of the worries today as tomorrow will be here soon and you can straighten out the problem.

I understand your fears and anxiety and please know that coming here and talking with us is a good way to decrease your anxiety.  You will find we are a really caring group of members and we understand how you feel.

Kindly,

Kitt

 

Posted 4/1/2012 2:40 PM (GMT 0)
You could call the pharmacy and find out what they say
Posted 4/3/2012 11:42 AM (GMT 0)
I got a call back from my psychiatrist on Sunday (I had left him a message at his office.) He told me the Anafranil 10 mg isn't available so he decided to give me the 25 mg. He said he had wanted me on the 10 because of the problems I had adjusting to Zoloft but that he thought the 25 mg would be fine because it is still a relatively low dose. He told me just to be aware of any side effects and if I have the terrible ones I had before just stop taking it and go to the ER. He doesn't, however, think I will have that problem with this med. These are capsules so they can't be cut (or crushed, chewed or anything else!) :( I think that's part of my fear. I've always had HUGE problem swallowing pills and once i start taking these I can't just skip it because I can't manage to get it down my throat that day. So I spoke with my husband and explained that I just need a couple of days to think all of this through. I'm on .25 mg xanax twice a day for another couple of weeks before (I believe) I am being moved to as needed doses. So I want to step back for a moment and think before I start a new med. Do I really need it or can I handle this? Should I try CBT before I get on something new? (I do want to try CBT anyway - I just haven't yet. My psychiatrist sees patients for med appointments only, no talk therapy). I now know how hard it can be to stop a med and I want to weigh the risks/benefits before I start something. So scared I'll get on it and then not be able to choke it down a couple of days in a row and then it will mess me all up. Or scared of how it will be when I eventually have to get off it. I did check and there is no liquid or chew/crushable version available. Should I bother the psychiatrist again and ask about something easier to swallow? Or quit being a baby and just take it? Or think about it for a couple of days before I start all of this again? Just wondering what you guys would do or what your opinions are based on your experiences. Thanks :)
Posted 4/3/2012 12:38 PM (GMT 0)
If I were in your situation, I would ask my doctor if there is something else you can take that is easier to swallow... You don't need extra anxiety about something that is already difficult (taking a new medication). Also see if you can get something that you are able to cut. That would make me feel better for sure!
Posted 4/3/2012 1:36 PM (GMT 0)
Don't feel bad. I know lots of people who hate taking pills. Some people just have a sensitive gag reflex. Gelcaps can be tricky. They do tend to stick. Have you tried a light coating of honey to help them down? A friends husband HATED taking pills and often gagged when he took them. She bought him a special cup to help him take them. It looks a bit silly, like those sippy cups kids use when they're learning to drink properly. It has a little section where you put the pills above the water so everything goes down at once. It helped him. She got it from amazon it think.
Starting new medication is a big thing so if you feel like you need a couple more days then I say take them.
good luck :)
Posted 4/3/2012 3:10 PM (GMT 0)
You could try putting it in pudding or applesauce.. Or since it's gel u can poke a hole in it and squeeze the liquid into your mouth instead of swallowing the pill, just a few tips I picked up seeing nurses do it at the hospital, when I was an assistant.
Posted 4/4/2012 1:57 PM (GMT 0)
Hi

I have been on this medication in the past and my understanding is the following dosages:-

Initial dose of clomipramine : 25 mg orally once a day at bedtime.
Maintenance dose: May increase to 100 mg per day during the first 2 weeks.
Maximum dose: 250 mg per day

I am not a doctor and agree with the others that you doctor should be consulted before you start the medication.

Hibee
Posted 4/17/2012 8:46 PM (GMT 0)
Hi everyone-

I want to start by saying I've been feeling a bit better the last week or so - maybe even almost 2 weeks now. I had decided not to take the Anafranil and I have been faithfully taking my Xanax 2x/day and I think that's helping although I've been on it 3 weeks now consistently and I want to hurry up and get off it before I end up with a benzo addiction... but anyway...

I saw my psychiatrist yesterday and spoke with him about my reluctance to start a new medication if I can handle this on my own. He seemed to hear what I was saying but told me that with my symptoms and history he strongly felt I should at least give the Anafranil a try. I had a HORRID reaction when I first started Zoloft and he knows that so he is understanding of my concern but still thinks this is the best option. So I guess tonight I take my first dose. I'm still worried because of my pill-swallowing issues but there is no other form of this drug and this is the drug he really thinks I need to be on. He did tell me that I could take this for even 4 or 5 days and if I find I can't handle the side effects or I can't choke it down I can stop with no problems which is good. I feel more awake and clearer since being off the Zoloft and I don't want to lose that but then again being anxious all the time and an increase in OCD symptoms really isn't good either. So I just thought I'd update what's going on with me.

I'm also wondering if any of you have ever made it through the initial couple of weeks of a new drug without feeling worse. I'd love to hear if that's at least a possibility. Also wondering if anyone has experience with Anafranil - I know Hibee mentioned being on it in the previous post. How were the side effects? How was the drug as far as being helpful for anxiety/depression/OCD? How was the inital period after you started taking it? Haha I have a lot of questions I guess.

Also - my psychiatrist wants me to stay on the Xanax (0.25 mg 2x/day) for the 3 weeks until I see him again while I adjust to the Anafranil. That's 6 weeks total of being on it consistently. Will I have a huge problem getting off of it? Ahh I wish I wasn't afraid of so many things!

Thanks for all the help and support and thanks in advance for your comments here:)
Posted 4/19/2012 2:52 AM (GMT 0)
Hi Anxious.....

My experience with AD's has been different both times. Although you had a bad experience with it, Zoloft has been a life saver for me. However, the first time I started it (in 2001) I had hardly any side effects. The worst one was hot flashes and even that was so bad. This time when I began taking it again (in February) I had quite a few side effects....nothing serious but a lot more that in 2001. I found this to be very strange however when i talked to my doctor about it he said it was probably because the first time I had major depression and this last time it was more anxiety/panic than depression. I don't know if that's really true but in any event I stuck with it and I feel SO much better.

Concerning the Xanax.....in 2001 per my doctor i took .25 mg for about 8 weeks while the Zoloft was kicking in and this last time I took .25mg for about 6 weeks....neither time did I become addicted. I haven't had to take a Xanax for about three weeks and had no problems. .25mg is the lowest dose and the way my doctor explained it to me is that I would have to take it for a long time and numerous times a day to get addicted. So, try not to be afraid and use it for the little time he wants you on it......btw, I still take .25mg (if needed) which is the same dosage I have taken for 11 years. But not 11 years straight. :) My point is if I was addicted to it after 11 years .25 wouldn't do anything for me....I would need a much higher dose. Long story long...ha....try to relax and follow your Dr's advise and give the AD time to do it's thing.

My best to you!
Packer.
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