I'm under antidepressants namely (fluoxetine, Paroxetine, Venlafaxine and clomipramine). Clomipramine is the latest addition to this combination of SSRI and SNRI. Initially when started clomipramine at 25 mg and 50 mg, I felt better for around 2-3 days after which my MDD and OCD went back to the bottom. Doctor increase it to 75 mg, again felt better for 2-3 days before it got worse. The same thing happened when the dosage was increased to 100 mg. Now my doctor told me to make it 150 mg. I'm confused about it. I need clarity with regard to my condition of clinical Depression and why it isn't working properly.

Dr. Saranya DevanathanPsychiatrist47yrs exp

90% (1503 ratings)

Ask Free Question

Dear lybrate-user, MDD and OCD are chronic disorders needing long term treatment. Just taking a SSRI or SNRI may not improve fully. You need to do ERP (exposure and response prevention) therapy also in addition. Clomipramine needs to be escalated to 300-400 mg/day if you can tolerate the side effects. You doctor is doing that slowly so that your get used to side effects. She/he is also using other antidepressants, my be in low dose to increase your tolerance. Initial feeling better will be there because of clomipramine's dual action. That does not mean that the improvement will last. Please follow the dose advised by your doctor. If you have some concerns please talk to her/him about it.  

1 person found this helpful