Clomipramine verses Venlafaxine

[Ryanlion]

Hi everyoneDoes anyone know how much Clomipramine would equal 150mgs of Venlafaxine? Which of these drugs perform best if anyone has tried them for a while.

[Hidden]

Effexor (Venlafaxine) is an entirely different pharmacy to Clomipramine formula and approved use.

From your tagged ident giving a reasonable basis to assume that your question relates to generalised anxiety then you may want to know that Clomipramine is formulated to treat OCD - where OCD is a derided disorder arising from AAD Acute Anxiety Disorder. In that sense Clomipramine MAY give some benefit IF it helps with the pathological outcomes associated with an anxiety disorder rather than a generalised anxiety condition.

To use Clomipramine for generalised anxiety is to use it 'off label' and means to use it in an unproved way.

The reason I say this is because when I was 39 years I began to have some terrible problems with my nervous system that triggered long forgotten anxiety stemming from my childhood experiences. My Dr. asked me if I was anxious and at first I took him somewhat off base. Later that same day I remembered how my childhood traumas were characterised and what gave rise to a persistent learned behavioural response to key triggers that plagued me for the first 21 years of life. To me it seemed that my anxiety was intermittent and only really became known to me through the autonomic nervous responses that present in the pathology of fear. We all know what autonomic fear means because it is very basic.

To suggest it here: it means dilated pupils, stomach and bowel cramps, raised blood pressure, sweats, and without a natural response (flight or flight) it often is overwhelming if the mind takes a direct psychological (psychosomatic) control and we become behaviourally directed to our own unreasonable anticipation of fearful events and by direction - anxiety and perhaps eventually to depression..

I realised that my anxiety was more generalised and didn't amount to a disorder and so discussing that with my Dr. the next day he prescribed Effexor (Venlafaxine).

My childhood was full of justification for both fear and anxiety and so anxiety and learned behavioural predictions to anxious behaviour were entirely rational.

So my 39 year episode of nervous exhaustion due to an intense work load was also entirely physical - yet finally pressed me into experiencing my old hat and lovely friend of my childhood - anxiety. Fortunately for me it was nipped in the bud rather quickly and after a few years when the environmental stresses were abated I came off Effexor (Venlafaxine) and asked my Dr. to prescribe a beta blocker just to modulate the phasing off process.

There isn't a precise way of giving equivalence between two drugs as to dosage when they are wholly different types of drugs chemically formulated to entirely different clinical trial based usages. That's the 'off label' meaning and the regulated and approved meaning.

And perhaps more importantly your tag for anxiety doesn't define a disorder or a psychological frame of reference. Terms like anxiety and even depression can give us a sense of commonality between different pharmaceutical compounds and treatments - but only your Dr, can properly advice you contextually in clinic based on your presentations and understanding of your own anxiety that defines the condition or else gives rise to a diagnosis of disorder. .

[Ryanlion in reply to Hidden]

Thank you for your response i can identify with a little of what you say.

[Hidden in reply to Ryanlion]

Ok.

So your question about equivalencies of dosage between two treatments for similar conditions MAY be best understood from the Drs point of view in the first instant.

If you have been prescribed Venlafaxine at 150mg dosage and your Dr. now believes that your condition is actually a disorder then he MAY simply be trying to find the right medicine for YOU.

In that ordinary clinical sense of a Dr. in general medicine then that MAY mean that he has a reason to believe that you are likely to have a disorder where anxiety is concerned - and in that belief he MAY prescribe Clomipramine.

Your question MAY be simply an anxiety driven need to control your own outcomes whilst yielding to a medical intervention.

But that is simply speculation.

May I ask what 'little' of what I said you can identify with?

[Ryanlion in reply to Hidden]

The anxiety & fear in childhood due to my upbringing.I am just not doing well on venlafaxine, been on it 2 years but it is the only drug that is doing something. Depression too. I was on clomipramine for years but it stopped working but it was so much better than venlafaxine,

[Hidden]

I understand.

May I ask where you were experiencing this fear and anxiety during the ages of 3 to 9 years?

Home?

Street?

School?

Church?

Gang?

And if relevant may I also ask if you can sense whether this fear and anxiety was more pressed onto you in any of those environments through sensory means outside of a visible or auditory trigger OR whether they were products arising out of a clear physical consequence to how you may have been perceived or the cultural framework you lived in?

OR if your reaction to those environments (often labelled as behaviour or an environmentally derived learning difficulty due to fear and anxiety preventing good outcomes) was exacerbated by authority figures implementing a stern cultural framework?

Teachers

Pastor

Policeman

Doctor

Gang leader

I am asking these questions because they pertain to my own experience and if I can help then I would surly want to do so.

On a rational front these kinds of chronological markers in experience and in present rational thought processes CAN take us from emotional memories which trigger anxiety such as fear and anger into forming an emotional shape in our rational minds that MAY help us to contain those emotions and in the end MAY help to reduce anxiety and cope with stress better.

[Ryanlion in reply to Hidden]

Mostly home, had a violent alcoholic father

[Hidden in reply to Ryanlion]

Thank you.

Having asked so many questions and having laid out a basic autonomic nervous system view of the relationship between fear and anxiety expressing it as an implied furtherance to learning in childhood years - as a psychosomatic induction of fear based on a learned behaviour established in your childhood - I can see that your condition is rather more clinical than behavioural.

Further, having expressed published statutory and clinical opinions on the 'off label' meaning when using different anti depressants to treat anxiety (the only tag I had from your post (this post) I took the liberty of reading your other posts dated back to 10 months ago, along with your own responses to others' posts.

I see that your therapy began 20 years ago and that your anxiety is clear in your own understanding - at least in the sense generally theorised out classical conditioning (Pavlov) and Operant Conditioning (Skinner).

A more psychiatric view would predicate to Maslow's Hierarchy of Needs model for induced behaviour. (Depending whether the psychiatrist were theorising out of Psychoanalytical or Behavioural models in psychology.

For example:

'Depression is more complexed than it being a 'state of fear'. There are many resons for depression. That book was written a long time ago when little was known about depression. Obviously the author had never suffered depression. Yet fear is at the root of anxiety but thats different to depression. Acceptance also is preferable to fighting it, not passive acceptance but active acceptance.' (your comment 1 month ago in another post).

I can see from your own respondent comments to others on the forum that the principle psychiatric therapy you have received MAY have led to at least a diagnosis of clinical depression as the baseline diagnosis and so the medications are chiefly to address that - where anxiety is seen as a contributor.

And now you have shared a childhood basis to answer that possible causal link between fear, anger and anxiety - though not necessarily clinical depression out of my own experience of these things.

Thank you for that.

I am going to think about whether there may be any validity in trying to explain anything out of behavioural psychology - perhaps only to encourage you in your journey and certainly not to express any learned experience of clinical depression when I have never been clinically depressed myself. If I can then I'll come back.