How to treat OCD using clomipramine - #21953
I'm a 29y old woman, I suffer from OCD from 10y ago, in July I started sertraline 50mg, then increased it to 75mg, with no improvement, a GP told me to take clomipramine in combination, but I was afraid from Serotonin syndrome, so I stopped sertraline gradually 3months ago, but I didn't start clomipramine yet, now I feel that I want to try it to treat my OCD
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Hello,
Clomipramine is effective for OCD, but it should be started alone (not with sertraline) to avoid serotonin syndrome — you did the right thing by stopping sertraline first.
How it is usually started: Start clomipramine 25 mg at night Increase slowly every 5–7 days (25 → 50 → 75 mg) Typical effective dose: 100–150 mg/day (sometimes lower works) Improvement takes 4–6 weeks, full benefit up to 10–12 weeks
Common side effects: sleepiness, dry mouth, constipation, dizziness
Important precautions: Avoid combining with SSRIs ECG may be advised before higher doses Do not stop suddenly
Best results: Clomipramine + CBT (ERP therapy)
Please start this under psychiatrist supervision, especially for dose increases.
I trust its clear Thank you !
You have a long-standing obsessive–compulsive disorder (OCD) that did not adequately respond to sertraline. Since you have completely stopped sertraline for 3 months, there is no risk of serotonin syndrome from starting clomipramine now. Clomipramine is an effective and evidence-based treatment for OCD, especially when SSRIs are ineffective. It can be started safely at a low dose and increased gradually under medical supervision. Combining medication with cognitive behavioral therapy (CBT), particularly exposure and response prevention (ERP), offers the best chance of improvement. With proper dosing and monitoring, clomipramine can significantly reduce OCD symptoms and improve quality of life.
Hello dear See as per clinical history clomipramine is recommended. It is also comparatively safer. It should be started with single dose of 25 mg. It should be increased gradually. However in case of allergy some alternative medicine should be used. I suggest you to please get in person consultation with neurologist or concerned about for better clarity and safety Regards
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