anyone come across this drug before ?

[husband]

My wife has been taken off Prozac because of the extreme nervous and anxiety side effects.

The local mental health nurse has pescribed a drug called Clomipramine, which apparently is an anti-depressant which also helps control obsessive thoughts (my wifes PND has triggered a specific fear that she could harm our baby with knives - see my previous post)

Does anyone have any experience with this drug ?

[deborah not logged on]

Clomipramine is an 'old-fahioned' antidepressant drug, known tried and tested.

It is quite sedating and is known as being in a class of drugs known as 'tricyclics'.

As it is not one of the newer types of drug why has she been put on this? Why is your wife so nervous? I will have a quick look on the other posting but for now thats all i can tell you about it.
I'm not sure if yuo can B/Feed with it but as she was on prozac i am assuming she wasn't B/Feeding then either?
Deborah X

[Deborah not logged]

Dear Husband,

I've just read through yuor story, and the treatment your wife has received so far is appauling.
All Anti D's make you anxious and jittery when they start off- it takes around 1 week or so to assess the full effects and to see if they will work and help her in the long run. Maybe she should have been put on a sedating and anxiety reducing drug to start with?
I don't know where you live but if you are in the Uk is there a Mother & Baby Unit (psychiatic) your wife could be referred to?
Is she very bad day to day or is it the fact that she has the fears about knives (which is very very common with PNI) and is scared?

The spiralling thoughts are also part and parcel of PNi too.
Why has your wife been referred to a CBTherapist this early on??
Was this a private appointment or NHS?? CBT should really be used when your wife is stable on her Anti'ds as it hasn;t any real benefits when PNi is acute in its symptoms.
So i am right she wasn't on medication but just the CBTherapy for 4 months??

Valium for PNI? this is a big No NO! its addictive in ;long term use and its effects are short lived so more and more is needed for the same effect. She also has a baby to care for! Who is to help her with that?? I am presuming you are not working so thats why she was given valium?
I am also assuming here her symptoms are now 6 months old and she is starting sertraline?
First off: has she support emotionally from her mum,a freind a good HV or support group nearby for women with PNI??
2nd: Has she been seen by a specialist in PNI? A PERINATAL MENTAL HEALTH SPECIALIST? This is a psychiatrist who has specialist qualifications in PNI and who treats women as having an illness in its own right not one which is classed under'' general mental health''?

3. If not take her/get the GP to refer her out of area, some GPs have to apply to the PCT (primary Care Trust) to ''request'' a specialist referral if the service you are seeking isn't in your area. This is where the problem lies.
Some 'schools of thought' in psychiatry think PNI or PND as they call it is quote: ''depression after childbirth''.
Specialist Psychiatrists in PNI think its ''an illness perculiar to pregnancy birth and early postnatal period''
so depending on the view of the PCT MAY determine the outcome of the referral but do try, as the more women request this service the more it is needed.
Let us know how you are getting on but personally i am not impressed at the standard of treatment she has had so far.
Love
Deborah X

[husband]

Deborah,

Thanks for the reply -

If I'm honest, the support from the local authority(health visitor, GP) have been good (they have done what they can given the resources/funding etc) - but as you suggest, I feel that they have now reached the limit of our local areas facilities. A referral to the local mental health team was I think the last option to them.

The mental health nurse said that as the nervous and anxiety had not passed in the three weeks while taking the Prozac then it was probably not the right drug for her. She said to stop taking it for five days, if the side effects went, then that would prove the Prozac was the cause and if so she would pescribe Clomipramine (not sertraline - my mistake). The nurse suggested that as the main symptom of my wifes PND was the fear of knives, then the Clomipramine would be a good choice as this also helps alleviate obbsessive thoughts as well as depression - this kind of makes sense.

The nervousness and anxiety did ease considerably during the 5 days and at the second appointment yesterday my wife was pescribed Clomipramine.

I have spoken to many people about the treatment my wife has received and the general concensus appears to be that we have done all the right things so far (granted that seeing a private CBT probably is unnecsessary at this early stage, but my wife does appear to benefit from it) - however there is no doubt that the local mental health team have no specialist PND skills and if this new drug does not help either then I will certainly look to get her referred to a mother & baby unit (I have discovered from the APNI helpline that the closest to us is at the queen elizabeth hospital in Brimingham - about 1 hour drive from us).

As I write this my wife has just returned from our GP who wanted to see how the referral to the mental health team went - apparently she (the GP) is happy about the change of drugs.

Thanks again Deborah, its fantastic to get support like this.....


hubby

[Veritee]

Hi Husband

Just a thought - and I am no expert on medication - but sometimes the oldre ant Ds are prescribed if you are breastfeeding. pregnant or trying to get pregnant, as the older 'tricyclics' have been around a long time and known to be relatively 'safe' in these circumstanses..

Do any of these apply??

All the best

Veritee

PS have been following your story - how did the referal go?

[husband]

veritee,

thanks for checking up - in our case my wife isn't breastfeeding, pregnant or trying (I think the last two are about the furthest thing from her mind at the moment) - the change to the Clomipramine is simply a medical one (bad side effects of Prozac PLUS Clomipramine apparently has a more calming effect and will help with the obsessive knife thoughts - see previous post regardng referral)

thanks again for your spport