I have been taking clomipramine for five years, initially 75 mg/day. I reduced that to 1 x 25 mg one day, 2 x 10 mg the next day. How can I further taper and what can withdrawal symptoms be?
Joris Bartstra, journalist with medical diploma
Known withdrawal symptoms of antidepressants are restlessness and anxiety, dizziness, nausea, flu-like complaints such as headache, muscle aches and fatigue, irritability and poor sleep. Clomipramine is often used for complex anxiety symptoms, for example with compulsions: rituals that you have taught yourself (often unconsciously) to inhibit the anxiety. It is not really notorious for withdrawal symptoms when stopping, but if you decide to taper off, it is important that you really feel good again and the complaints are not ‘just around the corner’ so that you return to the original use as the protection is lost.
I therefore assume that you have discussed tapering with your practitioner. Your practitioner can also discuss the best schedule with you. It is important here that the last steps involve the most risk: using a little bit or nothing at all is at least as big a difference as a lot or little. So the last steps have to get smaller and smaller. Not 100-75-50-25-0 but for example 100-50-25-15-10-7.5-5 and so on. If necessary, the pharmacy can put together special tapering strips for you. How quickly you actually do it also depends on how sensitive you are to withdrawal. Again: discuss tapering thoroughly with your therapist.
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