Clomipramine cant get effect dosage without side effects. Memantine ? Lovox ?
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Hello,
I’m considering adding fluvoxamine (Luvox) to my regimen because I haven’t been able to increase clomipramine beyond 25 mg due to significant hypotension.
At the moment, I also seem unable to tolerate higher doses of other medications:
Clomipramine 25 mg (higher doses → severe hypotension)
Clonazepam 0.5 mg twice daily
Mirtazapine 7.5 mg (cannot increase due to side effects)
Aripiprazole (Abilify) 2 mg (cannot increase due to side effects)
Given my sensitivity to medications, I’m unsure about the best next step. Would you recommend trying memantine first as an augmentation strategy, or proceeding directly with adding fluvoxamine to my current regimen?
For context, I appear to be very sensitive to medication changes. In 2020, I had a difficult experience with sertraline (Zoloft).
I cross-tapered from venlafaxine (Effexor) 150 mg, which I had been on for 22 years, to sertraline. During that transition, I increased sertraline to 100 mg, then reduced it to 50 mg, and then back up to 100 mg within about a week. Shortly after that adjustment, I developed dystonic reactions (leg and trapezius involvement, head bobbing) along with fasciculations.
Because of that experience, I’m cautious about making changes too quickly and want to approach the next step as safely as possible. Currently my only side effects at lowdose clomipramine is sexual anesthesia and dry mouth but its not helping OCD enough.
What are thoughts on adding Memantine as adjunct to my current stack instead or another antidepressant or antipychotic
Thank you for your guidance.