Expert: Ivan Goldberg, M.D. - 7/25/2011

Question
Hi - thank you for looking at my question re. depression.  I have been on AD's for the last 12 years following Post Natal Depression. (originally seroxat/paxil)

I have tried to come off a number of times with very slow withdrawals but have never managed to stay off.

I am now on 35mg of anafranil/clomipramine and would like to know how this compares to ssri doses.  (ie what is the equivalent dose in prozac or paxil.)

This is because I would like to try to get on as low as possible to reduce any impact from being on ad's such a long time.  I think 35mg  anafranil may be = to something like 10mg prozac but Im just not sure.

Thank you for your help.

Sally

Answer
Hi Sally . . .

While clomipramine and fluoxetine (and paroxetine) are all antidepressants I know of no established set of equivalences for them. I have switched many patients from one of these medications to another of them and the dosage ratios have not been at all consistent. One individual taking 60 mg/day of fluoxetine may need 150 mg/day of clomipramine to feel well, while another individual taking the same amount of fluoxetine may do well on 25 mg of clomipramine when switched.

Best regards . . .

Ivan
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