marcopolo

Unusual side effects of clomipramine
associated with yawning

D McLean, RG Forsythe, IA Kapkin
Department of psychiatry, St John Regional Hospital, New Brunswick, Canada Canadian Journal of Psychiatry


Case 1 : A married woman in her late twenties presented with a three month history of depression. Psychiatrie assessment led to a diagnosis of a unipolar depressive illness, arising in an anancastic personality. She was treated as an out-patient, with clomipramine 100 mg per 24 hours. Complete symptom remission occurred within ten days. At that point, however, the patient questioned how long she would be "allowed" to take the medication. She sheepishly admitted that she hoped to take the medication on a long terrn basis, not so much because of the symptom relief that she had experienced, but rather because she had noted that since taking the medication, every time she yawned she had an orgasm. She found she was able to experience orgasm hy deliberate yawning. With discontinuation of the medication several weeks later, this phenomena disappeared.

Case 2 : A married male in his mid-twenties presented with symptoms of depression of three or four months duration. Psychiatric assessment established a diagnosis of unipolar depressive illness, occurring in a passive-aggressive personality. Treatment with clomipramine, 75 mg per 24 hours, on an out-patient basis produced complete symptorn relief within fourteen days. However, the patient was particularly ambivalent about continuing the medication, because he had noted a frequent intense urge to yawn without tiredness and that on many occasions when he yawned, he experienced orgasm, with ejaculation. He denied increased libidinal drive or related fantasy. Although he found this both awkward and embarrassing, he elected to continue the medication because of the therapeutic benefit he obtained. The awkwardness and embarrassment was overcorne by continuously wearing a condom. With discontinuation of the medication several weeks later, the phenomenon disappeared.

Discussion : These reported side effects have been discovered coincidentally during routine side-effect queries. However, no placebo-replacement or challenge by clomipramine following discontinuation has been attempted. The authors are unable to explain the origins of these peculiar phenomena, coinciding with the administration of clomipramine. These cases are being reported not only for the benefit of readers who might wish to explore the origins of these occurrences, but also because of the clinical implications for patient compliance. The authors suspect that these side effects may not have been reported previously (particularly the phenomenon of orgasm) because of patientunwillingless to reveal the experience. It is suggested that all patients receiving this medication should routinely be queried about their experiences with orgasm in order to more clearly establish the frequency of this phenomenon.




I have one question ...
WHERE DO I SIGN UP ?

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Those who can't laugh at themselves leave the job to others.

bernadette

O M G

we live in a strange world. yes we do.

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krwlz

I agree, where does one sign up...then again it could get messy.

cchris

I'm depressed

I'm tired,

Look out.........................YAWN

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There's a fine line between participation and mockery

grumpyolddude

"Doctor, I have an orgasm every time I sneeze. Can you prescribe anything for it?"

"Pepper."

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"Regret can be a harder pill to swallow than failure .With failure you at least know you gave it a chance..." David Howard

marcopolo

Truly a Classic !

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Those who can't laugh at themselves leave the job to others.