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NERVOUS SYSTEM › PSYCHOANALEPTICS › ANTIDEPRESSANTS › Non-selective monoamine reuptake inhibitors
clomipramine
N06AA04
Forms & Strengths
- Capsule: 25 mg, 50 mg, 75 mg
Adult Dosing
- Obsessive-Compulsive Disorder: Initial 25 mg/PO/daily, titrate gradually over 2 weeks to 100 mg/PO/daily, max 250 mg/PO/daily in divided doses
Pediatric Dosing
- Obsessive-Compulsive Disorder (Children > 10 years): Initial 25 mg/PO/daily, titrate gradually over 2 weeks to 3 mg/kg/day or 100 mg/PO/daily (whichever is smaller), max 3 mg/kg/day or 200 mg/PO/daily
Indications
- Obsessive-Compulsive Disorder (OCD)
Mechanism of Action
- Tricyclic antidepressant; potent and selective inhibition of serotonin (5-HT) reuptake, with secondary inhibition of norepinephrine reuptake via its active metabolite desmethylclomipramine
Contraindications
- Hypersensitivity to clomipramine or other tricyclic antidepressants
- Concurrent use of MAO inhibitors or within 14 days of discontinuation
- Acute recovery phase following myocardial infarction
- Long QT syndrome or history of ventricular arrhythmias
Adverse Reactions
- Xerostomia
- Somnolence
- Dizziness
- Constipation
- Weight gain
- Tremor
- Sexual dysfunction
- Orthostatic hypotension
- Lowered seizure threshold
- QT prolongation
Drug Interactions
- MAO inhibitors (risk of serotonin syndrome and hypertensive crisis)
- CYP2D6 inhibitors (may increase clomipramine plasma concentrations)
- CNS depressants and alcohol (enhanced sedation)
- QT-prolonging drugs (increased risk of ventricular arrhythmias)
- Anticholinergic drugs (additive anticholinergic adverse effects)
Curated Content: Needs Vetting Before Put to Clinical Use