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What is clomipramine? What is clomipramine used for?
Clomipramine (Anafranil) is a psychotropic agent used to treat obsessive-compulsive disorder (OCD). Clomipramine shares structural similarities with a class of antidepressants known as tricyclic antidepressants (TCAs).
The exact mechanism by which clomipramine exerts its therapeutic benefits is not fully understood. However, similar to other TCAs, clomipramine is thought to enhance the actions of norepinephrine and serotonin (chemical neurotransmitters in the brain that nerves use to communicate with one another) by blocking their reuptake and prolonging their activity. Clomipramine also has anticholinergic properties which means it blocks the action of another neurotransmitter, acetylcholine. This increases the risk for certain side effects. It also has weak antihistamine properties which appear to play a role in the mild sedative effects observed with use. Clomipramine was approved by the US FDA for the treatment of OCD in 1991.
What brand names are available for clomipramine?
Is clomipramine available as a generic drug?
Do I need a prescription for clomipramine?
What are the side effects of clomipramine?
The most common side effects associated with the use of clomipramine include:
- upset stomach,
- dry mouth,
- sexual dysfunction,
- weight gain,
- low blood pressure,
- respiratory problems, and
- visual changes.
Less common but serious side effects include:
What is the dosage for clomipramine?
: Treatment with clomipramine should be started at the lowest recommended dose and increased slowly based on patient response to minimize the risk for side effects. Clomipramine tablets are better tolerated when administered with meals.
Which drugs or supplements interact with clomipramine?
Patients starting treatment with clomipramine should consult with their doctor or pharmacist to find out if any of their current medications or supplements have any drug interactions with clomipramine. Also, patients receiving treatment with clomipramine should always consult with their doctor before starting treatment with any new medications.
Clomipramine generally is not recommended to be used with other tricyclic antidepressants or related cyclic antidepressants. Co-administration with medications that share similar properties increases the risk for side effects. Examples of similar antidepressants are amoxapine, imipramine (Tofranil), and desipramine (Norpramin).
Clomipramine shares pharmacological properties with Class IA and Class III antiarrhythmic medications. Co-administration increases the risk for QT prolongation and life-threatening arrhythmias. For this reason, use of clomipramine should be avoided with bretylium, dofetilide (Tikosyn), dronedarone (Multaq), flecainide (Tambocor), sotalol (Betapace), quinidine (Quinidex), procainamide (Pronestyl), propafenone (Rythmol), ranolazine (Ranexa), ibutilide (Corvert), and others.
Clomipramine should be avoided when possible or used cautiously with medications known to prolong the QTc interval. Examples of such medication are thioridazine (Mellaril), ziprasidone (Geodon), pimozide (Orap), and others.
Clomipramine increases the levels of serotonin in the brain. Co-administration with other medications that also increase serotonin levels increases the risk of serotonin syndrome. Symptoms of serotonin syndrome include rapid development of hyperthermia (high body temperature), high blood pressure, muscle rigidity, confusion, and delirium. Some medications that increase serotonin levels are monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, and linezolid (Zyvox). For a complete list, please ask your doctor or pharmacist.
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Is clomipramine safe to take if I'm pregnant or breastfeeding?
Clomipramine has not been adequately evaluated in pregnant women. Due to the lack of conclusive safety data, clomipramine should be used in pregnancy only if the benefit justifies the potential risk to the fetus. Clomipramine is classified as FDA pregnancy risk category C.
What else should I know about clomipramine?
What preparations of clomipramine are available?
Oral tablets: 25, 50, and 75 mg.
How should I keep clomipramine stored?
Tablets should be stored at room temperature, between 15 C to 30 C (59 F to 86 F). As with all medications, clomipramine tablets should be kept out of the reach of children and pets.
Clomipramine (Anafranil) is a drug prescribed to treat OCD or obessive-compulsived disorder. Off-label (not approved by the FDA to treat these conditions) uses of clomipramine include the treatment patients with major depression, panic attacks, anxiety disorders, and premature ejaculation. Side effects, drug interactions, dosing, storage, and pregnancy safety information should be reviewed prior to taking this medication.
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Related Disease Conditions
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizziness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Tourette syndrome is disorder, which symptoms include involuntary facial tics, motor tics, and vocal tics. The cause of Tourette syndrome is not known. ADHD is associated with Tourette syndrome. Treatment includes medication, psychotherapy, and in severe cases surgery.
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Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common separation anxiety treatment methods include therapy and medications. Factors that contribute to how quickly or successfully a child moves past separation anxiety by preschool age include: how well the parent and child reunite, the skills the child and adult have at coping with the separation, and how well the adult responds to the infant's separation issues. For example, children of anxious parents tend to be anxious children.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Depression in Children
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Depression in teenagers may be caused by many factors. Symptoms of teen depression include apathy, irresponsible behavior, sadness, sudden drop in grades, withdrawal from friends, and alcohol and drug use. Treatment of depression in adolescents may involve psychotherapy and medications.
Depression in the Elderly
Depression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants, psychotherapy, or electroconvulsive therapy.
Sexual Problems in Men
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The term sex addiction describes the behavior of someone who has an unusually strong sex drive or sexual obsession. Sex and thoughts of sex dominate a sex addict's thinking, making it difficult to work or engage in healthy personal relationships. Sex addicts may engage in exhibitionism, voyeurism, prostitution, compulsive masturbation, or cybersex. Treatment for sex addiction includes individual counseling, marital and/or family therapy, support groups, 12-step recovery programs, and in some cases, medications.
Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
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