Clomipramine Hydrochloride

Clomipramine Hydrochloride is used to treat-

• Obsessive Compulsive Disorder (OCD)
• Major Depressive Disorder (MDD)
• Depression.

Clomipramine Hydrochloride is an original tricyclic antidepressant, a member of the dibenzazepine group of compounds. It is presumed to influence obsessive and compulsive behaviors through it's effects on serotonergic neuronal transmission. The actual neurochemical mechanism is unknown but it has the capacity to inhibit the reuptake of serotonin (5-HT) which is thought to be important (like obsessions, compulsion) thus hampers social acquaintance.

Initial dose is 25 mg at bed time about a week, gradual increase of dose should not be exceeded more than 150 mg per day in adult and 75 mg per day in elderly patient. Dose can be given as divided form to reduce gastrointestinal disturbances. Not recommended for children.

Swallow this capsules whole with a drink of water. Keep taking your medicine until your doctor tells you to stop. Do not stop because you do not feel any better. This medicine may take up to 4 weeks to work. The medicine may be taken as one dose at night or as smaller doses at intervals during the day.

Medicines for depression, particularly-

• MAOIs e.g. tranylcypromine, phenelzine, moclobemide;
• SSRIs e.g. fluoxetine (or have taken within the last 3 weeks), fluvoxamine, paroxetine, sertraline;
• SNaRIs e.g. venlafaxine; tricyclic and tetracyclic antidepressants e.g. amitriptyline, dothiepin, maprotiline
• Diuretics, also known as ‘water tablets’, e.g. bendroflumethiazide, furosemide
• Anaesthetics, used for the temporary loss of bodily sensation
• Blood pressure lowering agents (Beta blockers), Anti-coagulants etc.

• Patients who have shown hypersensitivity to Clomipramine Hydrochloride or hypersensitivity to other tricyclic antidepressants belonging to the dibenzazepine group
• Patient with acute recovery phase following a myocardial infarction
• Should not be used in with MAO (Monoamine Oxidase) inhibitors within 14 days

The most frequent side effects are gastrointestinal disturbances, Headache, dizziness, nausea, constipation, dry mouth, increased sweating, shaking hands, tremor, difficulty in passing urine, problems with their eyes, feeling tired or sleepy, sexual disturbance, restlessness.

No adequate well-controlled studies of safety for pregnancy. Limited data suggest that clomipramine is likely to be excreted in human breast milk. Although it has known risk of damage to fetus.

Talk to your doctor or pharmacist before taking Clomipramine if you:

• have ever had suicidal thoughts
• suffer from epilepsy (fits)
• have had a head injury or have suffered brain damage
• are going to have electric shock therapy (ECT)
• have other problems with your heart
• have been told you have a low level of potassium in your blood (hypokalaemia). The doctor will need to treat this before you start taking clomipramine
• have kidney disease
• suffer from schizophrenia or other mental health conditions
• have a blood disorder
• have an overactive thyroid gland
• have had severe constipation for a long time
• have a tumour (cancer) of the adrenal gland (such as phaeochromocytoma or neuroblastoma)
• liver disease
• have low blood pressure
• wear contact lenses

It has been reported that adults can experience dryness of mouth, dilated pupils, coma, convulsions. Tachycardia/ cardiac arrhythmia, respiratory depression and alteration in blood pressure are noted.

Tricyclic & related anti-depressant drugs

Do not store above 30°C. Keep away from light and out of the reach of children.