Clomipramine

Clomipramine is a tricyclic antidepressant. It is used in adults to treat obsessive-compulsive disorder (OCD). It also treats muscular weakness (cataplexy) associated with repeat attacks of sleepiness (narcolepsy) and can manage depression that is unresponsive to other medicines.

Clomipramine works by increasing the levels of chemical messengers in the brain that stabilizes and enhances the mood. It is better to take it before bedtime because it can make you feel sleepy. It can be taken with or without food, but you should take it at a fixed time each day for better efficacy. The dose and duration will be decided by your doctor so that you get the right amount to control your symptoms. If you have missed any dose, take it as soon as you remember. Do not skip any dose and finish the full course of treatment even if you feel better. This medication must not be stopped suddenly without talking to the doctor. Your dose may be modified or gradually decreased before stopping the medication.

The most common side effects of this medicine include indigestion, loss of appetite, dryness in the mouth, nausea, and constipation among others. It may also cause dizziness and drowsiness, do not drive or do anything that requires mental focus until you know how this medicine affects you. To lower the chances of dizziness, rise slowly if you have been sitting or lying down. It may also lead to weight gain in some people. Most of the common side effects tend to be mild and temporary. Your doctor may be able to suggest ways of preventing or reducing side effects if they bother you or do not go away. Serious side effects associated with this medicine are rare.

Before taking this medicine, it is important to tell your doctor if you are taking or have recently taken any other medicines for the same or any other diseases. Pregnant and breastfeeding women should take this medicine with proper consultation and caution. This medicine is not addictive, but you can experience additional side effects (withdrawal symptoms) if you stop taking it suddenly. If you notice any sudden mood change or get suicidal or self-harm thoughts, you must consult the doctor without delay. Also, remember to take this medicine strictly as advised by the doctor as an overdose of this medication may lead to a serious health emergency.

• Obsessive-compulsive disorder
• Depression
• Treatment of Narcolepsy (Uncontrollable daytime sleepiness)

Obsessive-compulsive disorder
Obsessive-compulsive disorder (OCD) is a disorder that affects mental health. People may develop a cycle of obsessions and compulsions, irrespective of age. Obsessions are unwanted, repeated thoughts, images, or urges that trigger excessively distressing feelings. Clomipramine helps relieve symptoms of obsessive-compulsive disorder by increasing the level of a chemical called serotonin in your brain. It has fewer side effects than other medicines and is normally taken once a day. Keep taking the medicine until your doctor advises you to stop.

Depression
Clomipramine is thought to work by affecting the balance of certain chemicals (such as serotonin) in the brain. It helps improve mood and feelings of wellbeing, relieve anxiety and tension, help you sleep better, and increase your energy level. It is used to treat depression that is unresponsive to other medicines. You need to take it regularly as it is prescribed for it to be most effective and should not stop taking it suddenly.

Treatment of Narcolepsy (Uncontrollable daytime sleepiness)
Narcolepsy is a sleep disorder that causes excessive daytime drowsiness. The affected person may experience excessive sleepiness, sleep paralysis, hallucinations, and in some cases episodes of cataplexy (partial or total loss of muscle control). Clomipramine stimulates the brain and makes you fully awake. It also relieves these abnormal symptoms and regulates the sleep cycle. This restores normal sleeping habits and improves your quality of life. You will feel more energetic and will be able to perform better in your daily activities.

Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them

Common side effects of Clomizil

• Drowsiness
• Urinary incontinence
• Altered libido
• Constipation
• Dryness in mouth
• Aggravation of depression
• Agitation
• Anxiety
• Blurred vision
• Delirium (acute confusional state)
• Dizziness
• ECG changes
• Erectile dysfunction
• Fatigue
• Headache
• Hypomania
• Increased appetite
• Nausea
• Orthostatic hypotension (sudden lowering of blood pressure on standing)
• Palpitations
• Ringing in ear
• Sleep disorder
• Sweating
• Tremors
• Weight gain
• Confusion
• Hallucination
• Mania
• Micturition disorders
• Altered blood sugar level

Take this medicine in the dose and duration as advised by your doctor. Clomipramine is to be taken with food.

Clomipramine is a tricyclic antidepressant. It increases the levels of chemical messengers in the brain that help in regulating the mood and treat depression.

• It may take 4 to 6 weeks for Clomipramine to start working. Keep taking it as prescribed.
• It may cause sleepiness. Take it at bedtime and do not drive or do anything requiring concentration until you know how it affects you.
• Avoid consuming alcohol when taking Clomipramine as it may cause excessive sleepiness.
• Monitor your weight during the treatment as this medicine can cause weight gain and increased appetite.
• Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.

Stahl SM, editor. Clomipramine. In: Stahl's Essential Pschopharmacology: Prescriber's Guide. 5th ed. New York, New York: Cambridge University Press; 2014. pp. 129-35.

Briggs GG, Freeman RK, editors. A Reference Guide to Fetal and Neonatal Risk: Drugs in Pregnancy and Lactation. 10th ed. Philadelphia, PA: Wolters Kluwer Health; 2015. pp. 298-300.

Clomipramine hydrochloride. Whitby, Ontario, Canada: Patheon Inc.; [revised Jun. 2014]. [Accessed 22 Mar. 2019] (online) Available from:

Chaves RG, Lamounier JA. Breastfeeding and maternal medications. J Pediatr (Rio J). 2004;80(5 Suppl):S189-S198. [Accessed 20 Mar. 2019] (online) Available from:

Central Drugs Standard Control Organisation (CDSCO). [Accessed 22 Mar. 2019] (online) Available from: