It is used for the treatment of obsessive–compulsive disorder, panic disorder, major depressive disorder, and chronic pain.
Tricyclic; Antidepressant
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.
ORAL Adjunct for cataplexy associated w/ narcolepsy: Adult: Initially, 10 mg daily gradually increased to 10-75 mg daily. Elderly: Dose reduction may be needed. Obsessive compulsive disorder; Panic disorder; Phobias: Adult: Initially, 25 mg daily, gradually increased to 100-150 mg daily over 2 wk. Max: 250 mg daily. Child: 10 yr: Initially, 25 mg daily, increased gradually over 2 wk. Max: 3 mg/kg/day or 100 mg daily, whichever is smaller. Give in divided doses. Once titrated, dose may be given as a single dose at bedtime. Elderly: Initially, 10 mg daily. Depression: Adult: Initially, 10 mg daily; may increase gradually to 30-150 mg daily if needed. Up to 250 mg daily or more may be required in more severe cases. Elderly: Initially, 10 mg daily; may increase gradually over 10 days to 30-75 mg daily. Max Dose: 100-150 mg daily. INTRAMUSCULAR Depression;Obsesslve compulsive disorder: Adult: Initially, 25-50 mg daily, may increase dose gradually. Max: 100-150 mg daily. Substitute w/ oral dosage as soon as possible. Elderly: Initially, 10 mg daily gradually increased to 30-75 mg if necessary. INTRAVENOUS Depression;Obsessive compulsive disorder: Adult: Initially, 50-75 mg diluted in 250-500 ml of 0.9% Na Cl or 5% glucose infused over 1.5-3 hr. Substitute w/ oral therapy when a satisfactory response has been achieved. The initial oral dose can be double the max parenteral dose; adjust subsequently according to response.
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.
Hypersensitivity. Concomitant use of MAOls; recovery phase following Ml, heartblock or other arrhythmias; mania; childn. Cardiovascular insufficiency; narrow-angle glaucoma; urinary retention; history of epilepsy; renal or hepatic dysfunction; electroconvulsive therapy; hypotension; hyperthyroidism or concomitant treatment w/ thyroid preparations; suicidal tendencies; surgery; pregnancy & lactation; tasks requiring mental alertness; elderly; avoid abrupt withdrawal.
Dryness of mouth; disturbances in micturition; drowsiness, increased sweating; sexual dysfunction; confusion, paraesthesia. ataxia. tremors; extrapyramidal symptoms; tinnitus, dizziness, fatigue, headache; wt gain esp in women; gynaecomastia & galactorrhoea. Death, rare (except in patients w/ preexisting sgnificant heart block & patients on MAOI therapy). Induction of mania in indMduals w/ underlying manic-depressive illness or worsening of psychoses in already psychotic individuals.
This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
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.
Do not store above 30°C. Keep away from light and out of the reach of children.
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