Clomipramine: Uses, Side effects, Dosage

Clomipramine belongs to a group of antidepressant drugs known as  tricyclic antidepressants. It is used in the treatment of depression and obsessive-compulsive disorders (OCD).

Clomipramine was first discovered in 1964 by the Swiss drug manufacturer Ciba-Geigyr.

It can cause withdrawal symptoms so don’t stop taking it without talking to your doctor.

Clomipramine Uses

Clomipramine is used in the treatment, and preventions of the following medical conditions;

  • Obsessive-compulsive disorder
  • Depression,
  • Panic disorder,
  • Autistic disorder (limited evidence),
  • Cataplexy and associated narcolepsy (limited evidence),
  • Chronic pain (e.g. central pain, tension headache, neuropathic pain, idiopathic pain disorder, diabetic peripheral neuropathy)
  • Onchophagia (limited evidence),
  • Trichotillomania (limited evidence),
  • Stuttering (limited evidence),
  • Premenstrual syndrome.
  • Premature ejaculation, and

Clomipramine may also be used for purposes not listed above.

Clomipramine Side Effects

Common side effects include

  • Dry mouth
  • Weight gain
  • Decreased sex drive (libido)
  • Tremor
  • Dizziness
  • Nervousness
  • Constipation
  • Decreased appetite
  • Excessive daytime sleepiness

Serious Side effects

  • Panic attacks
  • Acting on dangerous impulses
  • New or worsening depression, anxiety, or irritability
  • Extreme increases in activity or talking (mania)
  • Suicide attempts
  • Thoughts of suicide
  • Serotonin syndrome.


Pregnancy and Breast Feeding:

It is important that you and your baby stay healthy during pregnancy. If you become pregnant while taking clomipramine, talk to your doctor. It is important that you do not stop taking your medicine unless your doctor has told you. Ask your doctor about the potential benefits of taking medication during pregnancy or breastfeeding to make informed decisions about what is good for you and your baby.


Do not take this medicine if:

  • You are or have been allergic to clomipramine, other tricyclic antidepressants or any of the ingredients listed at the end of this leaflet.
  • If you think you have an allergic reaction, contact your doctor immediately or go to the emergency department of the nearest hospital.
  • Do not use this medicine if you have taken MAOIs such as isocarboxazid, linezolid, methylene blue, phenelzine, rasagiline, selegiline or tranylcypromine within the last 14 days.
  • You recently had a heart attack. This can make your condition worse.
  • You have a heart condition called congenital long QT syndrome
  • You are taking another tricyclic antidepressant
  • The expiry date (EXP) printed on the packaging has been exceeded.
  • The packaging is torn, has been tampered with or does not seem very correct.

How it works

Clomipramine works by preventing the reabsorption of serotonin and norepinephrine released into the nerve cells of the brain. This helps prolong their effects and, over time, relaxes mood and relieves depression. Antidepressants such as clomipramine have also been shown to be effective in relieving anxiety symptoms such as panic and anxiety.


Many drugs can interact with clomipramine. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • Cimetidine
  • Any other antidepressant;
  • Clonidine;
  • Bladder or urinary medicines such as darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin;
  • Bronchodilators such as aclidinium, ipratropium, tiotropium, or umeclidinium;
  • Guanethidine;
  • Medication for Parkinson’s disease;
  • Seizure medicine such as phenytoin or phenobarbital.
  • Cold or allergy medicine;
  • Diet pills, stimulants, ADHD medication (such as Ritalin or Adderall);
  • Medication to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome.


In short-term studies, antidepressants increase the risk of suicidal ideation and behavior in children, adolescents and young adults (under 24 years of age) taking antidepressants for major depressive disorder and other psychiatric disorders.

This increase was not observed in patients over 24 years of age. In adults over 65, a slight decrease in suicidal ideation was observed.

For children and young adults, the risks must be weighed against the benefits of taking antidepressants.

Patients should be carefully monitored for changes in behavior, clinical worsening and suicidal tendencies. This should be done during the first 1-2 months of treatment and dose adjustment.

The patient’s family should inform the provider of abrupt changes in behavior.

Behavioral deterioration and suicidal tendencies that are not symptoms may require discontinuation of treatment.

This medicinal product is not approved for use in pediatric patients.

Clomipramine Dosage

Treatment with clomipramine should be started at the minimum recommended dose and gradually increased according to the patient’s response to minimize the risk of side effects. Clomipramine tablets are better tolerated when taken with meals.

  • The recommended adult clomipramine dose is between 25 mg and 200 mg daily in divided doses, preferably at mealtimes and at bedtime. The dose depends on the circumstances but generally starts little and increases as needed.
  • Children and adolescents (10 to 17 years old) usually start with a dose of 25 mg per day, with the dose being increased by 25 mg every 3-4 days, as prescribed by your doctor.
  • If treatment is discontinued, the dose should be gradually reduced to avoid withdrawal effects.
  • It is important that you take this medicine as directed by your doctor. If you miss a dose, take it as soon as possible and follow the normal schedule. If it is almost time for your next dose, skip the missed dose and continue with your usual dosing schedule. Do not take a double dose to make up for the loss. Consult your doctor or pharmacist if you do not know what to do after you miss a dose.
  • Keep this medicine at room temperature and out of the reach of children.
  • Do not dispose of medicines in waste water (eg in the sink or toilet) or in household waste. Ask your pharmacist how to remove unnecessary or expired medicines.

Frequently Asked Questions (FAQS)

Q. 1 Can I drive after taking Clomipramine?

Clomipramine may cause drowsiness, dizziness and blurred vision and affect the ability to drive or operate machinery safely. Do not drive and do not use machines if they are interested.

Q. 2 Can I drink alcohol with clomipramine?

Avoid alcohol intake while taking clomipramine, as you will probably feel very sleepy, dizzy or confused, or have blurred vision. This effect is likely to be worse if you drink alcohol at the beginning of treatment or after a dose increase.

Q. 3 How to store The medicine?

Keep the medicine in its original packaging until you take it. If you take the medicine out of its original packaging, it may not work properly. Store the medicine in a cool, dry place where the temperature remains below 25 ° C. Do not store drugs or other drugs in the bathroom or in the sink. Do not leave it on the window sill or in the car. Heat and humidity can destroy some medicines. Keep this medicine in a place where children can not reach it. A closet at least one and a half meters above the ground is a good place to store medicine.

Q. 4 Why is this medication prescribed?

Clomipramine is used to treat people with obsessive-compulsive disorder. Other than this there are other unapproved uses of this medicine. Please check above.

Q. 5 Is it safe to use Clomipramine if you are pregnant?

Clomipramine belongs to category C. In studies in animals, these animals have had a pregnancy and some babies are born with problems. No well-controlled human studies have been conducted. Therefore, this drug may be used if the potential benefits to the mother outweigh the potential risks to the fetus.

Q. 6 Is it safe to use while Breast feeding?

Clomipramine has been detected in human breast milk. Because of the possibility of adverse effects in infants breastfeeding with chlomipramine, it is necessary to choose to stop breastfeeding or stop using this drug. The importance of the drug for the mother must be taken into account.

Q. 7 How to use this medicine?

Clomipramine is presented as an oral capsule. At the beginning of treatment, clomipramine is usually taken three times a day with meals, as the body adapts to the drug. After several weeks of treatment, clomipramine is taken once a day before bedtime. Follow the instructions on your prescription label carefully and ask your doctor or pharmacist if you are not explaining something.

Q. 8 Should I use Clomipramine  empty stomach, before food or after food?

Clomipramine tablets are better tolerated when taken after food.

Q. 9 Is this Clomipramine addictive or habit forming?

Clomipramine does not create dependence. However, do not stop taking clomipramine suddenly, as this can cause withdrawal symptoms such as nausea, vomiting, loss of appetite, headache, dizziness, chills, insomnia, agitation or anxiety.

Q. 10 What happens if i take Expired Clomipramine Tablet?

It is unlikely that taking a single dose of expired Clomipramine will result in an adverse event. However, please contact your primary health care provider or pharmacist for proper advice or if you feel unwell or unwell. The expired drug may become ineffective in the treatment of the prescribed conditions. As a safety measure, it is important not to use expired drugs. If you suffer from a chronic condition that requires constant treatment, such as heart problems, seizures and life-threatening allergies, you are safe in contact with your doctor. to get a new stock of medicines.

Q. 11 Does clomipramine make you sleepy?

Clomipramine can make you feel sleepy, tired,  dizzy. If you feel these symptoms, do not drive or work with machinery.

Q. 12 What should I do if I miss a dose of Clomipramine?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose if you forget to take your previous dose.

Q. 13 What should i do In case of Clomipramine overdose?

In case of overdose, call the poison helpline. If the victim has collapsed, has an attack, has breathing problems or can not be woken up, immediately call the 911 emergency number.

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