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Clomipramine

Clomipramine (brand-name Anafranil®) is a tricyclic antidepressant. more...

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Indications

  • Depression with lack of energy or mild agitation
  • Obsessive Compulsive Disorders (OCD)
  • Panic attacks with or without Agoraphobia
  • Narcolepsy
  • chronic pain with or without organic disease, particular headache of the tension type
  • Enuresis (involuntary nightly urinating in sleep) in children / adolescents
  • Off label, sometimes antidepressants of this type have been found helpful in reducing relapses in cocaine addicts and to help repair cocaine-caused neurotransmitter imbalances and early brain damage. Further studies are needed for Clomipramine in this regard.

It may take 2 to 3 weeks before the full effects of this medication are noticed in all indications.

Contraindications

  • Concomitant therapy with an (irreversible) MAO-Inhibitor (e.g. Tranylcypromin, Phenelzin)
  • Acute intoxication with central depressants (alcohol, psychoactive drugs, narcotics)
  • States of confusion (caution), absolutely contraindicated in patients with coma and Delirium tremens
  • Patients with massive agitation or anxiety (give sedative drugs concomittantly)
  • Hypersensitivity/Allergy against Clomipramine or other related tricyclic compounds
  • Hypertrophy of the Prostate with urine retention (=difficulty in urinating)
  • Caution : Hypertrophy of the Prostate without urine retention
  • Preexisting closed angle glaucoma
  • Epilepsy and other conditions which lower the seizure-threshold (alcohol-withdrawal, active brain tumors)
  • Serious liver disease (elimination is decreased), if Clomipramine is given consider dose reduction
  • Serious kidney disease (elimination is decresed), if Clomipramine is given consider dose reduction
  • Severe hypotension, shock, serious cardiovascular dysfunction (postinfarctous states, heart insufficience, arrhythmias), avoid high oral doses or injections/infusions
  • Preexisting bone marrow depression (leukopenia, thrombopenia, anemia, pancytopenia), can be worsened by Clomipramine
  • Overfunction of the thyreoid gland makes the patient more sensitive to side-effects of Clomipramine. Cautious doses should be used and the overfunction should be treated.
  • Caution should be exerted when treating pediatric patients under 18 yrs. of age

Pharmacology

Clomipramine is the 3-chloro derivative of Imipramine. Clomipramine is a strong, but not completely selective Serotonic-Reuptake-Inhibitor (SRI), as the active main metabolite Desmethyclomipramine acts preferably as inhibitor of Noradrenaline-Reuptake. Other hydroxy-metabolites are also active. Alpha-1-Receptor blockage and beta-down-regulation as well as postsynaptic antagonism on H1 (histaminergic)-receptors have been noted. A blockade of Sodium-channels and NDMA-receptors might, as with other tricyclics, account for its effect in chronic pain, particular of the neuropathic type.

Read more at Wikipedia.org


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Mallinckrodt purchases rights to five former Novartis products - Mallinckrodt Pharmaceuticals licenses central nervous system drugs from Novartis Pharmaceuticals
From Drug Store News, 9/10/01 by Diane West

Mallinckrodt Pharmaceuticals purchased the U.S. rights to five former Novartis Pharmaceuticals Corp.'s central nervous system products, including four tricyclic antidepressants: Anafranil (clomipramine HC1), Pamelor (nortiptyline HCl, USP) Tofranil (imipramine HCl) and Tofranil-P.M. (imipramine pamoate) and one benzodiazepine hypnotic compound, Restoril (temazepam).

COPYRIGHT 2001 Reproduced with permission of the copyright holder. Further reproduction or distribution is prohibited without permission.
COPYRIGHT 2001 Gale Group

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