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Clomipramine is used to treat patients with obsessive-compulsive disorder.
Clomipramine is a tricyclic agent with both antidepressant and antiobsessional properties. Like other tricyclics, Clomipramine inhibits norepinephrine and serotonin uptake into central nerve terminals, possibly by blocking the membrane-pump of neurons, thereby increasing the concentration of transmitter monoamines at receptor sites. Clomipramine is presumed to influence depression and obsessive and compulsive behaviour through its effects on serotonergic neurotransmission. The actual neurochemical mechanism is unknown, but Clomipramine capacity to inhibit serotonin reuptake is thought to be important. Clomipramine appears to have a mild sedative effect which may be helpful in alleviating the anxiety component often accompanying depression.

Special precautions

• Tell your doctor and pharmacist if you are allergic to Clomipramine or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially MAO inhibitors [phenelzine (Nardil) or tranylcypromine (Parnate)], even if you stopped taking them in the last 2 weeks; anticoagulants ('blood thinners') such as warfarin (Coumadin); benztropine (Cogentin); cimetidine (Tagamet); clonidine (Catapres); dicyclomine (Bentyl); digoxin (Lanoxin); disulfiram; flecainide (Tambocor); guanethidine (Ismelin); haloperidol (Haldol); levodopa (Sinemet, Dopar); medications for nausea, dizziness, or schizophrenia; oral contraceptives; propafenone (Rythmol); quinidine (Quinidex); secobarbital (Seconal); sedatives; selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), sertraline (Zoloft), and paroxetine (Paxil); tranquilizers; trihexyphenidyl (Artane); and vitamins. You must wait at least 5 weeks after stopping to take fluoxetine before beginning to take Clomipramine .
• Tell your doctor if you or anyone in your family has or has ever had depression, bipolar disorder (mood that changes from depressed to abnormally excited), or mania (frenzied, abnormally excited mood), or if you or anyone in your family has thought about or attempted suicide. Also tell your doctor if you have or have ever had a heart attack, seizures, problems with your urinary system or prostate, glaucoma, irregular heartbeat, problems with your blood pressure, thyroid problems, or heart, kidney, or liver disease.
• Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Clomipramine , call your doctor.
• If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Clomipramine .
• You should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
• Remember that alcohol can add to the drowsiness caused by this drug.
• Tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.
• Plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Clomipramine may make your skin sensitive to sunlight.
• You should know that your mental health may change in unexpected ways, especially at the beginning of your treatment and any time that your dose is increased or decreased. These changes may occur at any time if you have depression or another mental illness, whether or not you are taking Clomipramine or any other medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied, abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own.

Side Effects

• drowsiness
• dry mouth
• upset stomach
• vomiting
• diarrhea
• constipation
• nervousness
• decreased sexual ability
• decreased memory or concentration
• headache
• stuffy nose
• change in appetite or weight

If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• tremor
• seizures
• fast, irregular, or pounding heartbeat
• difficulty urinating or loss of bladder control
• depression
• delusions or hallucinations
• eye pain
• shakiness
• difficulty breathing or fast breathing
• severe muscle stiffness
• unusual tiredness or weakness

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to Clomipramine .