Clomipramine Hydrochloride is used to treat–

• Obsessive Compulsive Disorder (OCD)
• Major Depressive Disorder (MDD)
• Depression

Clomipramine Hydrochloride is a tricyclic antidepressant belonging to the dibenzazepine group. It is believed to affect obsessive and compulsive behaviors by acting on serotonin transmission in the brain. Although its exact mechanism is not fully known, it works by inhibiting the reuptake of serotonin (5-HT), which plays a key role in controlling obsessions and compulsions, thereby helping improve social functioning.

Initial dose is 25 mg at bed time about a week, gradual increase of dose should not be exceeded more than 150 mg per day in adult and 75 mg per day in elderly patient. Dose can be given as divided form to reduce gastrointestinal disturbances. Not recommended for children.

Administration

Swallow this capsules whole with a drink of water. Keep taking your medicine until your doctor tells you to stop. Do not stop because you do not feel any better. This medicine may take up to 4 weeks to work. The medicine may be taken as one dose at night or as smaller doses at intervals during the day.

Medicines used for depression, especially–

• MAOIs e.g. tranylcypromine, phenelzine, moclobemide
• SSRIs e.g. fluoxetine (or taken within the past 3 weeks), fluvoxamine, paroxetine, sertraline
• SNRIs 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 temporary loss of sensation
• Blood pressure lowering drugs (beta-blockers), anticoagulants, etc.

• Patients with known hypersensitivity to Clomipramine Hydrochloride or other tricyclic antidepressants of the dibenzazepine group
• Patients in the acute recovery phase after myocardial infarction
• Should not be used with MAO (Monoamine Oxidase) inhibitors within 14 days

Common side effects include gastrointestinal disturbances, headache, dizziness, nausea, constipation, dry mouth, excessive sweating, hand tremors, difficulty in urination, vision problems, fatigue or drowsiness, sexual dysfunction, and restlessness.

There are no well-controlled studies confirming safety during pregnancy. Limited evidence suggests that clomipramine may pass into breast milk and may pose a risk to the fetus.

Consult your doctor or pharmacist before taking Clomipramine if you:

• have ever experienced suicidal thoughts
• have epilepsy (seizures)
• have had a head injury or brain damage
• are undergoing electroconvulsive therapy (ECT)
• have heart-related problems
• have been diagnosed with low potassium levels in the blood (hypokalaemia), which should be treated before starting this medicine
• have kidney disease
• have schizophrenia or other mental disorders
• have a blood disorder
• have an overactive thyroid gland
• have had severe constipation for a long time
• have a tumour of the adrenal gland (such as phaeochromocytoma or neuroblastoma)
• have liver disease
• have low blood pressure
• wear contact lenses

Overdose symptoms may include dry mouth, enlarged pupils, coma, seizures, rapid heartbeat (tachycardia), irregular heart rhythm, breathing difficulties, and changes in blood pressure.

Tricyclic & related anti-depressant drugs

Do not store above 30°C. Keep away from light and out of reach of children.