Generic Clomipramine

Introduction

Clomipramine is a tricyclic antidepressant (TCA) most commonly prescribed for obsessive-compulsive disorder (OCD) and, in many jurisdictions, for major depressive disorder. It is supplied as oral tablets in strengths of 10 mg, 25 mg, and 50 mg. The medication belongs to the dibenzazepine class of TCAs and exerts its therapeutic effect by modulating the synaptic availability of serotonin and norepinephrine. Besides its primary indications, clinicians occasionally use clomipramine for panic disorder chronic tension-type headache, and certain pain syndromes, although these uses may vary by country.

What is Clomipramine?

Clomipramine is a synthetic, aromatic, tricyclic compound synthesized in the early s. It is marketed worldwide under several brand names, including Anafranil, Deptran, and Clomipram. The drug is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI) within the broader TCA family. While the exact manufacturer differs by region, the active ingredient is identical across all licensed preparations.

How Clomipramine Works

Clomipramine blocks the reuptake transporters for serotonin (5-HT) and, to a lesser extent, norepinephrine, increasing their concentrations in the synaptic cleft. The elevated serotonin levels are thought to underlie the drug’s efficacy in OCD, where serotonergic dysregulation is a central pathophysiological feature. By also modestly enhancing norepinephrine signaling, clomipramine contributes to mood elevation in depressive states.

The onset of clinical benefit typically appears within 2-4 weeks for mood symptoms and may require 6-12 weeks for full resolution of obsessive-compulsive symptoms. The drug’s half-life ranges from 19 to 37 hours, allowing once-daily dosing after the initial titration phase. Metabolism occurs primarily via hepatic CYP2D6, with renal excretion of metabolites.

Conditions Treated with Clomipramine

• Obsessive-Compulsive Disorder (OCD): FDA-approved; the drug reduces intrusive thoughts and compulsive behaviors by enhancing serotonergic neurotransmission.
• Major Depressive Disorder (MDD): Approved in several countries; the combined serotonin-noradrenaline effect improves mood, energy, and sleep.
• Panic Disorder: Recognized in European labeling; the anxiolytic action mitigates sudden panic attacks.
• Chronic Tension-Type Headache: Some national formularies include clomipramine for prophylaxis, owing to its neuromodulatory properties.

In each of these conditions, clomipramine’s ability to increase synaptic serotonin is the primary driver of therapeutic benefit.

Off-Label and Investigational Uses of Clomipramine

• Post-Traumatic Stress Disorder (PTSD): Small open-label studies suggest symptom reduction, but large-scale trials are lacking.
• Social Anxiety Disorder: Case series report improvement, though evidence remains limited.
• Bulimia Nervosa: Historical data indicate reduced binge-purge cycles; this indication is not formally approved.
• Diabetic Neuropathic Pain: A few randomized trials have shown modest analgesic effects, attributed to central serotonergic modulation.

These applications are not approved by regulatory agencies such as the FDA or EMA. Patients should consider off-label use only under the direct supervision of a qualified healthcare provider, as safety and efficacy have not been definit establishedIs) within the past 14 days. Caution is advised in patients with a history of seizure disorders, hepatic impairment, or who are taking drugs that strongly inhibit CYP2D6.

Risks, Side Effects, and Interactions

Common

• Dry mouth
• Constipation
• Blurred vision
• Drowsiness or insomnia (dose-dependent)
• Weight gain

Rare

• Orthostatic hypotension
• Sexual dysfunction (e.g., decreased libido)
• Hyponatremia (especially in older adults)

Serious

• Cardiac arrhythmias (QT prolongation)
• Serotonin syndrome when combined with serotonergic agents
• Severe neutropenia or agranulocytosis
• Hepatotoxicity

Drug-Drug Interactions

• MAO inhibitors: May precipitate hypertensive crisis or serotonin syndrome; a 14-day washout is required.
• Selective serotonin reuptake inhibitors (SSRIs) & other serotonergic drugs: Heightened risk of serotonin syndrome.
• CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): Increase clomipramine plasma levels, raising toxicity risk.
• Anticholinergic agents (e.g., diphenhydramine): Additive anticholinergic burden (dry mouth, urinary retention).
• QT-prolonging medications (e.g., quinidine, sotalol): May exacerbate cardiac conduction delays.

Patients should disclose all prescribed, over-the-counter, and herbal products before initiating therapy.

Use: Dosing, Missed Dose, Overdose

• Starting dose: 25 mg once daily, usually taken in the evening to mitigate initial drowsiness.
• Titration: Incremental increases of 25 mg every 3-4 days may be employed, targeting 100-250 mg/day for OCD and 150-250 mg/day for depression, divided into one or two doses as tolerated.
• Maximum dose: Generally not to exceed 250 mg per day, except under specialist supervision.

Missed dose: If a dose is forgotten within 12 hours, take it as soon as remembered. Skip the missed dose if it is near the time of the next scheduled dose; do not double-dose.

Overdose: Symptoms may include severe dizziness, cardiac arrhythmia, seizures, or loss of consciousness. Immediate medical attention is essential; contact emergency services or a poison-control center.

Precautions:

• Take tablets with a full glass of water; food does not markedly affect absorption but may reduce gastrointestinal upset.
• Avoid alcohol, which can intensify sedation and dizziness.
• Refrain from operating heavy machinery or driving until the individual’s response to the medication is known.

What** Given its half-life of up to 37 hours, the drug is largely cleared within 5-7 days. However, metabolites may persist longer, and withdrawal symptoms (e.g., dizziness, irritability) can appear during this period. A tapered discontinuation plan is recommended.

Glossary

Serotonin Reuptake Inhibition

The process by which a drug blocks the transporter that normally removes serotonin from the synaptic cleft, thereby increasing its availability to stimulate receptors.

Anticholinergic Effects

Side effects caused by blocking acetylcholine receptors, leading to symptoms such as dry mouth, blurred vision, constipation, and urinary retention.

Serotonin Syndrome

A potentially life-threatening condition characterized by agitation, hyperthermia, autonomic instability, and neuromuscular abnormalities, occurring when serotonergic activity becomes excessive.

CYP2D6

A hepatic enzyme that metabolizes many psychotropic medications; genetic variations can make individuals poor or ultra-rapid metabolizers, influencing drug levels.

Buying Clomipramine from Our Online Pharmacy

Clomipramine is available for purchase through our online pharmacy, offering a discreet, cost-effective pathway to obtain the medication when local options are limited. Prices are kept close to manufacturer cost, ensuring affordability without compromising quality. All tablets are sourced from licensed, verified suppliers that meet international Good Manufacturing Practice (GMP) standards, providing confidence in product integrity.

Delivery is performed through secure, trackable channels. Standard international airmail typically arrives within three weeks, while express services can be expected within seven days. Packaging is plain and unbranded protectinglabel applications, must be made under the supervision of a qualified healthcare professional. Readers are assumed to be responsible adults capable of making informed health decisions. Our online pharmacy provides access to Clomipramine for individuals who may encounter limited availability through conventional pharmacies, insurance formularies, or who are seeking affordable generic alternatives. Always discuss any medication changes with a qualified provider before beginning, adjusting, or stopping therapy.