Clomipramine

DEA Class;  Rx

Common Brand Names; Anafranil

Hypersensitivity

Severe cardiovascular disorder

Narrow angle glaucoma

Any drugs or conditions that prolong QT interval

Acute recovery post-MI

Xerostomia (84%)

Headache (50-55%)

Constipation (47%)

Ejaculation failure (42%)

Fatigue (35-40%)

Nausea (30-35%)

Impotence (20-25%)

Weight gain (18%)

Weight loss (5%)

Hepatotoxicity (1-3%)

Dyspepsia

Blurred vision

Urinary retention

Orgasm incapacity, libido change

BPH, urinary/GI retention, hyperthyroidism, seizure disorder, brain tumor, respiratory impairment

Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

Clinical worsening and suicide ideation may occur despite medication in adolescents and young adults (18-24 yr)

Potentially life-threatening serotonin syndrome reported when coadministered with drugs that impair serotonin metabolism (in particular, MAOIs, including nonpsychiatric MAOIs, such as linezolid and IV methylene blue)

Risk of anticholinergic side-effects

Rare cases of drug rash with eosinophilia and systemic symptoms (DRESS) reported with use; in event of severe acute reactions such as DRESS, discontinue clomipramine therapy immediately and institute appropriate treatment

Pregnancy Category: C

Lactation: distributed in breast milk, do not nurse (AAP states effect on nursing infants is unknown but may be of concern)