Clomipramine hydrochloride belongs to a group of medicines called "tricyclic antidepressants". This is thought to work either by increasing the amount of chemical "messengers" in the brain or by making their effects last longer. Clomipramine is a potent inhibitor of serotonin re-uptake in the brain. Significant antagonism at cholinergic and α1-receptors. Weak antagonism at dopamine receptors. It has also antidepressant, sedative and anticholinergic effects.

Clomipramine Hydrochloride is used to treat depression, obsessions and phobias (irrational fears). It is also used to treat muscular weakness (cataplexy) associated with repeat attacks of extreme sleepiness (narcolepsy) in adults.

The usual dosages for adults are as follows:

• For depression: 10 mg to 150 mg daily. Severe cases may need even higher doses.
• For obsessions and phobias: 10 mg to 150 mg daily.
• For cataplexy: 10 mg to 75 mg daily.

The elderly: Elderly patients often need a lower dose because they are more likely to experience side effects.

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.

• Known hypersensitivity to clomipramine and any of the excipients in the tablets.
• Cross-hypersensitivity to tricyclic antidepressants of the dibenzazepine group.
• Concomitant use with a monoamine oxidase (MAO) inhibitor, or within 14 days before or after treatment with an irreversible MAO inhibitor, or within 14 days before moclobemide, a reversible MAO inhibitor.
• Acute and recovery stages of myocardial infarction.
• Congenital long QT syndrome.

Very common side effects are increase in appetite and weight gain, headaches, dizziness, nausea, constipation, dry mouth, increased sweating, shaking hands, tremor, difficulty in passing urine, problems with their eyes, feeling tired or sleepy, sexual disturbances, restlessness.

Check with your doctor or pharmacist before taking your medicine if:

• you have epilepsy (fits)
• you have an overactive thyroid gland
• you have a tumour (cancer) of the adrenal gland (such as phaeochromocytoma or neuroblastoma)
• you have low blood pressure
• you wear contact lenses
• you have had severe constipation for a long time
• you find yourself thinking about suicide
• you have had a head injury and suffered brain damage
• you are going to have ECT (electroconvulsive therapy)
• you have an irregular heart beat or other problems with your heart
• you have been diagnosed as having a low level of potassium in your blood (hypokalemia)
• you have schizophrenia or any other mental disorder
• you are elderly
• you have glaucoma(increased pressure in the eye)
• you have liver or kidney disease
• you have any blood disorder
• you have difficulties in passing urine (e.g. due to diseases of the prostate)

Use in Special Populations

Older people: Elderly patients generally need lower doses than young and middle-aged patients. Side effects are more likely to occur in older patients.

Use in Children and Adolescents (<18 years): The safety and efficacy of clomipramine for the treatment of depression or other psychiatric disorders in children and adolescents aged less than 18 years has not been satisfactorily established. Clomipramine should not be used in this age group for the treatment of depression or other psychiatric disorders

Pregnancy & Lactation

Pregnancy category C. As clomipramine passes into human milk, babies should be weaned or clomipramine gradually withdrawn.