Clomipramine: Price, Dosage & Where to Buy

Clomipramine is a tricyclic antidepressant used to treat obsessive-compulsive disorder (OCD), particularly persistent unwanted thoughts and repetitive behaviours that cause distress or interfere with daily life. It is available as oral capsules and requires a prescription in the United Kingdom, with treatment reviewed by the prescriber to assess its ongoing benefit and the need for continued use.

Clomipramine is used to treat obsessions and compulsions in people with obsessive-compulsive disorder (OCD). Obsessions are recurring, persistent thoughts, images, ideas or urges that feel unwanted. Compulsions are repeated actions performed in response to an obsession or according to a fixed pattern, even when the person recognises them as excessive or unreasonable.

The symptoms described in the label cause marked distress, occupy substantial time, or significantly interfere with social life or work. Clinical studies included adults, children and adolescents with moderate-to-severe OCD. Continued treatment needs periodic review to assess whether it remains useful.

The label lists oral capsules containing 25 mg, 50 mg and 75 mg. The usual starting dose is 25 mg daily for adults, children and adolescents. The label lists gradual increases for adults to approximately 100 mg during the first 2 weeks, followed by further gradual increases to a maximum of 250 mg daily.

The label lists initial divided doses with meals to reduce stomach and bowel side effects. The label lists a daily maximum for children and adolescents during initial increases of 3 mg/kg or 100 mg, whichever is smaller. The label lists a later daily maximum for children and adolescents of 3 mg/kg or 200 mg, whichever is smaller.

The label lists the option of the total daily dose once daily at bedtime after gradual dose increases, to reduce daytime sleepiness. Ongoing treatment is periodically reassessed by the prescriber, with adjustments aimed at maintaining the lowest effective dosage.

Tricyclic antidepressants affect chemical messengers that nerve cells use to communicate in the brain. They reduce the reabsorption of messengers such as serotonin and noradrenaline after these have been released, allowing their effects to last longer between nerve cells. These changes can influence brain pathways involved in thoughts, emotions and behaviour.

Medicines in this class also affect other chemical signalling systems, which helps explain effects such as dry mouth, constipation and sleepiness. Their action is not limited to a single symptom or pathway.

There are no adequate, well-controlled studies in pregnant women. The label states that use during pregnancy should be considered only when the potential benefit justifies the potential risk to the baby.

Withdrawal symptoms, including jitteriness, tremor and seizures, have been reported in newborn babies whose mothers used clomipramine until delivery. The label does not specify breastfeeding guidance; discuss this with a doctor or pharmacist.

A missed dose can interrupt the prescribed treatment routine. Follow the missed-dose advice in the medicine leaflet or ask a pharmacist if unsure.

Avoid doubling a dose to make up for a missed one. If doses are repeatedly missed, discuss this with the prescriber rather than changing the treatment schedule independently.

The label specifies storage at 20º to 25ºC in a well-closed, light-resistant container with a child-resistant closure. Keep the capsules out of the sight and reach of children to maintain safe storage.