Category: Clomipramin

While taking antidepressants you might ignore the possible side effects of the medication, which can land you in trouble at times. Knowing about these side effects can help you contact emergency medical help in advance. Let us know about the major side effects of clomipramine that can lead to complications.

Common side effects of clomipramine

• fatigue
• tremor
• constipation
• urination disorder
• weight gain
• dyspepsia
• ejaculatory disorder
• nausea
• nervousness
• visual disturbance
• myoclonus
• paresthesia
• anorexia
• xerostomia
• drowsiness
• headache
• dizziness
• insomnia
• diaphoresis

Other side effects are

• hot flash
• skin rash
• taste disorder
• anxiety
• sleep disorder
• muscle twitching
• hypertonia
• memory impairment
• non-puerperal lactation
• fever
• vomiting
• orthostatic  hypotension
• tachycardia
• tinnitus

Major side effects

You should call medical help immediately in case you experience any of the below mentioned side effects

• body pain or aches
• bladder pain
• blurred vision
• cloudy or bloody urine
• confusion
• crawling, itching, crawling, numbness, tingling or prickling feelings
• nervousness or fear
• fever
• feeling empty or sad
• irritability
• hearing changes
• side pain or lower pain
• poor concentration
• sneezing
• poor concentration
• voice changes
• chest wheezing or tightness
• unusual weakness or tiredness
• faintness, light-headedness or dizziness when rising suddenly from a sitting or lying position

Less common

• chills
• breast enlargement
• Anger that is difficult to control
• speech problems
• burning sensation while urinating
• hyperventilation
• vomiting or nausea
• paranoia
• painful sexual intercourse
• Throbbing and severe headache
• shaking
• restlessness
• Swelling of lower legs, feet, fingers or face
• change in moods
• dry mouth
• racing, fast, irregular, pounding pulse or heart beat

Minor side effects

Some minor side effects of clomipramine do not need medical help. As the body gets used to the treatment, these side effects disappear with time.  Your health care provider can help you know how to reduce or prevent these minor side effects. In case these side effects continue to exist for a longer period, contact your health care provider immediately.

More Common

• constipation
• dry skin
• sour or acid stomach
• heartburn
• welts, skin rash or hives
• joint pain
• swelling
• pimples
• scaly, dry or cracked skin
• shaking or trembling of  feet or hands
• redness of arms, neck, face or upper chest
• diarrhea

Less common

1. irregular, absent or missed menstrual period
2. sores, white spots, ulcers on tongue, lips or inside mouth
3. breast pain

The side effects can range from mild to severe and any side effect that lasts long or is bothersome, need immediate medical attention. Do not ignore these side effects as they can be fatal too. Seek emergency help to treat these side effects. Your doctor can help you reduce the side effects.

Certain medicines are not safe for use during breastfeeding or pregnancy. However some other medicines can be used safely in breastfeeding or pregnancy provided the benefits are higher than the risks to the unborn baby. Always discuss with your doctor if you are planning to conceive or if pregnant, before you use any medication.

Clomipramine and pregnancy

There are certain situations where it is not safe to use clomipramine and pregnancy is the one.  Although clomipramine doesn’t lead to birth defects in animal studies, but it was linked to defects in heart in humans.  Also it is linked to various withdrawal symptoms like blue skin, seizures and muscle weakness in babies born to woman who used clomipramine during third trimester of their pregnancy.

For pregnant women, clomipramine is not safe for use. Clomipramine hydrochloride is not safe. This is reported based on human and animal studies and looking at the effects of clomipramine in pregnancy.

Withdrawal symptoms in babies were been reported in cases wherein mothers used clomipramine during third trimester of pregnancy. The symptoms seen in new born are

• blue skin
• shakiness
• jitteriness
• muscle weakness or muscle tension
• seizures

Clomipramine and breastfeeding

If you are using clomipramine while breastfeeding, it is very important to be aware of the fact that this medication is secreted into breast milk. Generally, doctors often say that it is fine to breastfeed your baby while using the medication as in some cases the benefits of breastfeeding are higher than risks. However, complete data regarding the risks to the child is still unknown because there are no studies available that explain the benefits and risks of using clomipramine while breastfeeding.

As clomipramine transfers in breast milk and looking at the side effects of the medication, manufacturers often warn to calculate the risks of the medication to the baby before clomipramine is used by breastfeeding mothers.  So, check with your paediatrician or physician to know if you can use clomipramine while breastfeeding.

Depending upon your current health condition, your physician can help you take the right decision. Each and every situation is different, so let your doctor judge what is right for you. Many women undergo depression during this stage and seek immediate medication to overcome the unbearable symptoms of depression, but taking any hasty decision without discussing with your doctor can ham your baby.

Make sure you inform your doctor if you are pregnant or planning to conceive and using clomipramine already.  Use of clomipramine during pregnancy can affect how your pregnancy progresses. You can always check with your doctor if he can suggest you any alternative medication to manage depression. Try not to take clomipramine during pregnancy or breastfeeding as antidepressants can harm your baby as they are linked to many side effects too.

It is better to be on the safer side and avoid antidepressants during pregnancy/breastfeeding to avoid severe withdrawal symptoms in your baby or complications in pregnancy. Try to treat depression using safe and non narcotic drugs.

During the starting phase of titration, Clomipramine should be prescribed in split doses with food to lessen gastrointestinal side effects. The main objective of starting phase of titration is to reduce side effects by allowing tolerance to different side effects to build patient time, in case tolerance is not built.

Initial Treatment or Dose adjustment in Adults

Treatment using Clomipramine should be started with an initial dose of 25mg/daily, which can be gradually increased based on patient’s tolerance to 100mg during the period of first two weeks. While starting with titration, Clomipramine should be prescribed in split doses with food to lessen gastrointestinal side effects. Later the dosage can be increased gradually in coming several weeks up to maximum -250mg/daily. After titration the complete daily dose can be given once in a day at bedtime to reduce daytime sedation.

Initial Treatment or Dose adjustment in Adolescents and Children

As in adults, the initial dose of 25mg/daily should be prescribed, which can be gradually increased (also given in split doses with food to lessen gastrointestinal side effects.) in first two weeks, based on patient’s tolerance up to maximum dosage of 3mg/kg or 100mg. Later the dosage can be increased gradually in coming several weeks up to maximum -200mg/daily. After titration the complete daily dose can be given once in a day at bedtime to reduce daytime sedation.

Continuation/Maintenance Treatment in Children, Adults and Adolescents

Well, there are no standard studies available that can answer the question as how long you can continue to take Clomipramine, OCD is basically a chronic condition and it is sensible to observe continuation for a patient who responds well to the treatment. Although the ability of Clomipramine after ten weeks is not yet documented in controlled trials, patients have been given the therapy on a continual basis under trial period for up to one year. However, the dosage adjustments are made to maintain lowest effective dose for the patient. The patient should also be examined on a regular basis to check if they still need treatment. During maintenance the daily dose should be given once in a day during bedtime.

Clomipramine – Over dosage and treatment

Over dosage of Clomipramine can even lead to death in many cases. Over dosage can take place either with use of Clomipramine in combination with other drugs or alone with Clomipramine. Symptoms and signs of over dosage entirely depends on the severity and other factors for example the quantity of drug absorbed, time gap of drug ingestion and age of the patient. An ECG and cardiac monitoring should be initiated immediately. The patient must be kept under medical supervision for at least 6 hours with cardiac monitoring and for signs of hypotension, respiratory or CNS depression, seizures, cardiac dysrhythmias or conduction blocks.

All patients suspected of Clomipramine over dosage should get gastrointestinal decontamination treatment. This includes gastric lavage accompanied by activated charcoal. If consciousness is disabled, the airway should be obtained before lavage.

In case Clomipramine over dosage make sure you call medical help immediately.