Keep your regular appointments with your doctor. This is so your doctor can check on your progress.
This medicine may make you feel sleepy. If this happens, do not drive or use tools or machines. Do not drink alcohol.
Tell your doctor if you experience any troublesome side-effects.
|Type of medicine||A tricyclic antidepressant|
|Used for||Treatment of depression, obsessions and phobias; cataplexy associated with narcolepsy|
|Available as||Capsules and modified-release tablets|
Clomipramine belongs to a group of medicines called tricyclic antidepressants. It helps ease the symptoms of a number of different conditions.
Depression: the exact cause of depression is not known. It can develop for no apparent reason or it may be triggered by a life event such as a relationship problem, bereavement, or illness. With depression you have a consistently low mood and other symptoms severe enough to interfere with your normal day-to-day activities.
Phobias and obsessions: a phobia is strong fear or dread of a thing or an event, which is out of proportion to the reality of the situation. Obsessions are unpleasant thoughts, images, or urges that keep coming into your mind. Both of these can cause feelings of distress and can prevent you from getting on with normal activities.
Cataplexy associated with narcolepsy: narcolepsy is a long-term problem which affects sleep. It is often associated with a condition called cataplexy. Cataplexy is the word used to describe a sudden loss of muscle control, often triggered by an emotion such as anger or excitement. This can cause you to drop things or to stumble.
Clomipramine can help ease the symptoms in each of these conditions. It is thought to work by interfering with brain chemicals (such as serotonin) which may be involved in causing the symptoms.
Before taking clomipramine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking clomipramine it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have an overactive thyroid gland.
- If you have any problems with the way your liver works.
- If you have epilepsy or sugar diabetes.
- If you have had problems with constipation over a long time.
- If you have any difficulties passing urine, or if you have had prostate trouble.
- If you have a heart disorder or blood vessel disease.
- If you have had a mental health problem (in particular, bipolar disorder or psychosis).
- If you have glaucoma (increased pressure in your eyes).
- If you have been told you have phaeochromocytoma (a tumour on your adrenal gland).
- If you have porphyria (this is a rare inherited blood disorder).
- If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines. This is especially important if you have recently taken a medicine for depression, known as a monoamine-oxidase inhibitor (MAOI).
- If you have ever had an allergic reaction to a medicine.
How to take clomipramine
- Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about clomipramine and will provide you with a full list of the side-effects which you may experience from taking it.
- Clomipramine can make you feel sleepy so your doctor may advise you to take a small dose when you first start taking it, and then to increase your dose gradually as your body gets used to it.
- It is usual to take clomipramine once a day at bedtime, although it can also be taken in smaller doses two or three times a day. The directions for taking the capsules/tablets will be printed on the label of the pack to remind you what the doctor said to you. If you have any questions about what dose to take, ask your pharmacist for advice.
- Many people find if helps to swallow the capsules/tablets with a drink of water. You can take clomipramine before or after meals.
- If you forget to take a dose, take it as soon as you remember unless your next dose is due. If it is nearly time for your next dose then take the next dose when it is due but leave out the forgotten dose. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- If you are taking clomipramine for depression, you may feel that it is not working for you straightaway. It can take a week or two for the effect to build up, and 4-6 weeks before you feel the full benefit. It is important that you do not stop taking it thinking it is not helping. Also, while you feel depressed, you may have distressing thoughts, and think about harming yourself or ending your life. If this happens, it is very important that you tell your doctor about this straightaway. There are several types of antidepressants - each type works in a slightly different way and can have different side-effects. If you find that clomipramine does not suit you, then let your doctor know, as another antidepressant may be found that does.
- If you drink alcohol, ask your doctor for advice. Your doctor is likely to recommend that you do not drink alcohol while you are on clomipramine, as it increases the risk of side-effects, such as feeling sleepy.
- Some people who take clomipramine find that their skin becomes more sensitive to sunlight than usual. Do not use sunbeds and try to avoid strong sunlight until you know how your skin reacts. Use a sun cream with a high sun protection factor.
- Your doctor may ask you to carry on taking clomipramine even after you feel better. This is to help stop your symptoms from returning.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because a number of medicines can increase the risk of side-effects from clomipramine, including some painkillers, flu remedies and antihistamines which can be bought from pharmacies.
- If you have diabetes you may need to check your blood glucose more frequently. This is because clomipramine can alter the levels of sugar in your blood. Your doctor will advise you about this.
- If you are due to have any medical treatment, tell the person carrying out the treatment that you are taking this medicine, as it can interfere with some anaesthetics.
- Continue to take clomipramine unless your doctor tells you otherwise. Stopping treatment suddenly can sometimes cause problems and your doctor may want you to reduce your dose gradually if this becomes necessary.
Can clomipramine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with clomipramine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common clomipramine side-effects||What can I do if I experience this?|
|Dry mouth||Try chewing sugar-free gum or sugar-free sweets|
|Constipation||Try to eat a well-balanced diet containing plenty of fibre and drink plenty of water each day|
|Blurred vision, feeling sleepy, dizzy or tired||If this happens, do not drive or use tools or machines. Do not drink alcohol|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Feeling faint or light-headed, especially when getting up from a sitting or lying position||Getting up more slowly may help. If you begin to feel faint, sit down until the feeling passes|
|Feeling or being sick, diarrhoea||Stick to simple meals - avoid rich or spicy foods. If you are sick or have diarrhoea, drink plenty of water to replace lost fluids|
|Changes to blood test results and ECG changes||If necessary, your doctor will monitor for these|
|Sweating, hot flushes, difficulty in passing urine, increased appetite, feeling confused, feeling anxious or restless, disturbed sleep, lack of concentration, feeling shaky, muscle weakness, itchy skin rash, weight changes, changes in sexual function, breast tenderness, changes in taste, ringing in ears, yawning||If any of these become troublesome, speak with your doctor for advice|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist for further advice.
How to store clomipramine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Anafranil® 10 mg, 25 mg and 50 mg Capsules and 75 mg sustained release Tablets; Novartis Pharmaceuticals UK Ltd, The electronic Medicines Compendium. Dated August 2013.
- British National Formulary; 67th Edition (March 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall