Clomipramine
It is a mood elevator but not euphorient which haa potent antidepressant effect. Tolerence to the antichlolinergic and hypotensive effects of the drug develops gradually, though antidepressant action is sustained. There are some evidence of physical dependence occuring when high doses have been used for long periods-malaise, chills, muscle pain may occur on discontinuation and have been considered withdrawal phenomena. Cardiovascular effects are prominent, occur at therapeutic concentrations & may be dangerous in overdose.Edogenous depression. Obsessive compulsive neurosis and phobic states.
Obsessional & phobic states : 25 mg increasing gradually to 100-150 mg daily. Depression: 10 mg increasing gradually to 30-150 mg daily in div. doses or as a single dose at night. Max. 250 mg daily. Elderly : Initially 10 mg daily; Max 75 mg daily. Not recommended for children.
Epilepsy, cardiovascular disease, narrow angle glaucoma, MAOIS, urinary retention, Ischaemic heart disease.
Myocardial infraction. Hyperthyroidism. Elderly patients. Concurrent admn. of C.N.S. depressants, alchol, antihypertensives. Paediatrics: Not recommended. Pregnancy: Safety not established. Lactation: The drug passes in to breast milk and may affect the baby. Elderly: Reduced dose necessary.
Postural hypotension, jaundice, rashes, tremors, convulsions, sedation, drowsiness, altered alertness, constipation, dry mouth. Cardiac arrhythmias.
Strokes, Hyperpyrexia, convulsions & death can occur if taken concurrently with MAOIs. In combination with adrenaline & Noradrenaline it causes hypertension & arrhythmias. Barbiturates increase metabolism.Conversely cimetidine, gaunethidine, haloperidol & phenothiazines block the metabolism.
