About clomipramine

This belongs to the group of medicines known as tricyclic antidepressants.

Clomipramine is used to treat depression, especially when the patient is experiencing difficulty sleeping.

When depression occurs, there may be a decrease in the amount of the chemicals noradrenaline and serotonin released from nerve cells in the brain. The release of these chemicals results in a mood lifting effect. Clomipramine works by stopping these chemicals from going back into the nerve cells.

Clomipramine can also be used to treat phobias (fears) and obsessions, and cataplexy, which is collapsing associated with narcolepsy (extreme sleepiness).

Clomipramine is available in capsule (10mg, 25mg, 50mg), liquid (25mg/5ml) and injection (25mg/2ml) form. It is also available as a modified release preparation, strength 75mg, which means clomipramine is released slowly over the day to give a better effect.

It is also sometimes known as: Anafranil; Anafranil SR. You may notice the use of any of these names on the packaging of your medicine.

Before taking clomipramine

Before taking clomipramine make sure your doctor or pharmacist knows:

• if you are pregnant, trying for a baby or breast-feeding
• if you suffer from liver or thyroid problems
• if you wear contact lenses
• if you have suffered from constipation for a long time
• if you have had a recent heart attack, suffer from hypotension (low blood pressure) or any other heart problems
• if you have low levels of potassium in your blood
• if you suffer from epilepsy, phaeochromocytoma (a growth on the adrenal glands), glaucoma (increased pressure in the eye), if you are experiencing or have ever experienced difficulty urinating (passing water), psychoses (mental problems), or porphyria (a blood disorder)
• if you are prone to dizziness or fainting, particularly when getting up from a lying or sitting position
• if you have ever had an allergic reaction to this or any other tricyclic antidepressants
• if you are taking any other medicines, including those available to buy without a prescription, herbal or complementary medicines

How to take clomipramine

• Always read the manufacturer’s information leaflet, before beginning treatment.
• Take clomipramine exactly as directed by your doctor.
• It may take several weeks before you begin to feel the benefits of this treatment.
• Do not stop taking clomipramine without speaking to your doctor first. Stopping treatment suddenly can cause problems and your doctor will probably want to reduce your dose gradually.
• Take clomipramine at the same times each day to avoid missing any doses. If you do forget to take a dose, take it as soon as you remember and take the next dose at the usual time. If it is almost time for your next dose, leave out the missed dose and continue taking it at the normal times.
• Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of clomipramine contact your doctor or go to the accident and emergency department of your local hospital at once. Always take the container with you, even if it is empty.
• Clomipramine is for you. Never give it to others even if their condition appears to be the same as yours.

Getting the most from your treatment

• Before taking any ‘over-the-counter’ medicines, check with your pharmacist which medicines are safe to take alongside clomipramine.
• Clomipramine can cause drowsiness and blurred vision. Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you were not fully alert or able to see properly.
• Try to avoid alcohol as it will increase feelings of drowsiness. If you do drink alcohol, drink only in moderation and be aware of its effects on you.
• Clomipramine can occasionally cause a dry mouth. If you experience this try chewing sugar-free gum, sucking ice or sugar-free sweets. If a dry mouth becomes too troublesome, discuss the problem with your doctor or pharmacist.
• Clomipramine may cause some people to sweat more than they usually do. If you experience this, take care not to become overheated during exercise or hot weather.
• Clomipramine can cause some people to become more sensitive to sunlight than they usually are. Avoid strong sunlight and sunbeds and use a suncream higher than factor 15 until you know how your skin reacts.

Can clomipramine cause problems?

Along with their needed effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome:

very common: drowsiness, dry mouth, blurred vision, constipation, difficulty urinating (passing water), sweating, feeling sick, shakiness, skin rashes, feeling restless, increased appetite, headache, dizziness, tiredness

common: hot flushes, pupil dilation (widening), confusion, agitation, yawning, muscle weakness, being sick, diarrhoea, skin rashes, itching, enlargement of the breasts or discharge from the nipples, taste disturbances, ringing in the ears

uncommon: fast or fluttering heartbeat, fits.

Important: If you experience the following symptoms contact your doctor or go to the accident and emergency department of your local hospital at once:- Fever (high temperature), loss of consciousness, stiffness of the muscles, paleness of the skin, a fast heartbeat, incontinence (passing water without control from the patient), jaundice (yellowing of the skin and whites of the eyes).

If you experience any other worrying or troublesome side effects, which you think may be due to this medicine, discuss them with your pharmacist.

How to store clomipramine

• Keep all medicines out of the reach of children.
• Store in a cool, dry place, away from direct light and heat.
• Never keep out of date or unwanted medicines. Discard them safely, out of the reach of children, or take them to your local pharmacist who will dispose of unwanted medicines for you.