Clomipramine (Anafranil)

Pharmacokinetics of Clomipramine

Clomipramine: Cytochrome P450 Metabolism

Substrate of (Metabolized by)
  • Clomipramine is a potent inhibitor of serotonin reuptake, but its desmethyl metabolite inhibits norepinephrine (NE) reuptake.
  • Clomipramine can be fatal in overdose.

Dosing for Clomipramine

Maximum Doses are typically < 250mg
  • Clomipramine comes in oral (PO) and intravenous (IV) formulations
  • Clomipramine may have a more problematic side effect profile due to its antiadrenergic, anticholinergic, and antihistaminergic-related side effects
  • Common side effects include sedation, constipation, weight gain, postural hypotension, and anticholinergic side effects such as dry mouth, blurry vision, and urinary retention).
  • Clomipramine is the most serotonergic of the tricyclic antidepressants.