Tricyclic antidepressant
Clomipramine hydrochloride
Brand names: Anafranil
Adult dose
Dose: OCD/depression: initial 25mg OD, increase gradually to 100–250mg/day
Route: PO
Frequency: OD-divided
Clinical pearls
- First-line TCA for OCD
- ECG before high-dose / cardiac risk
Contraindications
- Recent MI
- Arrhythmia
- Mania
- Severe hepatic impairment
- Concurrent MAOI
Side effects
- Anticholinergic effects
- Sedation
- Weight gain
- Cardiac conduction delay
- Lowered seizure threshold
- Sexual dysfunction
Interactions
- MAOIs (avoid; serotonin syndrome)
- SSRIs (raised TCA levels)
- QT-prolonging drugs
- CYP2D6 inhibitors
Monitoring
- BP
- ECG if cardiac risk
Reference: BNF; NICE CG31; https://bnf.nice.org.uk/drugs/clomipramine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Drugs
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF