Clomipramine is a tricyclic antidepressant often used for obsessive‑compulsive disorder (OCD) and some types of depression and panic. If SSRIs didn’t help or caused bad side effects, clomipramine can be a strong option. It’s prescription-only and can work well, but it comes with specific risks and interactions you should know about.
Doctors most commonly prescribe clomipramine for OCD. It changes brain chemicals to reduce compulsions and intrusive thoughts. You won’t feel better overnight — expect at least 2–4 weeks for signs of improvement and up to 8–12 weeks for full benefit.
Typical adult dosing starts low to cut side effects (for example, 25 mg once daily) and is slowly raised. For OCD, many people end up between 100–250 mg per day split into two or three doses. For depression smaller ranges like 75–150 mg are common. Children and older adults need lower doses and closer monitoring.
Always follow your prescriber’s plan. Don’t mix clomipramine with MAO inhibitors or other drugs that raise serotonin without clear medical direction — combining them can trigger life-threatening serotonin syndrome.
Common side effects are dry mouth, drowsiness, constipation, blurred vision, sweating, and weight gain. Because clomipramine can slow electrical signals in the heart, it may cause fast or irregular heartbeat and low blood pressure when standing. Serious effects—like seizures, severe heart rhythm problems, or severe urinary retention—are less common but possible.
Important warnings: younger people (under 25) may have an increased risk of suicidal thoughts when starting antidepressants — check in with your doctor or family if mood or behavior changes. Don’t stop clomipramine suddenly; tapering down with your doctor lowers withdrawal and relapse risk.
Watch for interactions: combining clomipramine with SSRIs, SNRIs, triptans, linezolid, or methylene blue raises serotonin risk. Other meds that prolong QT interval or lower seizure threshold need caution. Tell your prescriber about heart disease, glaucoma, prostate problems, or any seizure history.
Practical tips that help: take the larger dose at night if clomipramine makes you sleepy; avoid alcohol because it increases sedation; ask your doctor about an ECG if you’re older or on other heart drugs; report sexual side effects or big weight changes — these can often be managed. If you miss a dose, take it as soon as you remember unless it’s near the next dose — then skip the missed one and continue. In overdose, this drug can be dangerous — seek emergency care immediately.
Clomipramine can be very effective for the right person, but it needs close follow-up. If you have questions about side effects, dosing, or interactions, bring them up with your prescriber or pharmacist — they can tailor advice to your situation.
