Clomipramine - instructions for use, doses, side effects, contraindications

Antidepressant from the group of tricyclic compounds. Has psychostimulant, antidepressant and sedative effect. The effect of the drug is associated with the stimulation of serotonergic and adrenergic structures of the brain. It blocks predominantly reverse neuronal seizure of serotonin. Has anticholinergic, adrenoblocking and antihistamine action.

Pharmacokinetics:

After oral administration, up to 100% is absorbed in the gastrointestinal tract. The maximum concentration in the blood plasma is achieved after 1.5-4 hours. The connection with plasma proteins is 97.6%. Penetrates through the blood-brain and placental barrier, enters the breast milk.

Metabolism in the liver with the formation of an active metabolite of desmethylclomipramine.

The half-life is 21 hours. Elimination of the kidneys in the unchanged form and form of metabolites. With feces - in the form of metabolites.

Indications:

It is used to treat reactive, endogenous and organic depression, with involutional and latent forms of depression, depressive states in schizophrenia and psychopathies, depressive syndrome in the elderly, obsessive-compulsive syndrome, phobias and panic conditions, enuresis in patients over 5 years.

ICD-10

V.F20-F29.F20 Schizophrenia

V.F20-F29.F21 Chrysotile disorder

V.F20-F29 Schizophrenia, schizotypic and delusional disorders

V.F20-F29.F22 Chronic delusional disorders

V.F20-F29.F25.1 Schizoaffective disorder, depressive type

V.F20-F29.F25 Schizoaffective disorder

V.F20-F29.F29 Inorganic psychosis, unspecified

V.F30-F39.F31 Bipolar affective disorder

V.F30-F39.F32 Depressive episode

V.F30-F39.F33 Recurrent depressive disorder

V.F40-F48.F40.8 Other phobic anxiety disorders

V.F40-F48.F40 Phobic anxiety disorders

V.F40-F48.F41.2 Mixed anxiety and depressive disorder

V.F40-F48.F42 Obsessive-compulsive disorder

Contraindications:

Simultaneous administration of MAO inhibitors, individual intolerance, children under 5 years of age.

Carefully:

Spasmophilia, epilepsy, conduction disturbances and excitability of the myocardium, circulatory insufficiency, prostate disease, urinary disorders, glaucoma.

Pregnancy and lactation:

Recommendations for FDA - Category C. Contraindicated in pregnancy and lactation.

Dosing and Administration:

Use in children

Inside:

5-7 years - 25 mg per day;

8-14 years old - 25-50 mg each per day;

Older than 14 years - in the same doses as in adults.

Adults

Inside for 25 mg 2-3 times per day with a further increase in the dose for 1 week to 100-150 mg per day.

The highest daily dose: 150 mg.

The highest single dose: 50 mg.

Side effects:

Central and peripheral nervous system: nightmares, confusion, hallucinations, headache, "a sensation of a lump in the throat", tremor, syncope.

Respiratory system: dyspnea.

The cardiovascular system: tachycardia, stenocardia.

The system of hematopoiesis: leukopenia, thrombocytopenia, agranulocytosis, thrombocytopenic purpura, eosinophilia.

Digestive system: anorexia, dry mouth, constipation, flatulence.

Musculoskeletal system: myalgia, back pain.

Dermatological reactions: rarely - photosensitivity.

Sense organs: noise in ears.

Allergic reactions.

Overdose:

Increased side effects.

Treatment is symptomatic, with severe anticholinergic symptoms - the introduction of cholinesterase inhibitors.

Interaction:

Tricyclic antidepressants can not be administered together with non-selective MAO inhibitors. The interval between taking these drugs should be at least 2 weeks.

Special instructions:

During treatment, patients are forbidden to drink alcohol and drive vehicles and work with moving mechanisms.

Instructions

Clomipramine (Clomipraminum)