Clomipramine

About clomipramine

Clomipramine belongs to a group of medicines called tricyclic antidepressants. It helps ease the symptoms of a number of different conditions.

Depression: the exact cause of depression is not known. It can develop for no apparent reason or it may be triggered by a life event such as a relationship problem, bereavement, or illness. With depression you have a consistently low mood and other symptoms severe enough to interfere with your normal day-to-day activities.

Phobias and obsessions: a phobia is strong fear or dread of a thing or an event, which is out of proportion to the reality of the situation. Obsessions are unpleasant thoughts, images, or urges that keep coming into your mind. Both of these can cause feelings of distress and can prevent you from getting on with normal activities.

Cataplexy associated with narcolepsy: narcolepsy is a long-term problem which affects sleep. It is often associated with a condition called cataplexy. Cataplexy is the word used to describe a sudden loss of muscle control, often triggered by an emotion such as anger or excitement. This can cause you to drop things or to stumble.

Clomipramine can help ease the symptoms in each of these conditions. It is thought to work by interfering with brain chemicals (such as serotonin) which may be involved in causing the symptoms.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking clomipramine it is important that your doctor knows:

• If you are pregnant or breastfeeding.

• If you have an overactive thyroid gland.

• If you have any problems with the way your liver works.

• If you have epilepsy or diabetes (diabetes mellitus).

• If you have had problems with constipation over a long time.

• If you have any difficulties passing urine, or if you have had prostate trouble.

• If you have a heart disorder or blood vessel disease.

• If you have had a mental health problem (in particular, bipolar disorder or psychosis).

• If you have increased pressure in your eyes (glaucoma).

• If you have been told you have phaeochromocytoma, a tumour on your adrenal gland.

• If you have porphyria, a rare inherited blood disorder.

• If you are taking other medicines, including those available to buy without a prescription, as well as herbal and complementary medicines. This is especially important if you have recently taken a medicine for depression, known as a monoamine-oxidase inhibitor (MAOI).

• If you have ever had an allergic reaction to a medicine.
  

• Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about clomipramine and will provide you with a full list of the side-effects which you may experience from taking it.

• Clomipramine can make you feel sleepy so your doctor may advise you to take a small dose when you first start taking it, and then to increase your dose gradually as your body gets used to it.

• It is usual to take clomipramine once a day at bedtime, although it can also be taken in smaller doses two or three times a day. The directions for taking the capsules will be printed on the label of the pack to remind you what the doctor said to you. If you have any questions about what dose to take, ask your pharmacist for advice.

• Many people find if helps to swallow the capsules with a drink of water. You can take clomipramine before or after meals.

• If you forget to take a dose, take it as soon as you remember, unless your next dose is due. If it is nearly time for your next dose then take the next dose when it is due but leave out the forgotten dose. Do not take two doses together to make up for a missed dose.

• Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.

• If you are taking clomipramine for depression, you may feel that it is not working for you straightaway. It can take a week or two for the effect to build up, and 4-6 weeks before you feel the full benefit. It is important that you do not stop taking it thinking it is not helping. Also, while you feel depressed, you may have distressing thoughts, and think about harming yourself or ending your life. If this happens, it is very important that you tell your doctor about this straightaway. There are several types of antidepressants - each type works in a slightly different way and can have different side-effects. If you find that clomipramine does not suit you then let your doctor know, as another antidepressant may be found that does.

• If you drink alcohol, ask your doctor for advice. Your doctor is likely to recommend that you do not drink alcohol while you are on clomipramine, as it increases the risk of side-effects, such as feeling sleepy.

• Some people who take clomipramine find that their skin becomes more sensitive to sunlight than usual. Do not use sunbeds and try to avoid strong sunlight until you know how your skin reacts. Use a sun cream with a high sun protection factor.

• Your doctor may ask you to carry on taking clomipramine even after you feel better. This is to help stop your symptoms from returning.

• If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because a number of medicines can increase the risk of side-effects from clomipramine, including some painkillers, flu remedies and antihistamines which can be bought from pharmacies.

• If you have diabetes you may need to check your blood glucose more frequently. This is because clomipramine can alter the levels of sugar in your blood. Your doctor will advise you about this.

• If you are due to have any medical treatment, tell the person carrying out the treatment that you are taking this medicine, as it can interfere with some anaesthetics.

• Continue to take clomipramine unless your doctor tells you otherwise. Stopping treatment suddenly can sometimes cause problems and your doctor may want you to reduce your dose gradually if this becomes necessary.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with clomipramine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist for further advice.

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.