A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as clomipramine during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take clomipramine, but in some cases, a doctor may decide that clomipramine is the best medication to treat a child's condition.
You should know that your mental health may change in unexpected ways when you take clomipramine or other antidepressants even if you are an adult over age 24. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.
Your healthcare provider will want to see you often while you are taking clomipramine, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.
The doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with clomipramine. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from the FDA website: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273.
No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.
Clomipramine is used to treat people with obsessive-compulsive disorder (a condition that causes repeated unwanted thoughts and the need to perform certain behaviors over and over). Clomipramine is in a group of medications called tricyclic antidepressants. It works by increasing the amount of serotonin, a natural substance in the brain that is needed to maintain mental balance.
Clomipramine comes as a capsule to take by mouth. At the beginning of treatment, clomipramine is usually taken three times a day with meals as the body adjusts to the medication. After several weeks of treatment, clomipramine is usually taken once a day at bedtime. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take clomipramine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of clomipramine and gradually increase your dose.
It may take several weeks or longer for you to feel the full benefit of clomipramine. Continue to take clomipramine even if you feel well. Do not stop taking clomipramine without talking to your doctor. If you suddenly stop taking clomipramine, you may experience withdrawal symptoms such as dizziness, nausea, vomiting, headache, weakness, sleep problems, fever, and irritability. Your doctor probably will decrease your dose gradually.
Unless your doctor tells you otherwise, continue your usual diet.
Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
drowsiness
dry mouth
nausea
vomiting
diarrhea
constipation
nervousness
decreased sexual ability
decreased memory or concentration
headache
stuffy nose
change in appetite or weight
uncontrollable shaking of a part of the body
seizures
fast, irregular, or pounding heartbeat
difficulty urinating or loss of bladder control
believing things that are not true
hallucinations (seeing things or hearing voices that do not exist)
eye pain
shakiness
difficulty breathing or fast breathing
severe muscle stiffness
unusual tiredness or weakness
sore throat, fever, and other signs of infection
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
seizures
coma (loss of consciousness for a period of time)
drowsiness
restlessness
loss of coordination
sweating
stiff muscles
unusual movements
fast heartbeat
slowed breathing
blue discoloration of the skin
fever
widened pupils (dark circles in the center of the eye)
decreased urination
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Last Revised - 01/15/2012
AHFS® Consumer Medication Information. © Copyright, 2012. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.