Clomipramine
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Clomipramine is a tricyclic antidepressant approved for obsessive-compulsive disorder. It has strong serotonin reuptake inhibition plus typical tricyclic anticholinergic, antihistaminic, alpha-adrenergic, cardiac conduction, and seizure-threshold effects. It carries the antidepressant boxed warning for suicidal thoughts and behaviors in pediatric and young adult patients.
Exploratory record, not a reviewed medical publication.
See the editorial and medical-review policies for the publication gate.
This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.
What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Clomipramine is a tricyclic antidepressant approved for obsessive-compulsive disorder. NutriStack rates the supporting evidence as strong. Common adult dosing is Start 25 mg once daily, usually with meals, and titrate gradually toward 100 mg/day during the first 2 weeks. Usual adult range is 100-250 mg/day; maximum recommended adult dose is 250 mg/day., though a prescriber sets the actual dose. This profile indexes 3 sources.
- Treatment of obsessive-compulsive disorder1
- Reduction in obsessions and compulsions
- Occasional specialist use for treatment-resistant depression or anxiety-spectrum symptoms
The bottom line
Evidence rating strong. Most-documented uses: treatment of obsessive-compulsive disorder, reduction in obsessions and compulsions, occasional specialist use for treatment-resistant depression or anxiety-spectrum symptoms. 3 sources indexed (2005–2025), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Clomipramine inhibits serotonin and norepinephrine reuptake, with relatively potent serotonin transporter inhibition compared with many older TCAs. Its active metabolite desmethylclomipramine contributes norepinephrine reuptake inhibition. Antagonism at muscarinic, histamine H1, and alpha-1 adrenergic receptors explains dry mouth, constipation, sedation, weight gain, and orthostatic hypotension, while sodium-channel effects can worsen cardiac conduction in overdose or susceptible patients.1,2
Dosing & protocol.
Taking with meals during titration can reduce gastrointestinal adverse effects. Once stabilized, total daily dosing at bedtime may reduce daytime sedation.3
Full safety detail.
Side effects
- Dry mouth
- Constipation
- Blurred vision
- Urinary retention
- Sedation
- Weight gain
- Orthostatic hypotension
- Sexual dysfunction
- Sweating
- QT prolongation or conduction delay in susceptible patients
- Seizures, especially at higher doses
- Serotonin syndrome with serotonergic agents
- Withdrawal symptoms if stopped abruptly
Contraindications
- Hypersensitivity to clomipramine or other dibenzazepine TCAs1,2
- Concurrent use with an MAOI, linezolid, or intravenous methylene blue3
- Do not use during acute recovery after myocardial infarction
- Avoid in uncontrolled narrow-angle glaucoma or clinically significant urinary retention unless specialist-supervised
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Reviews & position papers
2- 1Practice guideline for the treatment of patients with obsessive-compulsive disorderAmerican Psychiatric Association · American Journal of Psychiatry · 2007
Guideline recognizes clomipramine efficacy for OCD while emphasizing tolerability and safety concerns relative to SSRIs.
- 2Tricyclic antidepressant poisoningThanacoody HKR, Thomas SHL · Toxicological Reviews · 2005
Review describes sodium-channel blockade, arrhythmia, seizure, and anticholinergic toxicity relevant to clomipramine overdose and high-risk patients.
Reference material
1- 3CLOMIPRAMINE HYDROCHLORIDE capsules, US Prescribing InformationURLU.S. National Library of Medicine · DailyMed · 2025
Labeling describes OCD indication, 25 mg starting dose, maximum adult dose of 250 mg/day, MAOI contraindication, and suicide warning.
Common questions.
Quick answers about Clomipramine, drawn from the data on this page.
What is Clomipramine?
Clomipramine is a tricyclic antidepressant approved for obsessive-compulsive disorder. It has strong serotonin reuptake inhibition plus typical tricyclic anticholinergic, antihistaminic, alpha-adrenergic, cardiac conduction, and seizure-threshold effects. It carries the antidepressant boxed warning for suicidal thoughts and behaviors in pediatric and young adult patients.
What is Clomipramine used for?
Commonly cited benefits of Clomipramine include: Treatment of obsessive-compulsive disorder; Reduction in obsessions and compulsions; Occasional specialist use for treatment-resistant depression or anxiety-spectrum symptoms. NutriStack rates the overall evidence as strong.
What is a typical dose of Clomipramine?
A typical adult dose of Clomipramine is Start 25 mg once daily, usually with meals, and titrate gradually toward 100 mg/day during the first 2 weeks. Usual adult range is 100-250 mg/day; maximum recommended adult dose is 250 mg/day.. The commonly recommended form is Oral capsule, often divided during titration and then consolidated at bedtime if tolerated. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Clomipramine?
Reported side effects include dry mouth, constipation, blurred vision, urinary retention, sedation, weight gain. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Clomipramine?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Clomipramine in NutriStack.
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.