Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Clomipramine
Drug ID BADD_D00499
Description Clomipramine, the 3-chloro analog of imipramine, is a dibenzazepine-derivative tricyclic antidepressant (TCA). TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, clomipramine does not affect mood or arousal, but may cause sedation. In depressed individuals, clomipramine exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Tertiary amine TCAs, such as clomipramine, are more potent inhibitors of serotonin reuptake than secondary amine TCAs, such as nortriptyline and desipramine. TCAs also down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission. TCAs also block histamine-H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively. See toxicity section below for a complete listing of side effects. Clomipramine may be used to treat obsessive-compulsive disorder and disorders with an obsessive-compulsive component (e.g. depression, schizophrenia, Tourette’s disorder). Unlabeled indications include panic disorder, chronic pain (e.g. central pain, idiopathic pain disorder, tension headache, diabetic peripheral neuropathy, neuropathic pain), cataplexy and associated narcolepsy, autistic disorder, trichotillomania, onchophagia, stuttering, premature ejaculation, and premenstrual syndrome. Clomipramine is rapidly absorbed from the gastrointestinal tract and demethylated in the liver to its primary active metabolite, desmethylclomipramine.
Indications and Usage Unlabeled indications include: depression, panic disorder, chronic pain (e.g. central pain, idiopathic pain disorder, tension headache, diabetic peripheral neuropathy, neuropathic pain), cataplexy and associated narcolepsy (limited evidence), autistic disorder (limited evidence), trichotillomania (limited evidence), onchophagia (limited evidence), stuttering (limited evidence), premature ejaculation, and premenstrual syndrome.
Marketing Status Prescription; Discontinued
ATC Code N06AA04
DrugBank ID DB01242
KEGG ID D07727
MeSH ID D002997
PubChem ID 2801
TTD Drug ID D0ZS8P
NDC Product Code Not Available
Synonyms Clomipramine | Chlomipramine | Chlorimipramine | Hydiphen | Clomipramine Maleate (1:1) | Clomipramine Monohydrochloride | Monohydrochloride, Clomipramine | Anafranil | Clomipramine Hydrochloride | Hydrochloride, Clomipramine
Chemical Information
Molecular Formula C19H23ClN2
CAS Registry Number 303-49-1
SMILES CN(C)CCCN1C2=CC=CC=C2CCC3=C1C=C(C=C3)Cl
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Poisoning and toxicityCytochrome P450 2D6P10635T57392Not Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Abdominal pain07.01.05.002--
Accommodation disorder06.02.04.001--Not Available
Acne23.02.01.001--Not Available
Ageusia17.02.07.001; 07.14.03.003--Not Available
Aggression19.05.01.001--Not Available
Agitation19.06.02.001; 17.02.05.0120.017710%
Agranulocytosis01.02.03.001--Not Available
Akathisia17.01.02.002; 19.06.02.0060.008855%
Albuminuria20.02.01.001--Not Available
Alopecia23.02.02.001--
Alveolitis allergic22.01.01.002; 10.01.03.008--Not Available
Amenorrhoea21.01.02.001; 05.05.01.002--
Anaemia01.03.02.001--
Anaphylactic shock24.06.02.004; 10.01.07.002--Not Available
Anaphylactoid reaction24.06.03.007; 10.01.07.003--Not Available
Aneurysm24.02.01.001--Not Available
Angle closure glaucoma06.03.01.001--Not Available
Anticholinergic syndrome17.05.01.0010.008855%Not Available
Anxiety19.06.02.002--
Apathy19.04.04.002--Not Available
Aphasia19.21.01.001; 17.02.03.001--
Apraxia17.02.03.002; 19.21.01.002--Not Available
Arrhythmia02.03.02.0010.008855%Not Available
Arthralgia15.01.02.001--
Arthropathy15.01.01.003--Not Available
Asthenia08.01.01.0010.035420%Not Available
Ataxia17.02.02.001; 08.01.02.004--
Atrial flutter02.03.03.003--
Atrial septal defect03.07.02.002; 02.04.02.0090.013282%Not Available
Atrioventricular block02.03.01.002--Not Available
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