clomipramine / Generic mfg. - LARVOL DELTA

New-Onset Psychotic Symptoms Associated With Neuromodulation in a Patient With Severe OCD: A Case Report. (PubMed, J ECT) - "He had a longstanding history of contamination obsessions, "just-right" phenomena, repeating compulsions, and severe avoidance, with minimal response to multiple trials of Serotonin Reuptake Inhibitors (SRIs) including clomipramine...Symptoms resolved with antipsychotic treatment. We describe the clinical course and discuss putative mechanisms underlying the emergence of psychosis with neuromodulation in OCD."

Journal • CNS Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry

The ABC:s of obsessive-compulsive disorder (PubMed, Lakartidningen) - "If treatment response is inadequate, low-dose antipsychotics can be added, followed by a switch to clomipramine. Deep transcranial magnetic stimulation (dTMS) and deep brain stimulation (DBS) may be considered for severe, treatment-resistant OCD."

Journal • Review • CNS Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry

Middle meningeal artery lidocaine infusion for refractory migraine: First case report in Portugal (EHF-EHC 2025) - "Various pharmacologic classes were tried without benefit: antihypertensives and calcium channel blockers (propranolol, candesartan, flunarizine), antiepileptics (valproic acid, topiramate, oxcarbazepine), antidepressants (amitriptyline, nortriptyline, venlafaxine, fluvoxamine, sertraline, clomipramine), other preventives (prednisolone, oxitriptan, melatonin), cycles of botulinum toxin (PREEMPT protocol), monoclonal antibodies (galcanezumab, fremanezumab, erenumab), and atogepant. At the time of the procedure, the patient was on eptinezumab 100 mg and botulinum toxin every three months but continued to have daily headaches, with severe intensity and reliance on eletriptan for acute relief...It constitutes an invasive therapeutic approach that should be considered only as a rescue option for carefully selected patients with severely refractory migraine. Further studies and long-term follow-up are needed to assess efficacy and safety."

Case report • Clinical • Anorexia • CNS Disorders • Migraine • Pain

Comparative gastrointestinal effects of antidepressants for the acute treatment of adults with major depressive disorder: a network and dose‒response meta-analysis. (PubMed, Transl Psychiatry) - "Commonly used antidepressants have different gastrointestinal effects. Duloxetine, levomilnacipran, and vilazodone carry a higher risk of inducing nausea and vomiting, whereas trazodone, amitriptyline, agomelatine, and mirtazapine tend to be better tolerated. Amitriptyline, clomipramine, and reboxetine are more prone to induce constipation. Diarrhoea is more commonly associated with vilazodone, fluvoxamine, and sertraline. Amitriptyline, reboxetine, and duloxetine are more likely to cause anorexia. Amitriptyline, reboxetine, and trazodone are related to causing dry mouth. Compared with the placebo, amitriptyline, fluoxetine, and paroxetine were associated with a greater incidence of dyspepsia."

Journal • Retrospective data • Review • Anorexia • CNS Disorders • Constipation • Depression • Dyspepsia • Gastroenterology • Gastrointestinal Disorder • Major Depressive Disorder • Mood Disorders • Psychiatry • Xerostomia

From Genes to Lifestyle: A Multi-Dimensional Framework for Alzheimer's Disease Prevention and Therapy. (PubMed, Ageing Res Rev) - "Drug repurposing analyses using DrugBank have identified promising therapeutic candidates, including FDA-approved agents (e.g., valproic acid, raloxifene, and clomipramine) and naturally derived compounds (e.g., quercetin and fisetin), which may modulate key AD-related pathways. Collectively, these integrative insights advocated for a multidimensional precision medicine framework that spans genetic, cellular,network, and lifestyle levels of regulation. This shift from single-target therapeutics to an integrated "gene-cell-network-lifestyle" paradigm open new theoretical and translational avenues for delaying or mitigating AD progression."

Journal • Review • Alzheimer's Disease • CNS Disorders • Inflammation

Exploring the therapeutic potential of psilocybin for Obsessive-Compulsive Disorder - A translational approach (Neuroscience 2025) - "Our preclinical model will evaluate psilocybin's effects in a disease-relevant context, allowing for a deeper understanding of the underlying neurobiological mechanisms of psilocybin's therapeutic effects. To generate a developmental model of OCD, Sprague-Dawley rat pups were administered clomipramine or saline control from postnatal days 9 to 16... This study employs a translational approach to evaluate the therapeutic potential of psilocybin in OCD aiming to improve understanding of psilocybin's effects and inform future research directions in the treatment of OCD."

CNS Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • FOS

Validation in Drosophila of the in silico predicted clomipramine as repurposable for SOD1-ALS. (PubMed, Neurotherapeutics) - "Current Food and Drug Administration-approved drugs -riluzole, edaravone, and tofersen - offer limited clinical benefit due to ALS multifactorial etiology and high heterogeneity...Leveraging the SAveRUNNER algorithm, we identified several potentially repurposable candidates, including clomipramine (Anafranil®), mianserin (Lantanon®/Tolvon®), and modafinil (Provigil®)...Our results demonstrate that clomipramine is the most promising candidate, ameliorating lifespan reduction, improving climbing abilities, and mitigating both genomic instability and inflammation, key pathological hallmarks of these SOD1-ALS models. Despite needing further validation in higher organisms, our Drosophila findings represent preliminary yet significant support for clomipramine's action as an add-on treatment for SOD1-ALS."

Journal • Amyotrophic Lateral Sclerosis • CNS Disorders • Inflammation • Respiratory Diseases

Sertraline-Induced Urine Incontinence. (PubMed, Eur J Case Rep Intern Med) - "Sertraline can rarely cause urinary incontinence, with symptoms showing a dose-response relationship that improves after dose reduction.Recognition and management of this adverse effect (through dose adjustment, switching or adjunctive therapy) allows clinicians to maintain psychiatric remission while minimising distressing urinary symptoms."

Journal • CNS Disorders • General Anxiety Disorder • Mood Disorders • Psychiatry • Urinary Incontinence • Urology

Approach to Treatment-Refractory OCD in Partial Hospital and Residential Treatment (AACAP 2025) - "The presentation will also provide an overview of evidence-based treatment modalities in treatment-resistant cases, and common pitfalls that interfere with treatment effectiveness. Treatment-refractory OCD is defined as failure to respond to 2 adequate SSRIs, or an SSRI and clomipramine, in addition to failure of adequately delivered high-fidelity CBT with exposure and response prevention (ERP). OCD can be a chronic and debilitating illness for children and adolescents. Understanding treatment-refractory patient characteristics and treatment approaches in specialized residential and partial programs is important to improve treatment response and reduce the duration of untreated illness.OCD, RTX, OTH"

Clinical • Pediatrics

When Treatments Stall: The Need for Outside-the-Box Thinking in Residential OCD Treatment (AACAP 2025) - "By the end of this talk, the audience members will be able to workshop creative solutions when refractory OCD patients present to their clinical practice.OCD, TREAT, RTX"

CNS Disorders • Depression • Pediatrics • Psychiatry

Clomipramine Induced Oxidative Stress and Morphological Alterations in the Prefrontal Cortex and Limbic System of Neonatal Rats. (PubMed, Brain Sci) - "Early exposure to CLO can cause long-lasting neurochemical and structural alterations in the brain regions associated with the regulation of emotions and some behavioral responses that can persist over time and affect behavior in adulthood."

Journal • Preclinical • Inflammation

Identifying Early Presentation of Serotonin Syndrome in a 20-Year-Old Man Prescribed Clomipramine and Quetiapine: A Case Report. (PubMed, Cureus) - "The patient's HR stabilized following administration of lorazepam 2 mg intramuscular (IM) and metoprolol 5 mg intravenous (IV), but he remained rigid and diaphoretic for several more hours. Few cases of mild and masked serotonin syndrome have been reported due to the difficulty in recognizing and quickly treating such cases. Cases of serotonin syndrome should continue to be reported in order to familiarize clinicians with the varied presentation."

Journal • Cardiovascular • Critical care • Mood Disorders • Movement Disorders • Obsessive-Compulsive Disorder • Psychiatry

EFFECT OF MULTIMODAL TREATMENT IN TRIGEMINAL NEURALGIA REFRACTORY TO MONOTHERAPY (WCN 2025) - "Multimodal therapy was administered in combination with the following medications: carbamazepine, pregabalin, clomipramine, valproic acid, tramadol, lamotrigine, phenytoin, amitriptyline, venlafaxine, and rescue therapy with intramuscular administration of betamethasone, ketorolac, and tramadol. : Multimodal pharmacological therapy, using combinations of different drugs for neuropathic pain (anticonvulsants, antidepressants, opioids, corticosteroids) shows greater effectiveness in the pharmacological treatment of trigeminal neuralgia refractory to monotherapy, significantly reducing the frequency and intensity of pain, improving quality of life and improving sleep."

Monotherapy • CNS Disorders • Neuralgia • Pain

Hydrolysis of O-, N-, and N+-glucuronide metabolites in human feces. (PubMed, Drug Metab Dispos) - "In this study, the stability of 5 representative O-, N-, and N+-glucuronides (ifenprodil O-glucuronide, valsartan N-glucuronide, candesartan N-glucuronide, camizestrant N-glucuronide, and clomipramine N+-glucuronide) was evaluated in pooled human feces in the presence or absence of β-glucuronidase inhibitors and in aqueous solutions at various pH levels. SIGNIFICANCE STATEMENT: This study demonstrates the rapid hydrolysis of 5 glucuronides to their parent drugs in human feces. The findings highlight the importance of analyzing early and late fecal pools in human absorption, distribution, metabolism, and excretion for drugs with prominent glucuronides in order to determine the origin of the parent drugs in feces."

Journal

Report of a case: importance of multidisciplinary work in a day hospital (ECNP 2025) - "Over the years, he has received various treatments without reaching a premorbid level or maintaining an improvement of obsessive symptoms: pharmacological (fluvoxamine, fluoxetine, risperidone, clomipramine, bromazepam, sertraline), psychotherapeutic (poor adherence and ineffectiveness of psychotherapeutic intervention) and surgical (rejected by the surgeon because he believed there were still less invasive therapeutic options)...The treatment was adjusted by adding Abilify and Venlafaxine and lowering the Sertraline dose...CONCLUSIONS A psychiatric day hospital offers an alternative to traditional hospitalization and it is an effective option for the treatment of Obsessive Compulsive Disorder, as it offers a structured environment and intensive support that allows patients to develop skills to manage their symptoms over the long term, while maintaining daily life. Day hospital benefits patients by improving their quality of life, reducing social isolation, increasing..."

Clinical • CNS Disorders • Cognitive Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry

New frontiers in neurobiological approaches for treatment-resistant obsessive-compulsive disorder (ECNP 2025) - "While serotonin reuptake inhibitors (SRIs) - including selective serotonin reuptake inhibitors (SSRIs) and clomipramine - in combination with cognitive behavioural therapy focusing on exposure and response prevention (CBT-ERP), remain the gold-standard treatments for OCD, up to 40–60% of patients fail to achieve adequate symptom remission with these therapies...In cases of partial response, augmentation with second-generation antipsychotics—particularly risperidone and aripiprazole—has demonstrated efficacy...Glutamate-modulating agents such as memantine and ketamine have shown promise in open-label studies and small RCTs...Other investigational agents—including N-acetylcysteine, topiramate, and riluzole—have shown inconsistent but intriguing results, warranting further study... The reconceptualization of OCD as a disorder of dysfunctional brain circuits and neurochemical imbalance has catalysed a new era of targeted treatments. Glutamate-modulating drugs,..."

CNS Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry

Inflammatory biomarkers and antidepressant response: towards personalised treatment (ECNP 2025) - "For example, tricyclic antidepressants such as clomipramine and imipramine, as well as the SSRI citalopram, have been shown to inhibit the release of pro-inflammatory cytokines including IL-6, IL-1β, and TNF-α in human monocytes. [2] In contrast, some studies have reported that patients with elevated CRP levels may respond better to antidepressants that target the noradrenergic or dopaminergic systems, such as venlafaxine or bupropion. Moreover, adjunctive treatment with anti-inflammatory agents, including nonsteroidal anti-inflammatory drugs (NSAIDs) and minocycline, has been associated with enhanced antidepressant efficacy in patients with elevated inflammatory biomarkers... Inflammatory biomarkers, particularly CRP and IL-6, show considerable promise as predictors of antidepressant response in MDD. Personalizing antidepressant therapy based on baseline inflammatory profiles may allow for more targeted treatments, improving patient outcomes and reducing the time spent..."

Biomarker • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry • CRP • IL1B • IL6 • TNFA

A case of treatment-resistant depression unresponsive to multiple antidepressants, antipsychotics, mood stabilizers, and electroconvulsive therapy is presented (ECNP 2025) - "He was started on fluoxetine 40 mg/day at an external center in early 2023...Due to lack of clinical improvement, olanzapine 2.5 mg/day and venlafaxine 75 mg/day were initiated, with the latter increased to 150 mg/day. His suicidal ideation and restlessness worsened, leading to further emergency admissions and multiple medication adjustments.The patient was subsequently treated with a series of psychotropic medications, including escitalopram (up to 20 mg/day), clonazepam, lorazepam, amisulpride, and clomipramine, in various combinations...He was hospitalized multiple times and underwent six sessions of ECT, without significant improvement.Later, his regimen was modified to include quetiapine (100 mg/day IR and up to 200 mg/day XR), trifluoperazine, and alprazolam...Mood stabilizers, including valproic acid 750 mg/day and lamotrigine up to 100 mg/day, were introduced, along with aripiprazole and continued quetiapine...In this patient, persistent suicidality, poor..."

Clinical • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Movement Disorders • Psychiatry • Suicidal Ideation

Diagnostic challenge in a patient with cognitive complaints: a case of severe depression mimicking dementia (ECNP 2025) - "Risperidone and aripiprazole were later added for augmentation but discontinued due to side effects...At discharge, her medications included clomipramine 300 mg, clonazepam 2 mg, mirtazapine 15 mg, and quetiapine 200 mg...Clomipramine was discontinued due to potential cardiac side effects, and duloxetine 60 mg/day was initiated. Mirtazapine was continued, and donepezil was discontinued...Misdiagnosis may lead to delays in appropriate treatment. In elderly patients with cognitive complaints, depression should be carefully considered in the differential diagnosis to ensure effective care(3)."

Clinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • Depression • Insomnia • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • Sleep Disorder

Treatment-resistant ocd in an adult patient with autism spectrum disorder and nbea gene deletion: a case report (ECNP 2025) - "Despite treatment with multiple SSRIs (duloxetine, sertraline, paroxetine), TCA (clomipramine) and low doses of antipsychotics (risperidone, brexpiprazole), her symptoms persisted...Notably, a case in the literature described a patient with ASD and an NBEA deletion who exhibited paranoid behaviors and responded positively to prazosin, an alpha-1 adrenergic antagonist...Early genetic screening may help identify individuals at risk for ASD, OCD, and associated behavioral disturbances, allowing for more tailored interventions. Further research is needed to clarify the neurobiological mechanisms underlying NBEA-associated phenotypes and to develop more effective therapeutic approaches."

Case report • Clinical • CNS Disorders • Mental Retardation • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • NBEA

Response probability to single intravenous racemic ketamine with psychopharmacological combinations: a pooled post-hoc study (ECNP 2025) - "The combination of ketamine with antidepressants that block 5-HT2A receptors (such as mirtazapine, mianserine, trazodone, and agomelatine; n = 41) significantly increased the response rate to 58.5%, compared to 28.9% in those who did not receive these combinations. In contrast, combining ketamine with serotonin reuptake inhibitors (escitalopram, fluoxetine, paroxetine, sertraline, vortioxetine; n = 34) or with antipsychotics characterized by higher D2 than 5-HT2A blockade (amisulpride, aripiprazole, cariprazine; n = 10) significantly reduced the response rate to 26.5% and 0%, respectively, compared to 53.8% and 48.7% in those not receiving these combinations. Combination of ketamine with serotonin and norepinephrine reuptake inhibitors (clomipramine, venlafaxine, duloxetine, milnacipran; n = 30) or with antipsychotics (n = 40), compared to ketamine without SNRIs or without antipsychotics, did not significantly alter the probability of response (p = 0.369 and p = 0.083,..."

Retrospective data • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Esketamine enabled deprescribing of most medications in a highly polymedicated patient with treatment-resistant depression (ECNP 2025) - "Despite sequential and combined use of high-dose antidepressants—including venlafaxine, mirtazapine, bupropion (Elontril), vortioxetine (Brintellix), duloxetine, escitalopram, and clomipramine (Anafranil)—as well as mood stabilizers (valproate, lamotrigine, lithium) and various anxiolytics, the patient failed to achieve symptom remission...This significant improvement allowed for the gradual discontinuation of all antidepressant medications and mood stabilizers, maintaining only low-dose quetiapine at night for sleep...Esketamine facilitated not only symptom remission but also the deprescription of complex medication regimens, optimizing both clinical outcomes and medication burden in refractory depression. The observed relapse after discontinuation and subsequent improvement upon re-initiation emphasize the importance of maintenance strategies and individualized long-term management for patients with TRD.[3]"

Clinical • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry • Suicidal Ideation

Combination of cognitive behavioral therapy and naltrexone in trichotillomania: A case report (ECNP 2025) - "She had a history of nonresponsiveness to 60 mg/d of fluoxetine, 225 mg/d of venlafaxine, and 10 mg/d of escitalopram + 5 mg/d aripiprazole despite using adequate duration...Clomipramine was prescribed at the beginning of the CBT...The patient showed substantial improvement in hair-pulling symptoms after 16 sessions of CBT combined with naltrexone, suggesting that this multimodal approach may offer an effective alternative when first-line treatments fail. Further controlled studies are warranted to better establish the efficacy and tolerability of opioid antagonists and therapies in trichotillomania."

Case report • Clinical • CNS Disorders • Psychiatry

Inhibition of acid sphingomyelinase increases SMN levels and connects sphingolipid metabolism to Spinal Muscular Atrophy. (PubMed, Biomed Pharmacother) - "Furthermore, when they are treated with the SMPD1 inhibitor clomipramine, SMN levels also increase and a significant decrease in neurite degeneration is observed. Those results propose new therapeutic avenues for this devastating disease and represent a new method of finding modifiers and drugs for human diseases."

Journal • Genetic Disorders • Metabolic Disorders • Movement Disorders • Muscular Atrophy • Rare Diseases • SMA4 • SMN1 • SMN2

INTEGRATIVE SYSTEMATIC REVIEW ON PHARMACOLOGICAL, PSYCHOTHERAPEUTIC AND NEUROSTIMULATORY TREATMENT OPTIONS IN TREATMENT-RESISTANT ANXIETY DISORDERS. (PubMed, Psychother Psychosom) - "According to RCTs, selective serotonin reuptake inhibitors (SSRI) or clomipramine are effective in TR-PD after failure to respond to cognitive behavioral therapy (CBT). In pharmacological TR-SAD, switching from one SSRI to another or to venlafaxine was found helpful in open label trials. RCTs further suggest augmentation with quetiapine, risperidone, olanzapine or pregabalin in TR-GAD, pindolol in TR-PD and clonazepam in TR-SAD. Open label studies in TR-AD provide preliminary evidence for ketamine or augmentation with nefazodone, reboxetine, buspirone, aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone, divalproex sodium, levetiracetam, zonisamide, flumazenil, pregabalin, cannabidiol and acamprosate...Only inconclusive support was identified for repetitive transcranial magnetic stimulation (rTMS) in TR-AD. In summary, this integrative review may provide an evidence base for expert recommendations, inform clinical guidelines, and inspire further research into..."

Journal • Review • CNS Disorders • General Anxiety Disorder • Mood Disorders • Psychiatry • Social Anxiety Disorder