clomipramine / Generic mfg. - LARVOL DELTA

CLINICALLY RELEVANT DRUG–DRUG INTERACTIONS BETWEEN ANTIDEPRESSANTS AND GASTROINTESTINAL MEDICATIONS: EVIDENCE FROM A SYSTEMATIC REVIEW AND FAERS ANALYSIS (UEGW 2026) - "Compared with reports involving either drug class alone, combined use was associated with a higher proportion of serious outcomes, particularly hospitalisation (40.4% vs. 29.8% and 24.8%, respectively).Disproportionality analyses identified robust signals for clinically relevant adverse events, particularly QT interval prolongation, across multiple antidepressant–acid-suppressive drug combinations, including fluvoxamine–pantoprazole, clomipramine–pantoprazole, fluoxetine–lansoprazole, citalopram–lansoprazole, and sertraline–pantoprazole. Clinically relevant drug–drug interactions between antidepressants and gastrointestinal medications were consistently identified across both the literature and real-world pharmacovigilance data. The findings highlight QT prolongation and neuropsychiatric disturbances as key safety concerns associated with commonly used combinations, particularly those involving acid-suppressive agents. These results underscore the importance of..."

Clinical • Review • CNS Disorders • Mental Retardation

Impact of neonatal tryciclic antidepressant administration on adulthood behavior of CD1 male mice strain (Neuroscience 2026) - "The neonatal administration of clomipramine (CMI), a tricyclic antidepressant, is a pharmacological model to develop depression-like behaviors in adult life...Behavioral analysis revealed reduced locomotor activity and rearing behavior in the CMI group; however, no significant differences were observed in grooming behavior or in the measures obtained from the FST and SIM tests. These findings suggest that the applied dose is insufficient to induce behavioral alterations indicative of hopelessness in CD1 mice, but does result in subtle modifications in specific behaviors, such as exploratory activity."

Preclinical • CNS Disorders • Depression • Mental Retardation

When Anatomy Overrides Algorithm: Refractory Constipation in an Adult With Cloacal Malformation (ACG 2026) - "Her medications included clomipramine and cariprazine, both associated with constipation. Sagittal MR defecography at rest (left panel) and during evacuation (right panel) demonstrating pelvic floor descent, small anterior rectocele, and small-to-moderate peritoneocele in the setting of postsurgical pelvic floor distortion from prior anorectal reconstruction. Rectal gel is visible within the reconstructed anorectal canal."

Clinical • Colorectal Cancer • Constipation • Gastroenterology • Gastrointestinal Disorder • Inflammatory Bowel Disease • Solid Tumor

Acute catatonia and psychosis in the context of seizure exacerbation in epilepsy: a case report. (PubMed, Front Psychiatry) - "We report a 44-year-old woman with a 27-year history of epilepsy, maintained on carbamazepine and topiramate, and a longstanding psychiatric history of major depressive disorder, obsessive-compulsive symptoms, and chronic nihilistic delusions and intermittent hallucinations documented at baseline. One week before admission, her antidepressant was switched from clomipramine to venlafaxine 150 mg/day...Management with escalating benzodiazepines and cautious antipsychotic uptitration (quetiapine XR, cariprazine) was associated with complete catatonic remission and psychotic symptom resolution over 29 days...Clinicians should resist anchoring on temporal associations between seizure activity and psychiatric symptoms. EEG findings must be interpreted in their pharmacological context; pharmacokinetic interactions should inform antipsychotic dose selection; and QTc prolongation warrants structured cardiac monitoring."

Journal • Anesthesia • CNS Disorders • Depression • Epilepsy • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry • CYP3A4

Inhibition of sodium-calcium exchanger by tricyclic antidepressants. (PubMed, Front Pharmacol) - "Tricyclic antidepressants (TCAs) such as amitriptyline, desipramine, and clomipramine are widely used for the treatment of neuropathic pain, yet the cellular mechanisms underlying their analgesic effects remain incompletely understood. These results provide direct evidence that amitriptyline inhibits NCX activity and alters neuronal Ca2+ handling. This effect may contribute to enhanced Ca2+-dependent desensitization of NMDA receptors and suppression of excitatory signaling, providing a mechanistic explanation of its analgetic properties."

Journal • Neuralgia • Pain

Medication Treatment Modulates Sleep Architecture and Cognitive-Related Cortical Hemodynamics in Narcolepsy Type 1. (PubMed, Nat Sci Sleep) - "In this pilot cohort, combination medication therapy was associated with prolongation of sleep latency and task-specific alterations in cortical hemodynamics in NT1 patients. fNIRS-derived parameters show preliminary potential as non-invasive biomarkers for predicting post-treatment sleep latency, which requires validation in larger independent cohorts."

Journal • Narcolepsy • Sleep Disorder

A retrospective audit of obsessive-compulsive disorder in a tertiary care hospital in Mumbai, India (WFSBP 2026) - "Fluoxetine was most commonly used, followed by Clomipramine, Clonazepam, Aripiprazole, and Memantine. This was a retrospective case record analysis of patients with OCD attending the psychiatry outpatient clinic of a single tertiary care hospital. Having established that OCD is often misunderstood, not easily diagnosed and remains an under-diagnosed (severe) psychiatric condition, epidemiological studies are warranted to in populous countries like India."

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

Parenteral clomipramine in inpatient depression: a retrospective cohort study of treatment patterns and patient characteristics. (PubMed, Gen Hosp Psychiatry) - "PARCL was mainly used for severe depression and was frequently positioned as an alternative to ECT. Prospective controlled studies are needed to clarify its comparative effectiveness, safety, and role in inpatient depression management in general hospital psychiatry."

Journal • Retrospective data • Alzheimer's Disease • Bipolar Disorder • CNS Disorders • Dementia • Depression • Psychiatry • Suicidal Ideation • Vascular Neurology

A pharmacometric framework for norepinephrine transporter occupancy and dose equivalence across psychotropic medications. (PubMed, J Psychopharmacol) - "These findings suggest that variability in NET engagement across psychotropic medications may not be fully captured by conventional class-based classifications. The proposed framework offers a mechanism-informed approach to comparative pharmacological analysis and introduces a conceptual noradrenergic activity index. This approach may be useful for hypothesis generation in future studies integrating pharmacokinetic-pharmacodynamic modeling with in vivo imaging and clinical outcomes."

Journal

Comparative Efficacy and Acceptability of 21 Antidepressant Drugs for the Acute Treatment of Adults With Major Depressive Disorder: A Systematic Review and Network Meta-Analysis. (PubMed, Focus (Am Psychiatr Publ)) - "In head-to-head studies, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were more effective than other antidepressants (range of ORs 1·19-1·96), whereas fluoxetine, fluvoxamine, reboxetine, and trazodone were the least efficacious drugs (0·51-0·84). For acceptability, agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine were more tolerable than other antidepressants (range of ORs 0·43-0·77), whereas amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and venlafaxine had the highest dropout rates (1·30-2·32)...These results should serve evidence-based practice and inform patients, physicians, guideline developers, and policy makers on the relative merits of the different antidepressants. National Institute for Health Research Oxford Health Biomedical Research Centre and the Japan Society for the Promotion of Science.Appeared..."

Journal • Retrospective data • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mental Retardation • Mood Disorders • Psychiatry

Prevalence of Psychotropic Drug Treatment Interventions in Patients Undergoing Metabolic and Bariatric Surgery: A Retrospective Study. (PubMed, Obes Surg) - "Although only a minority of patients required psychotropic drug treatment interventions, monitoring psychotropic drug treatment is essential for safe and effective treatment post-MBS. Greater attention is needed regarding altered drug exposure, and plasma concentration monitoring may help optimize psychotropic pharmacotherapy in these patients."

Journal • Retrospective data • CNS Disorders • Mental Retardation • Pain • Psychiatry

Impact of clomipramine postnatal exposure on sexual behavior and reproductive organs in female rats: role of sexual experience. (PubMed, Behav Brain Funct) - "Histological data showed that CMI reduces the population of primordial and primary follicles; however, no morphological modifications were detected in the uterine layers. In conclusion, the data show that even when sexual experience partially improved copulatory behavior in female rats exposed to CMI during the postnatal period, ovarian development was affected, which could compromise fertility."

Journal • Preclinical • CNS Disorders • Depression • Mental Retardation • Psychiatry

Clomipramine potentiates sorafenib efficacy in experimental hepatocellular carcinoma by targeting lysosomal sequestration and modulating the cathepsin B/Bcl-2/Beclin-1 axis. (PubMed, Mol Biol Rep) - "Treatment by CM in combination with SB could decrease neoplastic features in HCC group. The hepatic expression of Bcl2 was decreased, and the release of cytosolic cathepsin B was increased in the combination group. Also, the hepatic concentration of Beclin-1 decreased in the combination group and there was autophagosome accumulation in transmission electron microscope (TEM). The results indicate that the concomitant use of CM and SB may be considered a possible new therapeutic option in managing HCC by targeting the cathepsin B/Bcl2/Beclin-1 pathway."

IO biomarker • Journal • Hepatocellular Cancer • Oncology • Solid Tumor • BCL2 • BECN1 • CTSB

Optimized Oral Glutamatergic Augmentation in Refractory Home-Dominant Contamination Obsessive-Compulsive Disorder With Somatic, Affective, and Motivational Features: A Case Report of Incremental Functional Gains. (PubMed, Cureus) - "The Cheung glutamatergic regimen has been proposed as an oral, low-cost, ketamine-informed glutamatergic strategy using dextromethorphan, CYP2D6 inhibition, piracetam, and L-glutamine to modulate glutamatergic plasticity...A glutamatergic-oriented augmentation strategy was used as part of a complex, evolving regimen built around dextromethorphan, piracetam, and later L-glutamine, with pharmacokinetic potentiation via CYP2D6-inhibiting antidepressants, including fluoxetine, bupropion, and later low-dose paroxetine. Low-dose risperidone, clomipramine, pregabalin, propranolol, cyproheptadine, and other symptom-focused adjuncts were used and adjusted according to response and tolerability...The response was incomplete but clinically meaningful, especially in affective, somatic, motivational, and functional domains. Larger controlled studies are needed, and home-targeted exposure-based work remains essential."

Journal • CNS Disorders • Fatigue • General Anxiety Disorder • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • Suicidal Ideation

Pharmacological Intensification Strategies in Highly Refractory Obsessive-Compulsive Disorder: Evidence Synthesis and a Tertiary-Care Case Series. (PubMed, J Clin Med) - "Although current guidelines recommend optimized serotonin reuptake inhibitor (SRI) therapy, clomipramine switching, exposure and response prevention, and antipsychotic augmentation, a substantial proportion of patients continue to experience severe and disabling symptoms... The case series illustrates five strategies used in highly refractory OCD: supratherapeutic SSRI dosing, SSRI plus mirtazapine augmentation, dual SSRI therapy, serotonergic intensification in a clozapine-treated patient, and glutamatergic/GABAergic augmentation with topiramate... These cases suggest that carefully monitored pharmacological intensification may be feasible in selected specialist settings, but efficacy and safety require confirmation in prospective controlled studies. Recommendations: Pharmacological intensification should be reserved for highly refractory patients managed in specialist services, implemented with gradual titration, structured serotonin toxicity and electrocardiographic..."

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

Comparative efficacy and acceptability of anxiolytic drugs for the treatment of anxiety disorders: a systematic review and network meta-analysis (CINP 2026) - "Clomipramine had the highest efficacy and vortioxetine the least. However, in terms of acceptability, clomipramine led to the most study discontinuations, while clobazam had the lowest discontinuation rate, indicating that efficacy and acceptability do not always align... This network meta-analysis provides a unique comparison of the efficacy and acceptability of anxiolytics. It represents one of the most comprehensive evidence bases available to guide the choice of treatment for anxiety disorders in adults.1 Silexan® is a proprietary essential oil from Lavandula angustifolia, Dr. Willmar Schwabe GmbH & Co."

Retrospective data • Review • CNS Disorders • General Anxiety Disorder • Mood Disorders • Psychiatry

Sex differences in antidepressant serum levels (CINP 2026) - " Serum levels of amitriptyline, nortriptyline, citalopram, clomipramine, fluoxetine, fluvoxamine, imipramine, mirtazapine, paroxetine, sertraline, and venlafaxine, along with their active metabolites, were collected from the laboratory information system (GLIMS) database of the University Medical Centre Groningen (UMCG) between January 2016 and October 2024. Under current treatment guidelines, women are exposed to significantly higher antidepressant serum levels than men for citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, clomipramine, imipramine, nortriptyline, and venlafaxine. Subgroup analyses confirmed that the observed sex differences are unlikely to result from dosing practices but instead reflect sex differences in underlying mechanisms such as pharmacokinetic variations or sex-specific epigenetic regulation of hepatic drug-metabolizing enzymes. Whereas most antidepressants investigated are prescribed using standardized dosing regimens, dosing of..."

CNS Disorders • Depression • Mood Disorders • Psychiatry

Targeting glutamatergic dysregulation in severe treatment-resistant obsessive-compulsive disorder: integrating serotonergic, dopaminergic, and glutamatergic therapies (CINP 2026) - " Serotonergic optimization remains foundational, with high-dose SSRIs (fluoxetine 80 mg/day, sertraline 200 mg/day, paroxetine 60 mg/day) demonstrating clinical efficacy when trials are of adequate duration (≥12 weeks). Clomipramine, a tricyclic antidepressant with potent serotonergic properties, is effective as monotherapy or combined with SSRIs under careful monitoring.Dopaminergic/antipsychotic augmentation using low-dose atypical antipsychotics — including risperidone (0.5–3 mg/day), aripiprazole (10–20 mg/day), and quetiapine (150–300 mg/day) — yields response in approximately 30–50% of SSRI nonresponders, though metabolic and neurological adverse effects necessitate vigilant monitoring.Glutamatergic modulators, particularly memantine (5–20 mg/day), have shown promising results in open-label and controlled studies, with clinically meaningful reductions in Y-BOCS scores and favorable tolerability. Additional agents under investigation include lamotrigine,..."

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

Intranasal esketamine in treatment-resistant bipolar depression maintained on long-acting aripiprazole (CINP 2026) - " Case 1: A 30-year-old female with bipolar disorder was maintained on a monthly aripiprazole injection of 400 mg since June 2024 in combination with clomipramine 150mg, quetiapine 300mg, and lisdexamfetamine 30mg...Case 2: A 21-year-old female with bipolar disorder was maintained on a monthly aripiprazole injection 400 mg since February 2025 in combination with lithium 400 mg, lamotrigine 400mg, Zyprexa 10 mg, and bupropion 300mg...Case 3: A 31-year-old male with bipolar disorder was maintained on a monthly aripiprazole injection of 400 mg since May 2024in combination with desvenlafaxine 150mg...Case 4: A 38-year-old female with bipolar disorder was maintained on a monthly aripiprazole injection of 400 mg since July 2025 in combination with escitalopram 20 mg, Wellbutrin 300 mg, and lithium 400 mg. These cases demonstrated that there may be a role for adding intranasal esketamine in treatment-resistant bipolar depression in patients already maintained on monthly..."

Bipolar Disorder • CNS Disorders • Depression • Mood Disorders • Psychiatry

A case of prolonged delirium after the application of electroconvulsive therapy in the treatment of recurrent depressive disorder (CINP 2026) - "Anafranil, escitalopram, duloxetine, trazodone were used as antidepressants, and quetiapine as an antipsychotic...The patient used pharmacotherapy with 5 mg olanzapine, 150 mg bupropion and 0.5 mg alprazolam...Treatment is continued administration of quetiapine in a daily dose of 150 mg, along with the antidepressant bupropion 150 mg and the benzodiazepine lorazepam in a daily dose of 7.5 mg... Prolonged delirium after ECT is a rare clinical condition. So far, six cases of prolonged delirium associated with ECT have been registered. These cases show a rare but consistent pattern in which patients develop prolonged delirium after the third or fourth ECT treatment."

Clinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Depression • Mood Disorders • Psychiatry

Unexpected Improvement of Obsessive-Compulsive Disorder Symptoms Following the Mistaken Prescription of Clomiphene: A Novel Perspective on Hormonal Influences in OCD. (PubMed, Case Rep Psychiatry) - "Clomiphene citrate, a selective estrogen receptor (ER) modulator primarily used for infertility, is not indicated for psychiatric disorders but may influence neuroendocrine and serotonergic pathways...Her symptoms previously responded well to sertraline, clonazepam, and clomipramine...Future studies should longitudinally assess OCD symptom changes during hormonally sensitive periods, ideally in conjunction with standardized clinical measures and hormonal biomarkers. The case also underscores the ethical and patient-safety importance of preventing medication errors."

Journal • CNS Disorders • Depression • Infertility • Major Depressive Disorder • Mental Retardation • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • Sexual Disorders • ER

The Antidepressant Drug Clomipramine Inhibits the ABC Transporter BmrA. (PubMed, Chembiochem) - "Critically, one predicted site overlaps with the ATP-binding pocket. The results underscore the potential side-effects of clomipramine and highlight the value of bacterial models such as BmrA for studying novel inhibitors when studies on human proteins are not feasible."

Journal • ABCB1

Sexsomnia in a Young Man: A Non-REM Parasomnia With Diagnostic and Therapeutic Challenges. (PubMed, Am J Case Rep) - "Initial therapy with fluoxetine (20 mg/day), melatonin (3 mg nightly), and clomipramine (25 mg nightly) was unsuccessful, but self-administered valerian root supplementation achieved a 90% reduction in symptoms due to its GABAergic effects. Subsequent treatment with vortioxetine (20 mg daily) led to complete remission, continued during a 3-month follow-up period...The patient's positive response to valerian root highlights the potential role of natural supplements in managing selected cases. It further highlights the need for increased clinical awareness and future research into natural and behavioral interventions for sleep-related sexual disorders."

Journal • CNS Disorders • Mental Retardation • Mood Disorders • Obstructive Sleep Apnea • Psychiatry • Respiratory Diseases • Sexual Disorders • Sleep Disorder

Screening the Combination of Gemcitabine, Clomipramine, and Resveratrol in HL-60 Leukemia Cells. (PubMed, Curr Issues Mol Biol) - "These findings suggest that while each of these compounds individually has the potential to inhibit cell growth, their combined application does not enhance the cytotoxic effects beyond those observed with single treatments. These findings highlight the necessity of a rational approach when considering novel drug combinations."

Journal • Hematological Malignancies • Leukemia • Oncology

Empagliflozin mitigates depression-like behavior in diabetic mice via putative CRF1 receptor modulation: behavioral, biochemical and in silico studies. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "EMPA at doses of 5 and 10 mg/kg was administered orally as the test compound, while metformin (MET; 200 mg/kg) and clomipramine (CLMP, 10 mg/kg) alone and in combination (MET + CLMP) were used as standard treatments. This proposes that the potential of EMPA to regulate CUMS-induced aggravated depression in diabetic animals may be mediated through CRF1 modulation. These results suggested that EMPA has potential as a therapeutic agent for depression, especially in diabetic conditions linked to oxidative stress, likely through the CRF1-receptor."

Journal • Preclinical • CNS Disorders • Depression • Diabetes • Mental Retardation • Metabolic Disorders • Mood Disorders • Psychiatry • CAT