Clomipramine is principally used in the treatment of the obsessions and compulsions of obsessive-compulsive disorder (OCD), when these symptoms greatly disrupt the patient's daily activities. Obsessions are repetitive thoughts and impulses, and compulsions are repetitive behaviors. Patients with OCD find these experiences inappropriate, distressing, and time-consuming.
Clomipramine is one of the tricyclic antidepressants, so-called because of the three-ring chemical structure common to these drugs. In the 1940s and 1950s, pharmaceutical researchers synthesized a number of new compounds for possible medical use as antihistamines and sedatives. After testing in animal experiments, a few of these substances were selected for human study. One potential drug, a tricyclic compound called imipramine, was not useful in calming agitation, but it had a striking effect in improving the mood of certain patients with depression.
Since the discovery of imipramine, many other tricyclic antidepressants have been developed with somewhat differing pharmacological activities and side effect profiles. Within this group of drugs, clomipramine is exceptionally potent in affecting levels of serotonin in the brain. In this action, it is similar to serotonin-selective antidepressant drugs, like fluoxetine(Prozac), which act specifically on serotonin levels and are effective in OCD. Serotonin is a messenger chemical (neurotransmitter) involved in transmitting signals between nerve cells. Clomipramine reduces the effects on serotonin neurotransmission in depression and OCD symptoms.
Richard Kapit M.D., The Gale Group Inc., Gale, Detroit,