What is clomipramine used for?

Primarily for obsessive-compulsive disorder (OCD), for which it is FDA-approved. It is also used in major depression, panic disorder, agoraphobia, cataplexy and off-label for premature ejaculation.

How does clomipramine differ from SSRIs?

Clomipramine is a tricyclic antidepressant that inhibits reuptake of both serotonin and norepinephrine and also blocks histamine, muscarinic and alpha-1 receptors. This gives potent effects but at the cost of more side effects and significant cardiotoxicity in overdose, compared with the more favorable safety profile of SSRIs.

Is clomipramine available over the counter?

No. It is a prescription-only medicine that should be taken solely under medical supervision. It is not a dietary supplement, and abrupt discontinuation can cause withdrawal symptoms.

ApprovedFDA approvedStrong evidence

Clomipramine

Name: Clomipramine
Creator: MolekulaX

Tricyclic antidepressant (Anafranil), the most serotonergic TCA, FDA-approved for OCD.

AntidepressantTricyclic antidepressantAntidepressantMoodSerotoninNorepinephrine

Pharmacology

ClassAntidepressant · Mood

Primary targetSerotonin transporter (SERT) reuptake inhibition

Targets5 receptor targets

Half-lifeClomipramine ~32 hours; its active metabolite (desmethylclomipramine) is longer, ~54-77 hours

OnsetAnxiolytic/antidepressant effect develops over 2-6 weeks

EvidenceStrong evidence

Affected systemsSerotoninNorepinephrine

Contents

WHAT IS CLOMIPRAMINE?

Detailed overview

Clomipramine (Anafranil) is a tricyclic antidepressant (TCA) that raises synaptic monoamine levels by inhibiting the serotonin and norepinephrine transporters; it is the most strongly serotonergic of all TCAs. The FDA approved it for obsessive-compulsive disorder (OCD), and numerous randomized trials also support its efficacy in depression, panic disorder and on-demand treatment of premature ejaculation. Its side-effect burden comes from simultaneous blockade of histamine, muscarinic and alpha-1 receptors (sedation, dry mouth, orthostasis). It is a prescription-only medicine that must be used under medical supervision; overdose is cardiotoxic and life-threatening.

Mechanism

Serotonin and norepinephrine reuptake inhibition (TCA)

Main indication

OCD (FDA-approved), depression, panic

Legal status

Prescription-only medicine

Receptor profile

Serotonin transporter (SERT)Strong
Norepinephrine transporter (via active metabolite)Strong
Histamine H1 receptorModerate
Muscarinic acetylcholine receptorsModerate
Alpha-1 adrenergic receptorModerate

Safety

Side effects, stop signs, contraindications

Side effects · 6

Anticholinergic effects: dry mouth, constipation, blurred vision, urinary retention
Sedation, drowsiness and weight gain from H1 blockade
Orthostatic hypotension and dizziness from alpha-1 blockade
Sexual dysfunction: delayed or inhibited orgasm, reduced libido
Sweating, tremor, dose-dependent seizure risk (lowering of the seizure threshold)
Cardiotoxicity in overdose: QT prolongation, arrhythmia; TCA overdose is life-threatening

Contraindications · 5

With an MAO inhibitor or within 14 days of stopping one: risk of serotonin syndrome
Recent myocardial infarction, severe conduction disorder or known QT prolongation
Narrow-angle glaucoma, clinically significant prostate enlargement (urinary retention)
Epilepsy or lowered seizure threshold: increased seizure risk
Manic phase; increased suicidal ideation risk in children and young adults, close monitoring required

Related Nootropics

Same therapeutic category

Studies

Related research and clinical findings

Biol Psychiatry. 1990

Clomipramine in obsessive-compulsive disorder

PMID: 2207219Open

J Am Acad Child Adolesc Psychiatry. 1992

Clomipramine hydrochloride in childhood and adolescent obsessive-compulsive disorder: a multicenter trial

PMID: 1537780Open

Psychopharmacology. 1998

Behavioral versus pharmacological treatments of obsessive compulsive disorder: a meta-analysis

PMID: 9566805Open

Eur Urol. 2004

On-demand treatment of premature ejaculation with clomipramine and paroxetine: a randomized, double-blind fixed-dose study with stopwatch assessment

PMID: 15363569Open

J Clin Psychiatry. 1999

Paroxetine, clomipramine, and cognitive therapy in the treatment of panic disorder

PMID: 10665629Open

FAQ

Tricyclic antidepressant (Anafranil), the most serotonergic TCA, FDA-approved for OCD.

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Structure & chemistry

TypeAntidepressant

FormulaC19H23ClN2

UpdatedJuly 10, 2026

MolekulaX Editorial Team·Source-verified · PubMed · FDA · EMA

Updated: July 10, 2026

The information here is strictly for educational and scientific purposes. It does not replace medical advice or clinical consultation, and it does not encourage illegal substance or pharmaceutical use. Data is sourced. When in doubt, consult your doctor.